Time of morulation and trophectoderm quality are predictors of a live birth after euploid blastocyst transfer: a multicenter study

Rienzi, Laura; Cimadomo, Danilo; Delgado, A.; Minasi, Maria Giulia; Fabozzi, Gemma; Gallego, Raquel Del; Stoppa, Marta; Bellver, José; Giancani, Adriano; Esbert, Marga; Capalbo, Antonio; Remohı́, J.; Greco, Ermanno; Ubaldi, Filippo Maria; Meseguer, Marcos

doi:10.1016/j.fertnstert.2019.07.1322

Cited by 57 publications

(44 citation statements)

References 123 publications

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“…The authors concluded that this outcome is reproducible across different centers under specific culture conditions, such as individual culture in single-step medium at 37°C, 6% CO 2 , and 5% O 2 . 39…”

Section: Algorithmsmentioning

confidence: 99%

The clinical use of time-lapse in human-assisted reproduction

Minasi

Greco

Varricchio

et al. 2020

Clin Med�Insights�Reprod�Health

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A major challenge in the assisted reproduction laboratory is to set up reproducible and efficient criteria to identify the embryo with the highest developmental potential. Over the years, several methods have been used worldwide with this purpose. Initially, standard morphology assessment was the only available strategy. It is now universally recognized that besides being a very subjective embryo selection strategy, morphology evaluation alone has a very poor prognostic value. More recently, the availability of time-lapse incubators allowed a continuous monitoring of human embryo development. This technology has spread quickly and many fertility clinics over the world produced a remarkable amount of data. To date, however, a general consensus on which variables, or combination of variables, should play a central role in embryo selection is still lacking. Many confounding factors, concerning both patient features and clinical and biological procedures, have been observed to influence embryo development. In addition, several studies have reported unexpected positive outcomes, even in the presence of abnormal developmental criteria. While it does not seem that time-lapse technology is ready to entirely replace the more invasive preimplantation genetic testing in identifying the embryo with the highest implantation potential, it is certainly true that its application is rapidly growing, becoming progressively more accurate. Studies involving artificial intelligence and deep-learning models as well as combining morphokinetic with other non-invasive markers of embryo development, are currently ongoing, raising hopes for its successful applicability for clinical purpose in the near future. The present review mainly focuses on data published starting from the first decade of 2000, when time-lapse technology was introduced as a routine clinical practice in the infertility centers.

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Section: Algorithmsmentioning

confidence: 99%

The clinical use of time-lapse in human-assisted reproduction

Minasi

Greco

Varricchio

et al. 2020

Clin Med�Insights�Reprod�Health

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View full text Add to dashboard Cite

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“…The preferred clinical outcome in IVF is´the birth of a singleton healthy child at term´ [21][22][23][24]. Few studies have however assessed TLI information with live birth as primary endpoint [16,25,26].…”

Section: Introductionmentioning

confidence: 99%

Time-lapse imaging derived morphokinetic variables reveal association with implantation and live birth following in vitro fertilization: A retrospective study using data from transferred human embryos

Sayed

Reigstad

Petersen³

et al. 2020

PLoS ONE

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The purpose of this retrospective time-lapse data analysis from transferred preimplantation human embryos was to identify early morphokinetic cleavage variables that are related to implantation and live birth following in vitro fertilization (IVF). All embryos were monitored from fertilization check until embryo transfer for a minimum of 44 hours. The study was designed to assess the association between day 2 embryo morphokinetic variables with implantation and live birth based on Known Implantation Data (KID). The kinetic variables were subjected to quartile-based analysis. The predictive ability for implantation and live birth was studied using receiver operator characteristic (ROC) curves. Three morphokinetic variables, time to 2-cells (t2), duration of second cell cycle (cc2) below one threshold and cc2 above another threshold had the highest predictive value with regards to implantation and live birth following IVF treatment. The predictive pre-transfer information has little divergence between fetal heartbeat and live birth data and therefore, at least for early morphokinetic variables up to the four-cell stage (t4), conclusions and models based on fetal heartbeat data can be expected to be valid for live birth datasets as well. The three above mentioned variables (t2, cc2 below one threshold and cc2 above another threshold) may supplement morphological evaluation in embryo selection and thereby improve the outcome of in vitro fertilization treatments.

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“…Blastocyst quality is assessed based on blastocoel expansion, appearance of TE and appearance of ICM. TE grade has been shown to be a useful predictor of ongoing pregnancy rate for euploid embryos, and the critical role of the TE in mediating correct embryo implantation has been well established [1] .…”

Section: Discussionmentioning

confidence: 99%

Association Between Morphologic Grading and Implantation Rate of Euploid Blastocyst

Lou

Guan

et al. 2020

Preprint

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Objective To determine the association between the morphologic grading and implantation rate of euploid blastocysts in single frozen-thawed embryo transfer (SET) cycles.Design: Retrospective cohort study.Setting: Single university-based fertility centerPatient(s): Women aged 25–40 years undergoing euploid SET from January 2017 to December 2019 were identified.Main Outcomes Measure(s): Implantation rate (IR)Result(s): A total of 271 euploid SET cycles were included. The cycles were divided into three groups based on their morphologic grading before cryopreservation: good-quality (n = 58), average-quality (n = 88) and poor-quality blastocysts (n = 125). Good-quality blastocysts yielded statistically significantly higher implantation rates than poor-quality embryos (79.31% vs. 48%; adjusted odds ratio [OR] 3.269; 95% confidence interval [CI] 1.518–7.040). The OR remained significant after adjusting for maternal age, body mass index (BMI), type of infertility, basal follicle-stimulating hormone (FSH), AMH (anti-Müllerian hormone), peak endometrial thickness, type of SET cycle and day of blastocyst biopsy. According to post hoc analysis of age and the day of trophectoderm (TE) biopsy, the implantation rates in women aged < 35 years were higher after good-quality blastocyst transfer than poor-quality blastocyst transfer (80.39% vs. 48.62%, P = 0.003). Logistic regression analyses that adjusted for these variables identified higher implantation rates (OR 3.478, 95% CI 1.530–7.908) for good-quality blastocysts than for blastocysts that underwent poor-quality cycles, but not in women aged ≥ 35 years (71.43% vs. 62.50%, P = 0.402) (Table 2). The implantation rates were higher among women with good-quality blastocysts on both day 5 and day 6 of TE biopsy than among those with poor-quality blastocysts (day 5, 80.43% vs. 55.77%, P = 0.017; day 6, 75.00% vs. 42.47%, P = 0.074). Day 5 euploid blastocysts had no significant difference in implantation potential compared with similarly graded day 6 euploid blastocysts.Conclusions: Blastocyst morphologic grading was associated with implantation rate for euploid embryo transfers after adjustment for potential confounders. These findings suggest that evaluating blastocyst morphology is critical when selecting the best euploid blastocyst.

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Time of morulation and trophectoderm quality are predictors of a live birth after euploid blastocyst transfer: a multicenter study

Cited by 57 publications

References 123 publications

The clinical use of time-lapse in human-assisted reproduction

The clinical use of time-lapse in human-assisted reproduction

Time-lapse imaging derived morphokinetic variables reveal association with implantation and live birth following in vitro fertilization: A retrospective study using data from transferred human embryos

Association Between Morphologic Grading and Implantation Rate of Euploid Blastocyst

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