Embryo re-expansion does not affect clinical pregnancy rates in frozen embryo transfer cycles: a retrospective study

Giunco, Hunter; Connerney, M.K.; Boylan, C.F.; Koelper, Nathanael; Mersereau, Jennifer E.; Berger, David

doi:10.1007/s10815-021-02319-6

Cited by 9 publications

(3 citation statements)

References 20 publications

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“…Many studies have investigated post-warming parameters, and the degree of blastocyst re-expansion after warming has been reported as a positive predictor of clinical pregnancy by most studies [8,10,13,24,25,38] but not all [39]. However, the post-warming culture time (3-7 h), the mode of incubation (conventional versus time-lapse) and the definition of re-expansion (e.g., expansion status versus degree of re-expansion versus time taken for the blastocyst to fill the whole perivitelline space) differs between these studies.…”

Section: Discussionmentioning

confidence: 99%

Pre-Vitrification and Post-Warming Variables of Vitrified-Warmed Blastocysts That Are Predictable for Implantation

Gabrielsen,

Iversen,

Fedder

et al. 2023

JCM

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Human IVF embryos that are not used for fresh transfer are cryopreserved by vitrification for later embryo transfers. This study evaluates pre-vitrification and post-warming embryo characteristics that are suitable to predict the chance of clinical pregnancy in single vitrified blastocyst transfer (SVBT) cycles. In a multicenter observational trial (IMBOS trial), embryos were cultured in a time-lapse system before and after vitrification. Associations between clinical pregnancy, morphokinetic parameters, blastocyst collapse, KIDScore D5, pre-vitrification and post-warming Gardner scores, post-warming blastocyst size and re-expansion rates before SVBT were analyzed in 182 SVBTs which resulted in 89 clinical pregnancies. No association was found between clinical pregnancy after SVBT and the number of collapses or the maximal collapse size before vitrification. The multifactorial analysis of pre-vitrification Gardner scores showed a significant association with clinical pregnancy for trophectoderm grading but not for expansion/hatching status and inner cell mass grading. A significant association with clinical pregnancy was found for the time to reach a blastocyst after pronuclear fading (tB-tPNf), KIDScore D5 and post-warming size but not the rate of expansion or maximal expansion size. The selection of blastocysts for SVBT could benefit from using pre-vitrification parameters like tB-tPNf, trophectoderm grading and post-warming blastocyst size.

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Section: Discussionmentioning

confidence: 99%

Pre-Vitrification and Post-Warming Variables of Vitrified-Warmed Blastocysts That Are Predictable for Implantation

Gabrielsen,

Iversen,

Fedder

et al. 2023

JCM

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“…Traditionally, many studies have mentioned the importance of blastocyst re-expansion [ 33 , 34 , 35 ]. However, recent studies have shown that embryo re-expansion does not affect clinical outcomes [ 36 , 37 ]. Cruz et al also demonstrated that immediate embryo transfer after warming seemingly did not affect implantation potential [ 38 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical Usability of Embryo Development Using a Combined Qualitative and Quantitative Approach in a Single Vitrified-Warmed Blastocyst Transfer: Assessment of Pre-Vitrified Blastocyst Diameter and Post-Warmed Blastocyst Re-Expansion Speed

Park

Ahn

Seok

et al. 2022

JCM

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Improving the safety and efficacy of assisted reproductive technology programs has been a continuous challenge. Traditionally, morphological grading has been used for embryo selection. However, only a few studies have assessed the morphokinetic variables and morphological dynamics of blastocysts. In the present study, we aimed to perform a quantitative analysis of blastocyst diameter and re-expansion speed. This in-depth morphokinetic evaluation can correlate with currently observed pregnancy outcomes. In total, 658 single vitrified-warmed blastocyst transfer cycles were performed between October 2017 and December 2021, which were divided into four groups according to the pre-vitrified blastocyst diameter. After warming, the groups were subdivided according to the blastocyst re-expansion speed. These quantitative measurements were performed using a time-lapse system. Both diameter and speed are essential in determining the blastocyst quality, while age, day of freezing, and blastocyst quality are crucial from a clinical perspective. The application of both quantitative (diameter and speed) and qualitative (blastocyst quality scores) parameters can help evaluate the clinical usability of blastocysts. This method can prove useful for embryologists in counseling their patients and determining pregnancy patient-oriented strategies.

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“…A significantly higher clinical pregnancy rate was indeed found in association with the transfer of blastocysts with expansion grade 3 and 4 at vitrification and cultured overnight post-warming. Whether this finding might be as well associated with a higher rate of re-expansion during the longer culture is not clear, since the predictive value of blastocyst re-expansion for the implantation of frozen-thawed blastocysts is still a matter of debate [28].…”

Section: Discussionmentioning

confidence: 99%

Post-Thaw Day 5 Blastocyst Culture Time Prior to Transfer Does Not Affect Assisted Reproduction Technology (ART) Outcomes in Frozen-Thawed Embryo Transfer Cycles

Ciaffaglione

Reschini

Balli

et al. 2022

JCM

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The frozen embryo transfer (FET) technique has been progressively used more worldwide due to improved culture conditions, as well as enhanced survival rates after vitrification. However, little is known about the effect of the post-thaw blastocyst culture duration prior to transfer on live birth rate in FET cycles. In this retrospective observational study, we evaluated the influence of two distinct post-thaw blastocyst culture spans (2–4 h versus 20–22 h) on clinical pregnancy and live birth rate. A total of n = 1927 frozen–warmed cycles were included in the analysis. Among those, n = 885 warmed blastocysts were cultured for 2–4 h, and n = 1029 were kept in culture for 20–22 h prior to transfer; the remaining blastocysts did not survive the warming protocol. We observed no significant differences in live birth and clinical pregnancy rates between the two groups. The blastocyst morphological evaluation at transfer improved following the longer culture time. No differences between the two groups were found also for gestational and neonatal outcomes. This work shows that different post-thaw embryo culture timings do not negatively impact pregnancy outcomes. Overall, these results are important in the context of the embryological laboratory in order to better organize the workflow and avoid unnecessary timing-related workload.

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Embryo re-expansion does not affect clinical pregnancy rates in frozen embryo transfer cycles: a retrospective study

Cited by 9 publications

References 20 publications

Pre-Vitrification and Post-Warming Variables of Vitrified-Warmed Blastocysts That Are Predictable for Implantation

Pre-Vitrification and Post-Warming Variables of Vitrified-Warmed Blastocysts That Are Predictable for Implantation

Clinical Usability of Embryo Development Using a Combined Qualitative and Quantitative Approach in a Single Vitrified-Warmed Blastocyst Transfer: Assessment of Pre-Vitrified Blastocyst Diameter and Post-Warmed Blastocyst Re-Expansion Speed

Post-Thaw Day 5 Blastocyst Culture Time Prior to Transfer Does Not Affect Assisted Reproduction Technology (ART) Outcomes in Frozen-Thawed Embryo Transfer Cycles

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