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Association between blastocyst morphology and pregnancy and perinatal outcomes following fresh and cryopreserved embryo transfer

  • Jennifer B. BakkensenEmail author
  • Paula Brady
  • Daniela Carusi
  • Phillip Romanski
  • Ann M. Thomas
  • Catherine Racowsky
Assisted Reproduction Technologies
  • 17 Downloads

Abstract

Purpose

To assess the importance of each blastocyst morphological criteria with pregnancy and perinatal outcomes.

Methods

This single-center retrospective cohort study included blastocyst single embryo transfers (SET) performed between 1/2012–2/2018. Poisson regression was used to evaluate pregnancy outcomes following fresh and cryopreserved embryo transfer (CET) for association with blastocyst expansion, inner cell mass (ICM) quality, and trophectoderm (TE) quality. Among cycles resulting in live birth, associations with preterm birth, small for gestational age (SGA) and large for gestational age (LGA), were evaluated using logistic regression.

Results

A total of 1023 fresh and 1222 CET cycles were included, of which 465 (45.1%) fresh and 600 (48.5%) CET cycles resulted in singleton live birth. Clinical pregnancy rates increased with increasing expansion among fresh transfers (p for trend = 0.001) but not CET (p = 0.221), and with TE quality for both fresh and CET cycles (p = 0.005 and < 0.0001, respectively). Live birth rates increased with increasing expansion (fresh p = 0.005, CET p = 0.018) and TE quality (fresh p = 0.028, CET p = 0.023). ICM grade was not associated with pregnancy outcomes; however, higher ICM quality among CET cycles was associated with increased chance of preterm birth (p = 0.005).

Conclusions

In blastocyst SET, blastocyst expansion and TE quality were each associated with clinical pregnancy and live birth. While higher ICM quality was associated with increased chance of preterm birth among CET, no other associations with perinatal outcomes were identified. Clinicians can be reassured that pregnancies from blastocysts with lower expansion, ICM, or TE qualities are not more likely to result in adverse perinatal outcomes.

Keywords

Blastocyst morphology Perinatal outcomes Birthweight Preterm birth In vitro fertilization 

Notes

Compliance with ethical standards

This study was approved by the Partners Human Research Committee at the Brigham and Women’s Hospital (Protocol #2018P000317). All data was retrieved from standard records collected during clinical care, thus informed consent was not required.

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

10815_2019_1580_MOESM1_ESM.docx (28 kb)
ESM 1 (DOCX 27 kb)

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Obstetrics, Gynecology, and Reproductive BiologyBrigham & Women’s Hospital and Harvard Medical SchoolBostonUSA

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