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12.09.2019 | Assisted Reproduction Technologies | Ausgabe 11/2019

Journal of Assisted Reproduction and Genetics 11/2019

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

Zeitschrift:
Journal of Assisted Reproduction and Genetics > Ausgabe 11/2019
Autoren:
Jennifer B. Bakkensen, Paula Brady, Daniela Carusi, Phillip Romanski, Ann M. Thomas, Catherine Racowsky
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1007/​s10815-019-01580-0) contains supplementary material, which is available to authorized users.

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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.

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