Skip to main content
Erschienen in: Journal of Assisted Reproduction and Genetics 5/2015

01.05.2015 | Assisted Reproduction Technologies

A quantitative approach to blastocyst quality evaluation: morphometric analysis and related IVF outcomes

verfasst von: Cristina Lagalla, Marzia Barberi, Giovanna Orlando, Raffaella Sciajno, Maria Antonietta Bonu, Andrea Borini

Erschienen in: Journal of Assisted Reproduction and Genetics | Ausgabe 5/2015

Einloggen, um Zugang zu erhalten

Abstract

Purpose

To quantify blastocyst morphologic parameters with a feasible and standardized tool, investigating their predictive value on implantation outcome.

Method

The study retrospectively analyzes 124 blastocysts from 75 patients. Quantitative measurements of blastocyst expansion, inner cell mass and trophoectoderm were taken using digital image analysis software.

Result(s)

Blastocysts areas were found to be ranging from 11626.2 up to 35076.4 μm2. The area of an early blastocyst is A ≤ 18500 μm2 with a mean diameter d = 140 ± 9 μm, and the area of an expanded blastocyst is A ≥ 24000 with d = 190 ± 9 μm. While blastocyst mean area was not related to implantation rate, more expanded blastocysts displayed a significantly higher implantation rate. Trophoectoderm cell number is a predictor of positive outcome: since a higher of cells (25.6 ± 11.3 vs 16.3 ± 12.8) `forming a tightly knit epithelium is prognostic of implantation potential. Conversely, inner cell mass size is significantly related to implantation only in expanded blastocysts (3122.7 ± 739.0 vs. 2978.1 ± 366.0 μm2).

Conclusion(s)

