Journal
REPRODUCTIVE SCIENCES
Volume 28, Issue 4, Pages 1060-1068Publisher
SPRINGER HEIDELBERG
DOI: 10.1007/s43032-020-00349-6
Keywords
Embryo selection; Vitrified-warmed blastocyst transfer; Single embryo transfer; Blastocyst morphology
Categories
Funding
- Technology Innovation Program (Industrial Strategic Technology Development Program) - Ministry of Trade, Industry & Energy (MI, Korea) [20003838]
- Korea Evaluation Institute of Industrial Technology (KEIT) [20003838] Funding Source: Korea Institute of Science & Technology Information (KISTI), National Science & Technology Information Service (NTIS)
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Selecting a high-quality embryo is crucial for improving pregnancy outcomes, with blastocoel expansion and inner cell mass grade being important predictors for ongoing pregnancy. Embryos developing into blastocysts on day 5 and having higher expansion grades in pre-vitrified blastocysts are associated with successful pregnancy outcomes in single vitrified-warmed blastocyst transfer cycles.
The process of selecting a good quality embryo to improve the pregnancy outcomes is very important. The aim of our study was to elaborate the embryo selection process in a single vitrified-warmed blastocyst transfer (VBT) cycle by analyzing pre-vitrified and post-warmed blastocyst morphological factors to improve pregnancy outcomes. In this retrospective cohort study, we performed 329 single VBT cycles. The pre-vitrified and post-warmed morphological factors of all blastocysts were analyzed. Logistic regression analysis was conducted to select the independent morphological factor associated with ongoing pregnancy. The expansion of blastocoel (mid blastocoel; aOR 2.27, 95% CI.0.80-6.42,p = 0.12, expanded blastocoel; aOR 3.15, 95% CI.1.18-8.44,p = 0.02) in a pre-vitrified blastocyst and the grade of inner cell mass (ICM) (grade B; aOR 0.47, 95% CI.0.27-0.83,p = 0.01, grade C; aOR 0.22, 95% CI 0.09-0.56p < 0.01) in post-warmed blastocysts significantly predicted the ongoing pregnancy. After fertilization, the embryo developed as a blastocyst on day 5 (day 5) showed a higher ongoing pregnancy than that on day 6 (day 6) (aOR 0.50, 95% CI.0.26-0.94,p = 0.03). The results suggest that while selecting a vitrified-warmed blastocyst in a single VBT cycle, the day 5 vitrified blastocyst should be considered, and a higher expansion grade in the pre-vitrified blastocyst should be selected. Our study has shown that post-warmed ICM grade tends to be a predictive indicator for the selection of the best blastocyst and allows for successful pregnancy, with ongoing pregnancy in a single blastocyst transfer.
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