Embryo Selection Based on Morphological Parameters in a Single Vitrified-Warmed Blastocyst Transfer Cycle
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INFERTILITY: ORIGINAL ARTICLE
Embryo Selection Based on Morphological Parameters in a Single Vitrified-Warmed Blastocyst Transfer Cycle Hyun Jin Kim 1 & Jae Kyun Park 1,2 & Jin Hee Eum 1 & Haengseok Song 2 & Woo Sik Lee 1 & Sang Woo Lyu 1 Received: 6 July 2020 / Accepted: 5 October 2020 # Society for Reproductive Investigation 2020
Abstract The process of selecting a good quality embryo to improve the pregnancy outcomes is very important. The aim of our study was to elaborate the embryo selection process in a single vitrified-warmed blastocyst transfer (VBT) cycle by analyzing pre-vitrified and post-warmed blastocyst morphological factors to improve pregnancy outcomes. In this retrospective cohort study, we performed 329 single VBT cycles. The pre-vitrified and post-warmed morphological factors of all blastocysts were analyzed. Logistic regression analysis was conducted to select the independent morphological factor associated with ongoing pregnancy. The expansion of blastocoel (mid blastocoel; aOR 2.27, 95% CI.0.80–6.42, p = 0.12, expanded blastocoel; aOR 3.15, 95% CI.1.18–8.44, p = 0.02) in a pre-vitrified blastocyst and the grade of inner cell mass (ICM) (grade B; aOR 0.47, 95% CI.0.27– 0.83, p = 0.01, grade C; aOR 0.22, 95% CI 0.09–0.56 p < 0.01) in post-warmed blastocysts significantly predicted the ongoing pregnancy. After fertilization, the embryo developed as a blastocyst on day 5 (day 5) showed a higher ongoing pregnancy than that on day 6 (day 6) (aOR 0.50, 95% CI.0.26–0.94, p = 0.03). The results suggest that while selecting a vitrified-warmed blastocyst in a single VBT cycle, the day 5 vitrified blastocyst should be considered, and a higher expansion grade in the previtrified blastocyst should be selected. Our study has shown that post-warmed ICM grade tends to be a predictive indicator for the selection of the best blastocyst and allows for successful pregnancy, with ongoing pregnancy in a single blastocyst transfer. Keywords Embryo selection . Vitrified-warmed blastocyst transfer . Single embryo transfer . Blastocyst morphology
Introduction The development of the culture system and the cryopreservation of an embryo make it possible to increase the number of freeze-all strategies [1, 2]. Cryopreservation allows an embryo to escape the adverse effects of controlled ovarian hyperstimulation, such as decreased endometrial receptivity [3]. In
Hyun Jin Kim and Jae Kyun Park are co-first authors. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s43032-020-00349-6) contains supplementary material, which is available to authorized users. * Sang Woo Lyu [email protected] 1
Department of Obstetrics and Gynecology, Fertility Center of CHA Gangnam Medical Center, CHA University School of Medicine, 566 Nonhyeon-Ro, Gangnam-gu, Seoul 0635, South Korea
2
Department of Biomedical Science, CHA University, Seongnam, South Korea
addition, it has become a treatment option for women who are at risk of ovarian hyperstimulation syndrome [2]. Recently, IVF clinics have bee
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