Evaluation of blastocyst morphology with a digital image system could be a valuable tool to standardize blastocyst grading based on quantitative parameters. Therefore, digital analysis may be helpful in identifying the best blastocyst to transfer.
Literatur
2.
Zurück zum Zitat Fragouli J, Wells D. Aneuploidy in the human blastocyst. Cytogenet Genome Res. 2011;133:149–59.CrossRefPubMed Fragouli J, Wells D. Aneuploidy in the human blastocyst. Cytogenet Genome Res. 2011;133:149–59.CrossRefPubMed
3.
Zurück zum Zitat Munne S. Chromosome Abnormalities and their relationship to morphology and development of human embryos. Reprod Biomed Online. 2006;12(2):234–54.CrossRefPubMed Munne S. Chromosome Abnormalities and their relationship to morphology and development of human embryos. Reprod Biomed Online. 2006;12(2):234–54.CrossRefPubMed
4.
Zurück zum Zitat Braude P, Bolton V, Moore S. Human gene expression first occurs between the four- and eight-cell stages of preimplantation development. Nature. 1988;332:459–61.CrossRefPubMed Braude P, Bolton V, Moore S. Human gene expression first occurs between the four- and eight-cell stages of preimplantation development. Nature. 1988;332:459–61.CrossRefPubMed
5.
Zurück zum Zitat Gardner DK, Schoolcraft WB. In vitro culture of human blastocyst. In: Janson R, Mortimer D, editors. Towards Reproductive Certainty: Infertility and Genetics Beyond 1999. Carnforth: Parthenon Press; 1999. p. 378–88. Gardner DK, Schoolcraft WB. In vitro culture of human blastocyst. In: Janson R, Mortimer D, editors. Towards Reproductive Certainty: Infertility and Genetics Beyond 1999. Carnforth: Parthenon Press; 1999. p. 378–88.
6.
Zurück zum Zitat Gardner DK, Schoolcraft WB, Wagley L, Schlenker T, Stevens J, Hesla J. A prospective randomized trial of blastocyst culture and transfer in in-vitro fertilization. Hum Reprod. 1998;13:3434–40.CrossRefPubMed Gardner DK, Schoolcraft WB, Wagley L, Schlenker T, Stevens J, Hesla J. A prospective randomized trial of blastocyst culture and transfer in in-vitro fertilization. Hum Reprod. 1998;13:3434–40.CrossRefPubMed
7.
Zurück zum Zitat Blake DA, Farquhar CM, Johnson N, Proctor M. Cleavage stage versus blastocyst stage embryo transfer in assisted conception. Cochrane Database Syst Rev. 2007;4:CD002118.PubMed Blake DA, Farquhar CM, Johnson N, Proctor M. Cleavage stage versus blastocyst stage embryo transfer in assisted conception. Cochrane Database Syst Rev. 2007;4:CD002118.PubMed
8.
Zurück zum Zitat Papanikolaou EG, Kolibianakis EM, Tournaye H, Venetis CA, Fatemi H, Tarlatzis B, et al. Live birth rates after transfer of equal number of blastocysts or cleavage-stage embryos in IVF. A systematic review and meta-analysis. Hum Reprod. 2008;23:91–9.CrossRefPubMed Papanikolaou EG, Kolibianakis EM, Tournaye H, Venetis CA, Fatemi H, Tarlatzis B, et al. Live birth rates after transfer of equal number of blastocysts or cleavage-stage embryos in IVF. A systematic review and meta-analysis. Hum Reprod. 2008;23:91–9.CrossRefPubMed
9.
Zurück zum Zitat Kirkegaard K, Hindkjaer J, Grøndahl M, Kesmodel U, Ingerslev H. A randomized clinical trial comparing embryo culture in a conventional incubator with a time-lapse incubator. J Assist Reprod Genet. 2012;29:565–72.CrossRefPubMedCentralPubMed Kirkegaard K, Hindkjaer J, Grøndahl M, Kesmodel U, Ingerslev H. A randomized clinical trial comparing embryo culture in a conventional incubator with a time-lapse incubator. J Assist Reprod Genet. 2012;29:565–72.CrossRefPubMedCentralPubMed
10.
