Morphokinetics of vitrified and warmed blastocysts predicts implantation potential

Purpose It was studied whether morphokinetics of blastocoele re-expansion and hatching in vitrified-warmed blastocysts is predictive of implantation, clinical pregnancy, and live birth. Methods In 144 patients aiming for single warmed blastocyst transfer, blastocysts were cultured in a new time-lapse system (Miri (R) TL) immediately after warming. Video sequences with an image interval of 5 min were annotated and the corresponding morphokinetic variables were correlated with pregnancy outcome. In detail, tRE (start of re-expansion), tCRE (completion of re-expansion), tAH(hatching from the manipulated zona pellucida), and presence of collapses were recorded. Results In the pregnant group, tRE and tCRE were significantly lower (0.69 +/- 0.45 h and 2.16 +/- 0.94 h) as compared to the non-pregnant group (1.23 +/- 1.08 h and 2.70 +/- 1.20 h). Both variables and the duration of re-expansion (tCRE-tRE) allowed for distinction between non-pregnant, loss of pregnancy, and live birth/ongoing pregnancy. Presence and number of collapses showed no correlation with outcome. Conclusions Time-lapse imaging of vitrified-warmed blastocysts offers additional selection criteria allowing for prediction of implantation potential. As a consequence, cumulative pregnancy rate could be increased and time-to-pregnancy reduced.