Late stages of embryo progression are a much better predictor of clinical pregnancy than early cleavage in intracytoplasmic sperm injection and in vitro fertilization cycles with blastocyst-stage transfer

Rehman, Khurram; Bükülmez, Orhan; Langley, M.; Carr, Bruce R.; Nackley, Anna C.; Doody, K.M.; Doody, Kevin J.

doi:10.1016/j.fertnstert.2006.11.014

Cited by 78 publications

(68 citation statements)

References 33 publications

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“…To establish a numerical blastocyst morphology grading system based on Gardner's grading system [28], the blastocyst grade was converted to the multiplicative BQS proposed by Rehman et al [29]. The BQS is a metric of blastocyst quality that is based on established morphological criteria, and is defined as the product of the degree of expansion and hatching status and ICM and TE grades, where grade A is given the value 3, grade B is given a value of 2, and grade C is given a value of 1.…”

Section: Blastocyst Quality Score (Bqs)mentioning

confidence: 99%

Neonatal outcomes after the implantation of human embryos vitrified using a closed-system device

Iwahata

Hashimoto

Inoue³

et al. 2015

J Assist Reprod Genet

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Purpose Closed vitrification poses a risk of adversely affecting embryo development, while it may minimize the risk of contamination. We assessed the effects of closed-system human embryo vitrification on fetal development after implantation, neonatal outcome, and clinical safety. Methods This was a retrospective cohort study conducted at a private fertility clinic. A total of 875 vitrified-warmed blastocysts that were single-transferred under hormone-replacement cycles between November 2011 and December 2013 were randomly divided into two groups (closed vitrification, n 313; open vitrification, n 562) after receiving the patients' consent forms. Developmental competence after implantation, including gestational age, birth weight, sex, Apgar score, and anomalies of newborns, after the transfer of blastocysts vitrified by closing vitrification was compared with that obtained in the case of open vitrification. Results There were no significant differences between the use of closed and open vitrification systems in embryo development after implantation, gestational age, birth weight, sex ratio, Apgar score, and congenital anomalies of newborns. Conclusion Human embryos can be vitrified using a closed vitrification system without impairment of neonatal development.

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Section: Blastocyst Quality Score (Bqs)mentioning

confidence: 99%

Neonatal outcomes after the implantation of human embryos vitrified using a closed-system device

Iwahata

Hashimoto

Inoue³

et al. 2015

J Assist Reprod Genet

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“…We included blastocysts whose degree of expansion was categorised as BL4/5, whose inner cell mass (ICM) was categorized before freezing as A or B, and whose trophectoderm (TE) grade was categorized before freezing as B or C, according to Gardner's criteria [8]. To obtain a numerical blastocyst morphology grading system based on Gardner's criteria, the blastocyst grade was converted to the multiplicative blastocyst quality score (BQS) [27,33]. The BQS is a measure of blastocyst quality based on established morphologic criteria, and is defined as the product of the degree of embryo development and ICM and TE grades, where grade A is given the value 3; grade B is 2; and grade C is 1.…”

Section: Study 2: Cell Membrane Damage After Vitrificationmentioning

confidence: 99%

A closed system supports the developmental competence of human embryos after vitrification

Hashimoto

Amo

Hama

et al. 2013

J Assist Reprod Genet

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Purpose Closed-system vitrification may enable the risk of contamination to be minimised. We performed three studies to compare the developmental competence of human embryos vitrified using either a closed vitrification system (CVS; Rapid-i®) or an open vitrification system (OVS; Cryo-top®). Methods The first study was performed in vitro using 66 zygotes previously vitrified at pronuclear stage. These were warmed and randomised 1:1 to revitrification using either the OVS or the CVS. After re-warming, embryo development and blastocyst cell number were assessed. For the second study, also performed in vitro, 60 vitrified-warmed blastocysts were randomised 1:1:1 into three groups (OVS or CVS revitrification, or no revitrification). The proportion of dead cells was assessed by staining. The third study was performed in vivo, using 263 high-grade blastocysts randomly assigned to vitrification using either the CVS (n=100) or the OVS (n=163). After warming, single blastocyst transfer was performed. Results There were no differences between the CVS and the OVS in survival rate (100 % vs. 97 %), blastulation rate (96 h: 50 % vs. 50 %; 120 h: 68 % vs. 56 %), proportion of good blastocysts (96 h: 32 % vs. 22 %, 120 h: 47 % vs. 41 %), or mean number of cells (137 vs. 138). The proportion of dead cells in blastocysts re-vitrified by CVS (31 %) was similar to that for OVS (38 %) and non-revitrification (32 %). In vivo, the implantation rate for blastocysts vitrified using the CVS (54 %) was similar to that with the OVS (53 %).Conclusion Our studies consistently indicate that human embryos may be vitrified using a CVS without impairment of developmental competence.

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“…Sometimes, however, this conventional evaluation is not enough to get a successful pregnancy, and a seemingly good embryo morphology does not always lead to implantation and birth; this could be explained by the lack of endometrial receptivity but also because many embryos cease development before implantation. It has been proposed that extending culture to the later stages of embryo development is more natural and gives a higher implantation rate, and such later embryonic stage might also be more discriminative to allow better prediction of clinical pregnancy (8)(9)(10). Cochrane reports on blastocyst versus cleavage stage by Blake et al (11) provide evidence that there is a significant difference in pregnancy and live birth rates in favor of blastocyst transfer, with good-prognosis patients with high numbers of 8-cell embryos on day 3 being the most favored among subgroups for whom there is no difference in cycle cancellation.…”

mentioning

confidence: 99%

Time-dependent O2 consumption patterns determined optimal time ranges for selecting viable human embryos

Tejera

Herrero

Viloria

et al. 2012

Fertility and Sterility

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Late stages of embryo progression are a much better predictor of clinical pregnancy than early cleavage in intracytoplasmic sperm injection and in vitro fertilization cycles with blastocyst-stage transfer

Cited by 78 publications

References 33 publications

Neonatal outcomes after the implantation of human embryos vitrified using a closed-system device

Neonatal outcomes after the implantation of human embryos vitrified using a closed-system device

A closed system supports the developmental competence of human embryos after vitrification

Time-dependent O2 consumption patterns determined optimal time ranges for selecting viable human embryos

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