Zurück zum Zitat Cruz M, Gadea B, Garrido N, Pedersen KS, Martinez M, Perez-Cano I, et al. Embryo quality, blastocyst and ongoing pregnancy rates in oocyte donation patients whose embryos were monitored by time-lapse imaging. J Assist Reprod Genet. 2011;28:569–73.CrossRefPubMedCentralPubMed Cruz M, Gadea B, Garrido N, Pedersen KS, Martinez M, Perez-Cano I, et al. Embryo quality, blastocyst and ongoing pregnancy rates in oocyte donation patients whose embryos were monitored by time-lapse imaging. J Assist Reprod Genet. 2011;28:569–73.CrossRefPubMedCentralPubMed
11.
Zurück zum Zitat Bendus AEB, Mayer JF, Shipley SK, Catherino WH. Interobserver and intraobserver variation in day 3 embryo grading. Fertil Steril. 2006;86:1608–15.CrossRef Bendus AEB, Mayer JF, Shipley SK, Catherino WH. Interobserver and intraobserver variation in day 3 embryo grading. Fertil Steril. 2006;86:1608–15.CrossRef
12.
Zurück zum Zitat Alpha Scientists in Reproductive Medicine and ESHRE Special Interest Group of Embryology. The Istanbul consensus workshop on embryo assessment: proceedings of an expert meeting. Reprod Biomed Online. 2011;22:632–46. Alpha Scientists in Reproductive Medicine and ESHRE Special Interest Group of Embryology. The Istanbul consensus workshop on embryo assessment: proceedings of an expert meeting. Reprod Biomed Online. 2011;22:632–46.
13.
Zurück zum Zitat Alpha Scientists in Reproductive Medicine and ESHRE Special Interest Group of Embryology. The Istanbul consensus workshop on embryo assessment: proceedings of an expert meeting. Hum Reprod. 2011;26(6):1270–83.CrossRef Alpha Scientists in Reproductive Medicine and ESHRE Special Interest Group of Embryology. The Istanbul consensus workshop on embryo assessment: proceedings of an expert meeting. Hum Reprod. 2011;26(6):1270–83.CrossRef
14.
Zurück zum Zitat Hnida C, Engenheiro E, Ziebe S. Computer-controlled, multilevel, morphometric analysis of blastomere size as biomarker of fragmentation and multinuclearity in human embryos. Hum Reprod. 2004;19:288–93.CrossRefPubMed Hnida C, Engenheiro E, Ziebe S. Computer-controlled, multilevel, morphometric analysis of blastomere size as biomarker of fragmentation and multinuclearity in human embryos. Hum Reprod. 2004;19:288–93.CrossRefPubMed
15.
Zurück zum Zitat Ziebe S. Morphometric analysis of human embryos to predict developmental competence. Reprod Fertil Dev. 2013;26(1):55–64.CrossRefPubMed Ziebe S. Morphometric analysis of human embryos to predict developmental competence. Reprod Fertil Dev. 2013;26(1):55–64.CrossRefPubMed
16.
Zurück zum Zitat Paternot G, Debrock S, De Neubourg D, D’Hooghe TM, Spiessens C. Semi-automated morphometric analysis of human embryos can reveal correlations between total embryo volume and clinical pregnancy. Hum Reprod. 2013;28(3):627–33.CrossRefPubMed Paternot G, Debrock S, De Neubourg D, D’Hooghe TM, Spiessens C. Semi-automated morphometric analysis of human embryos can reveal correlations between total embryo volume and clinical pregnancy. Hum Reprod. 2013;28(3):627–33.CrossRefPubMed
17.
Zurück zum Zitat Beuchat A, Thevenaz P, Unser M, Ebner T, Senn A, Urner F, et al. Quantitative morphometrical characterization of human pronuclear zygotes. Hum Reprod. 2008;23:1983–92.CrossRefPubMed Beuchat A, Thevenaz P, Unser M, Ebner T, Senn A, Urner F, et al. Quantitative morphometrical characterization of human pronuclear zygotes. Hum Reprod. 2008;23:1983–92.CrossRefPubMed
18.
Zurück zum Zitat Santos Filho E, Noble JA, Wells D. A review on automatic analysis of human embryo microscope images. Open Biomed Eng J. 2010;4:170–7.CrossRefPubMed Santos Filho E, Noble JA, Wells D. A review on automatic analysis of human embryo microscope images. Open Biomed Eng J. 2010;4:170–7.CrossRefPubMed
19.
