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Journal of Assisted Reproduction and Genetics

, Volume 23, Issue 4, pp 171–175 | Cite as

Embryo morphology score on day 3 is predictive of implantation and live birth rates

  • Sara J. Dennis
  • Michael A. Thomas
  • Daniel B. Williams
  • Jared C. RobinsEmail author
Assisted Reproduction

Purpose : To determine if embryo cleavage state or morphology on day 3 correlates with implantation or live birth rates. A retrospective cohort study of all fresh embryo transfers over 2 years.

Methods : Patients were grouped by the average cleavage state and morphology. Cleavage state groups were: <6, ≥6, <8, and ≥8 cells. Morphology groups by average grade were: group 1 (best) = 1, group 2 = >1≤2, group 3 = >2≤3, and group 4 (worst) = >3≤4.

Results : The overall implantation rate for 158 cycles was 28.1% with a live birth rate of 37.3%. Morphologic state was highly predictive of both implantation rate and live birth rate. Implantation rates by group were 54.8% (group 1), 30.4% (group 2), 23.8% (group 3), and 11.1% (group 4). Likewise, live birth rates among groups were 61.5, 39, 20, and 21%, respectively. Cleavage state was not predictive of outcome.

Conclusions : Embryo grade is highly predictive of implantation and live birth rate and can be used to determine the number of embryos to transfer. Cleavage state is not predictive of outcome.

KEY WORDS:

Cleavage-state embryo embryo morphology in vitro fertilization pregnancy outcome. 

REFERENCES

  1. 1.
    Martin JA, Hamilton BE, Sutton PD, Ventura SJ, Menacker F, Munson ML: Birth: Final data for 2002. National vital statistics reports, 52(10). Hyattsville, MD. National Center for Health Statistics, 2003.Google Scholar
  2. 2.
    Centers for Disease Control and Prevention. 2002 Assisted Reproductive Technology Report Success. National Summary and Fertility Clinic Reports, December 2004Google Scholar
  3. 3.
    Veeck L: An Atlas of Human Gametes and Conceptuses. An Illustrated Reference for Assisted Reproductive Technology, 1999Google Scholar
  4. 4.
    Practice Committee, Society for Assisted Reproductive Technology and the American Society for Reproductive Medicine. Guidelines on the number of embryos transferred. Fertil Steril 2004 Sep;82(3):773–774.Google Scholar
  5. 5.
    Ebner T, Yaman C, Moser M, Sommergruber M, Polz W, Tews G: Embryo fragmentation in vitro and its impact on treatment and pregnancy outcome. Fertil Steril 2001;76:281–285PubMedCrossRefGoogle Scholar
  6. 6.
    Alikani M, Cohen J, Tomkin G, Garrisi J, Mack C, Scott R: Human embryo fragmentation in vitro and its implication for pregnancy implantation. Fertil Steril 1999;71:836–842PubMedCrossRefGoogle Scholar
  7. 7.
    Hsu M, Mayer J, Aronshon M, Lanzendorf S, Muasher S, Kolm P, Oehninger S: Embryo implantation in in vitro fertilization and intracytoplasmic sperm injection: Impact of cleavage status, morphology grade, and number of embryos transferred. Fertil Steril 1999;72:679–685PubMedCrossRefGoogle Scholar
  8. 8.
    Ziebe S, Petersen K, Lindenberg S, Anderson AG, Gabrielsen A, Nyboe Andersen A: Embryo morphology or cleavage state: How to select the best embryos for transfer after in-vitro fertilization. Hum Reprod 1997;12:1545–1549PubMedCrossRefGoogle Scholar
  9. 9.
    De Placido G, Wilding M, Strina I, Alviggi E, Alviggi C, Mollo A, Varicchio MT, Tolino A, Schiattarella C, Dale B: High outcome predictability after IVF using a combined score for zygote and embryo morphology and growth rate. Hum Reprod 2002;17:2402–2409PubMedCrossRefGoogle Scholar
  10. 10.
    Miliki A, Hinckley M, Gebhardt J, Dasig D, Westphal L, Behr B: Accuracy of day 3 criteria for selecting best embryos. Fertil Steril 2002;77:1191–1195CrossRefGoogle Scholar
  11. 11.
    Rijnders P, Jansen CA: The predictive value of day 3 embryo morphology regarding blastocyst formation, pregnancy and implantation rate after day 5 transfer following in-vitro fertilization or intracytoplasmic sperm injection. Hum Reprod 1998;13:2869–2873PubMedGoogle Scholar
  12. 12.
    Desai N, Goldstein J, Rowland D, Goldfarb J: Morphological evaluation of human embryos and derivation of an embryo quality scoring system specific for day 3 embryos: A preliminary study. Hum Reprod 2000;15:2190–2196PubMedCrossRefGoogle Scholar
  13. 13.
    Terriou P, Sapin C, Giorgetti C, Hans E, Spach JL, Roulier R: Embryo score is a better predictor of pregnancy than the number of transferred embryos or female age. Fertil Steril 2001;75:525–531PubMedCrossRefGoogle Scholar
  14. 14.
    Fisch JD, Sher G, Adamowicz M, Keskintepe L: The graduated embryo score predicts the outcome of assisted reproductive technologies better than a single day 3 evaluation and achieves results associated with blastocyst transfer from day 3 embryo transfer. Fertil Steril 2003;80:1352–1358PubMedCrossRefGoogle Scholar
  15. 15.
    Van Royen E, Mangelschots K, De Neubourg D, Valkenburg M, Van de Meerssche M, Ryckaert G, Eestermans W, Gerris J: Characterization of a top quality embryo, a step towards single-embryo transfer. Hum Reprod 1999;14:2345–2349PubMedCrossRefGoogle Scholar
  16. 16.
    Peterson CM, Reading JC, Hatasaka HH, Parker Jones K, Udoff LC, Adashi EY, Kuneck PH, Erickson LD, Malo JW, Campbell BF, Carrell DT: Use of outcomes-based data in reducing high-order multiple pregnancies: The role of age, diagnosis, and embryo score. Fertil Steril 2004;81:1534–1541PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, Inc. 2006

Authors and Affiliations

  • Sara J. Dennis
    • 1
  • Michael A. Thomas
    • 1
  • Daniel B. Williams
    • 1
  • Jared C. Robins
    • 1
    • 2
    Email author
  1. 1.Center for Reproductive HealthUniversity of CincinnatiCincinnatiUSA
  2. 2.2123 Auburn AvenueSuite A44Cincinnati,USA

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