Does early morphology provide additional selection power to blastocyst selection for transfer?

Abstract

Routine early developmental parameters are widely used in IVF centres to evaluate embryo development and fresh single-blastocyst transfer currently seems superior to single-embryo transfer. Would early morphological parameters help to choose the single blastocyst to be transferred, thereby improving the chances of implantation and live birth rate? This prospective observational study analysed the individual outcomes of 2617 embryos from 511 IVF couples scheduled for a single-blastocyst transfer. Embryo and blastocyst scores were constructed. There was a clear relationship between the kinetics and morphology of blastocysts and further implantation and live birth rate. There was a limited predictive value of embryo score with regard to blastocyst development and growth kinetics. Implanted and non-implanted blastocysts showed similar embryo scores. Thus usual morphological parameters on days 1 and 2 seem to have no additional value in indicating the right blastocyst to transfer. Non-invasive approaches might be helpful to increase the chances of implantation in the future.

The effect of sperm DNA fragmentation on the dynamics of the embryonic development in intracytoplasmatic sperm injection

“…During the first days of embryo culture, morphological criteria alone are generally only weakly predictive of both embryo development and capability to procure a pregnancy [9,10]. However, currently embryos are still classified and chosen for transfer in accordance to morphological and developmental scores [11].…”

Patient selection criteria for blastocyst transfers in extended embryo culture programs

“…In fact, our data showed that a good morphology on day three increases the likelihood that a blastocyst will be of good quality by up to threefold. Conversely, previous studies have suggested that the early embryo morphology is a poor predictor of the blastocyst quality in extended culture [14,15]. A recent study from Guerif et al [15] suggested that the relationship between early morphological parameters and the blastocyst morphology is weak.…”

“…Conversely, previous studies have suggested that the early embryo morphology is a poor predictor of the blastocyst quality in extended culture [14,15]. A recent study from Guerif et al [15] suggested that the relationship between early morphological parameters and the blastocyst morphology is weak. However, it was demonstrated that the degree of fragmentation on day three should be taken into account in the selection of the best blastocyst for transfer.…”

Peut-on éviter le travail du week-end en Assistance médicale à la procréation ?

“…Dans le cadre des politiques de transfert d'un seul embryon, la culture prolongé e pré sente un inté rêt majeur [22]. L'aspect morphologique pré coce des embryons n'apporte pas d'aide à la dé cision du blastocyste à transfé rer : aucune diffé rence n'a é té observé entre les blastocystes implanté s et non implanté s selon leurs caractè res morphologiques à J2 [23,24]. On peut donc en dé duire que si la politique du centre d'AMP est la culture prolongé e systé matique, il n'est pas utile d'observer les embryons aux stades J2/J3.…”