Zurück zum Zitat Santos Filho ES, Noble JA, Poli M, Griffiths T, Emerson G, Wells D. A method for semi-automatic grading of human blastocyst microscope images. Hum Reprod. 2012;27:2641–8.CrossRefPubMed Santos Filho ES, Noble JA, Poli M, Griffiths T, Emerson G, Wells D. A method for semi-automatic grading of human blastocyst microscope images. Hum Reprod. 2012;27:2641–8.CrossRefPubMed
20.
Zurück zum Zitat De Kock AD, Smuts MP, Madden JD, Rodriguez AJ, Chantilis SJ, Meintjes M. Digital image analysis of blastocysts. Morphometrics correlations with pregnancy outcome. Fertil Steril. 2006;86:S51–2.CrossRef De Kock AD, Smuts MP, Madden JD, Rodriguez AJ, Chantilis SJ, Meintjes M. Digital image analysis of blastocysts. Morphometrics correlations with pregnancy outcome. Fertil Steril. 2006;86:S51–2.CrossRef
21.
Zurück zum Zitat Ahlstrom A, Westin C, Reismer E, Wikland M, Hardarson T. Trophectoderm morphology: an important parameter for predicting live birth after single blastocyst transfer. Hum Reprod. 2011;26:3289–96.CrossRefPubMed Ahlstrom A, Westin C, Reismer E, Wikland M, Hardarson T. Trophectoderm morphology: an important parameter for predicting live birth after single blastocyst transfer. Hum Reprod. 2011;26:3289–96.CrossRefPubMed
22.
Zurück zum Zitat Balaban B, Urman B, Sertac A, Alatas C, Aksoy S, Mercan R. Blastocyst quality affects the success of blastocyst-stage embryo transfer. Fertil Steril. 2000;74:282–7.CrossRefPubMed Balaban B, Urman B, Sertac A, Alatas C, Aksoy S, Mercan R. Blastocyst quality affects the success of blastocyst-stage embryo transfer. Fertil Steril. 2000;74:282–7.CrossRefPubMed
23.
Zurück zum Zitat Dokras A, Sargent IL, Barlow DH. Human blastocyst grading: an indicator of developmental potential? Hum Reprod. 1993;8:2119–27.PubMed Dokras A, Sargent IL, Barlow DH. Human blastocyst grading: an indicator of developmental potential? Hum Reprod. 1993;8:2119–27.PubMed
24.
Zurück zum Zitat Goto S, Kadowaki T, Tanaka S, Hashimoto H, Kokeguchi S, Shiotani M. Prediction of pregnancy rate by blastocyst morphological score and age, based on 1,488 single frozen-thawed blastocyst transfer cycles. Fertil Steril. 2011;95:948–52.CrossRefPubMed Goto S, Kadowaki T, Tanaka S, Hashimoto H, Kokeguchi S, Shiotani M. Prediction of pregnancy rate by blastocyst morphological score and age, based on 1,488 single frozen-thawed blastocyst transfer cycles. Fertil Steril. 2011;95:948–52.CrossRefPubMed
25.
Zurück zum Zitat Hill MJ, Richter KS, Heitmann RJ, Graham JR, Tucker MJ, Decherney AH, et al. Trophectoderm grade predicts outcomes of single-blastocyst transfers. Fertil Steril. 2013;99(5):1283-9.CrossRefPubMed Hill MJ, Richter KS, Heitmann RJ, Graham JR, Tucker MJ, Decherney AH, et al. Trophectoderm grade predicts outcomes of single-blastocyst transfers. Fertil Steril. 2013;99(5):1283-9.CrossRefPubMed
26.
Zurück zum Zitat Honnma H, Baba T, Sasaki M, Hashiba Y, Ohno H, Fukunaga T, et al. Trophectoderm morphology significantly affects the rates of ongoing pregnancy and miscarriage in frozen-thawed single-blastocyst transfer cycle in vitro fertilization. Fertil Stertil. 2012;98:361–7.CrossRef Honnma H, Baba T, Sasaki M, Hashiba Y, Ohno H, Fukunaga T, et al. Trophectoderm morphology significantly affects the rates of ongoing pregnancy and miscarriage in frozen-thawed single-blastocyst transfer cycle in vitro fertilization. Fertil Stertil. 2012;98:361–7.CrossRef
27.
Zurück zum Zitat Zaninovic N, Berrios R, Clarke RN, Bodine R, Ye Z, Veeck LL. Blastocyst expansion, inner cell mass (ICM) formation, and trophectoderm (TM) quality: is one more important for implantation? Fertil Steril. 2001;76:S8.CrossRef Zaninovic N, Berrios R, Clarke RN, Bodine R, Ye Z, Veeck LL. Blastocyst expansion, inner cell mass (ICM) formation, and trophectoderm (TM) quality: is one more important for implantation? Fertil Steril. 2001;76:S8.CrossRef
