Journal
FERTILITY AND STERILITY
Volume 105, Issue 6, Pages 1476-U134Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.fertnstert.2016.02.014
Keywords
Time-lapse monitoring; blastocyst collapse; single embryo transfer; in vitro fertilization
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Objective: To ascertain the rate of blastocyst collapse observed by time-lapse monitoring in a retrospective cohort of unselected infertile patients undergoing single blastocyst transfer and to determine its association with live birth. Design: Blastocyst collapse and morphokinetic variables were scored according to previously published criteria. The association between blastocyst collapse and live birth was evaluated by a multivariate logistic regression analysis including morphokinetic variables and other confounders. Setting: Private infertility clinic. Patient(s): Patients who underwent 277 consecutive single blastocyst transfers (mean age, 38.4 +/- 3.9 years; range, 28-47 years) after minimal ovarian stimulation. Intervention(s): Minimal ovarian stimulation, prolonged embryo culture in time-lapse monitoring incubator, elective vitrification with subsequent vitrified-warmed single blastocyst transfer. Main Outcome Measure(s): Live birth rate per single blastocyst transfer in different blastocyst collapse groups (no, single, multiple collapses). Result(s): No, single, or multiple blastocyst collapses occurred in 54% (150/277), 22% (61/277), and 24% (66/277) of the cohort, respectively. In the multiple collapse group on average 2.9 contractions were seen (range, 2-9 contractions). Live birth rate decreased progressively between blastocyst collapse groups (36%, 31%, 14%); significantly lower if multiple collapses occurred. In a multivariate analysis, however, blastocyst collapse was not found to be a significant predictor and was confounded by stronger predictors such as morphokinetic variables t2, texpB(2), and female age. Conclusion(s): Blastocyst collapse pattern should not be evaluated alone without taking into account morphokinetic variables that are stronger predictors of reproductive outcome. (C) 2016 by American Society for Reproductive Medicine.)
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