The impact of age on blastocyst scoring after single and double embryo transfers

Abstract

Objective: The aim of the present study was to assess the putative relationship between patient's age and blastocyst scores, in single (SET) or double (DET) transfer cycles, that resulted in single or twin pregnancy or non-pregnancy. Second, we analyzed the effect of maternal age on clinical gestation and implantation rates after single and double blastocyst transfers. Methods: Retrospective analysis of 164 assisted reproduction cycles with embryo transfers. Results: Data demonstrated that for both, young (<35 years of age) and older (≥35 years of age) women, trophectoderm (TE) score is the most important parameter to assess concerning embryo selection. However, inner cell mass (ICM) also plays an important role on blastocyst selection in the group of older patients. In addition, our data shows that for young women the transfer of a single blastocyst results in similar gestational rates as those for DET. Conclusion: We suggest that blastocyst grading for patients aged 35 years or above shall be performed using a strict grading policy, possibly not of a single parameter, but TE, ICM and expansion grades together, to choose the "best combined-score blastocyst". DETs should be considered, particularly after previous cycles with pregnancy failures.

Effect of age and morphology on sustained implantation rate after euploid blastocyst transfer

“…Expansion rate can be measured by the degree of expansion observed on a specific day of culture or by the day of culture on which a blastocyst reaches a sufficient degree of expansion required for vitrification or biopsy. Many studies have shown an impact of morphology and expansion rate of unbiopsied blastocysts on pregnancy rates (Ahlstrom et al, 2013;Ahlström et al, 2011;Awadalla et al, 2020a;Bos-Mikich et al, 2016;Desai et al, 2016;Hill et al, 2013;Honnma et al, 2012;Subira et al, 2016;Thompson et al, 2013;Van Den Abbeel et al, 2013). More information is needed to determine if morphology and expansion rate are still associated with pregnancy after euploid embryos have been selected for transfer.…”