28.
Zurück zum Zitat Richter KS, Harris DC, Daneshmand ST, Shapiro BS. Quantitative grading of a human blastocyst: optimal inner cell mass size and shape. Fertil Steril. 2001;76:1157–67.CrossRefPubMed Richter KS, Harris DC, Daneshmand ST, Shapiro BS. Quantitative grading of a human blastocyst: optimal inner cell mass size and shape. Fertil Steril. 2001;76:1157–67.CrossRefPubMed
29.
Zurück zum Zitat Dal Prato L, Borini A, Trevisi MR, Bonu MA, Sereni E, Flamigni C. Effect of reduced dose of triptorelin at the start of ovarian stimulation on the outcome of IVF: a randomized study. Hum Reprod. 2001;16(7):1409–14.CrossRefPubMed Dal Prato L, Borini A, Trevisi MR, Bonu MA, Sereni E, Flamigni C. Effect of reduced dose of triptorelin at the start of ovarian stimulation on the outcome of IVF: a randomized study. Hum Reprod. 2001;16(7):1409–14.CrossRefPubMed
30.
Zurück zum Zitat Veeck LL, Zaninović N. An atlas of human blastocysts. New York: Parthenon Publishing Group; 2003. Veeck LL, Zaninović N. An atlas of human blastocysts. New York: Parthenon Publishing Group; 2003.
31.
Zurück zum Zitat Shapiro BS, Daneshmand ST, Garner FC, Aguirre M, Thomas S. Large blastocyst diameter, early blastulation, and low preovulatory serum progesterone are dominant predictors of clinical pregnancy in fresh autologous cycles. Fertil Steril. 2008;90:302–9.CrossRefPubMed Shapiro BS, Daneshmand ST, Garner FC, Aguirre M, Thomas S. Large blastocyst diameter, early blastulation, and low preovulatory serum progesterone are dominant predictors of clinical pregnancy in fresh autologous cycles. Fertil Steril. 2008;90:302–9.CrossRefPubMed
32.
Zurück zum Zitat Campbell A, Fishel S, Bowman N, Duffy S, Sedler M, Hickman CF. Modelling a risk classification of aneuploidy in human embryos using non-invasive morphokinetics. Reprod Biomed Online. 2013;26(5):477–85.CrossRefPubMed Campbell A, Fishel S, Bowman N, Duffy S, Sedler M, Hickman CF. Modelling a risk classification of aneuploidy in human embryos using non-invasive morphokinetics. Reprod Biomed Online. 2013;26(5):477–85.CrossRefPubMed
33.
Zurück zum Zitat Alfarawati S, Fragouli E, Colls P, Stevens J, Gutierrez-Mateo C, Schoolcraft WB, et al. The relationship between blastocyst morphology, chromosomal abnormality, and embryo gender. Fertil Steril. 2011;95:520–4.CrossRefPubMed Alfarawati S, Fragouli E, Colls P, Stevens J, Gutierrez-Mateo C, Schoolcraft WB, et al. The relationship between blastocyst morphology, chromosomal abnormality, and embryo gender. Fertil Steril. 2011;95:520–4.CrossRefPubMed
34.
Zurück zum Zitat Balaban B, Yakin K, Urman B. Randomized comparison of two different blastocyst grading systems. Fertil Steril. 2006;85:559–63.CrossRefPubMed Balaban B, Yakin K, Urman B. Randomized comparison of two different blastocyst grading systems. Fertil Steril. 2006;85:559–63.CrossRefPubMed
Metadaten
Titel
A quantitative approach to blastocyst quality evaluation: morphometric analysis and related IVF outcomes
verfasst von
Cristina Lagalla
Marzia Barberi
Giovanna Orlando
Raffaella Sciajno
Maria Antonietta Bonu
Andrea Borini
Publikationsdatum
01.05.2015
Verlag
Springer US
Erschienen in
Journal of Assisted Reproduction and Genetics / Ausgabe 5/2015
Print ISSN: 1058-0468
Elektronische ISSN: 1573-7330
DOI
https://doi.org/10.1007/s10815-015-0469-3

Weitere Artikel der Ausgabe 5/2015

Journal of Assisted Reproduction and Genetics 5/2015 Zur Ausgabe

Update Gynäkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.