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Effects of embryo characteristics in frozen-thawed single euploid blastocyst transfers on pregnancy outcomes: a retrospective cohort study

Year 2023, Volume: 9 Issue: 5 - September 2023, 1215 - 1223, 04.09.2023
https://doi.org/10.18621/eurj.1346766

Abstract

Objectives: Our study examined the effects of the trophectoderm biopsy (TB) day and the presence of necrotic foci (NF) or separate blastomeres (SB) within euploid embryos on in vitro fertilization (IVF) pregnancy outcomes.

Methods: This retrospective cohort study was conducted from January 2017 to September 2021 at Memorial Sisli Hospital, Istanbul, Turkey. The study comprised a total of 2758 frozen-thawed euploid embryo transfer cycles. After thawing, blastocysts were graded using Gardner's classification Top-Quality (TQ), Good-Quality (GQ), Moderate-Quality (MQ), Poor-Quality (PQ) and further divided into groups according to the presence of NF and/or SB and evaluated for pregnancy outcomes.

Results: There were significant correlations between pregnancy outcomes and the degree of blastocoele expansion, as well as the presence of NF or SB in the euploid embryo. Ongoing pregnancy rates were lower in the group with NF in the inner cell mass (ICM) or trophectoderm (TE) than in the group without NF. The presence of SB decreased the rates of ongoing pregnancy and increased the rates of miscarriage. Embryos with expansion grades ≤ 3 had lower rates of ongoing pregnancy and higher rates of miscarriage compared to embryos with expansion grades> 3. TQ and GQ embryos had a higher rate of ongoing pregnancy and a lower rate of miscarriage than MQ and PQ embryos.

Conclusions: When selecting the embryo to be transferred to a patient, careful consideration should be given to the morphological grade of the embryo as well as whether or not it contains NF and SB.

References

  • 1. Pirtea P, De Ziegler D, Tao X, Sun L, Zhan Y, Ayoubi JM, et al. Rate of true recurrent implantation failure is low: results of three successive frozen euploid single embryo transfers. Fertil Steril 2021;115:45-53.
  • 2. Rubio C, Bellver J, Rodrigo L, Castillón G, Guillén A, Vidal C, et al. In vitro fertilization with preimplantation genetic diagnosis for aneuploidies in advanced maternal age: a randomized, controlled study. Fertil Steril 2017;107:1122-9.
  • 3. Scott RT Jr, Upham KM, Forman EJ, Hong KH, Scott KL, Taylor D, et al. Blastocyst biopsy with comprehensive chromosome screening and fresh embryo transfer significantly increases in vitro fertilization implantation and delivery rates: a randomized controlled trial. Fertil Steril 2013;100:697-703.
  • 4. Munné S, Spinella F, Grifo J, Zhang J, Beltran MP, Fragouli E, et al. Clinical outcomes after the transfer of blastocysts characterized as mosaic by high resolution Next Generation Sequencing- further insights. Eur J Med Genet 2020;63:103741.
  • 5. Boynukalin FK, Abalı R, Gultomruk M, Yarkiner Z, Mutlu A, Bahceci M. Which factors affect the likelihood of miscarriage after single euploid blastocyst transfer? Reprod Biomed Online 2021;42:1187-95.
  • 6. Boynukalin FK, Gultomruk M, Cavkaytar S, Turgut E, Findikli N, Serdarogullari M, et al. Parameters impacting the live birth rate per transfer after frozen single euploid blastocyst transfer. PLoS One 2020;15:e0227619.
  • 7. Simon AL, Kiehl M, Fischer E, Proctor JG, Bush MR, Givens C, et al. Pregnancy outcomes from more than 1,800 in vitro fertilization cycles with the use of 24-chromosome single-nucleotide polymorphism-based preimplantation genetic testing for aneuploidy. Fertil Steril 2018;110:113-21.
  • 8. Mantikou E, Wong KM, Repping S, Mastenbroek S. Molecular origin of mitotic aneuploidies in preimplantation embryos. Biochim Biophys Acta 2012;1822:1921-30.
  • 9. Lagalla C, Coticchio G, Sciajno R, Tarozzi N, Zacà C, Borini A. Alternative patterns of partial embryo compaction: prevalence, morphokinetic history and possible implications. Reprod Biomed Online 2020;40:347-54.
  • 10. Coticchio G, Ezoe K, Lagalla C, Shimazaki K, Ohata K, Ninomiya M, et al. Perturbations of morphogenesis at the compaction stage affect blastocyst implantation and live birth rates. Hum Reprod 2021;36:918-28.
  • 11. Hur C, Nanavaty V, Yao M, Desai N. The presence of partial compaction patterns is associated with lower rates of blastocyst formation, sub-optimal morphokinetic parameters and poorer morphologic grade. Reprod Biol Endocrinol 2023;21:12.
  • 12. Zhao J, Yan Y, Huang X, Sun L, Li Y. Blastocoele expansion: an important parameter for predicting clinical success pregnancy after frozen-warmed blastocysts transfer. Reprod Biol Endocrinol 2019;17:15.
  • 13. Du QY, Wang EY, Huang Y, Guo XY, Xiong YJ, Yu YP, et al. Blastocoele expansion degree predicts live birth after single blastocyst transfer for fresh and vitrified/warmed single blastocyst transfer cycles. Fertil Steril 2016;105:910-19.e1.
  • 14. Kim HJ, Park JK, Eum JH, Song H, Lee WS, Lyu SW. Embryo selection based on morphological parameters in a single vitrified-warmed blastocyst transfer cycle. Reprod Sci 2021;28:1060-8.
  • 15. Capalbo A, Rienzi L, Cimadomo D, Maggiulli R, Elliott T, Wright G, et al. Correlation between standard blastocyst morphology, euploidy and implantation: an observational study in two centers involving 956 screened blastocysts. Hum Reprod 2014;29:1173-81.
  • 16. Viñals Gonzalez X, Odia R, Naja R, Serhal P, Saab W, Seshadri S, et al. Euploid blastocysts implant irrespective of their morphology after NGS-(PGT-A) testing in advanced maternal age patients. J Assist Reprod Genet 2019;36:1623-9.
  • 17. Irani M, O'Neill C, Palermo GD, Xu K, Zhang C, Qin X, et al. Blastocyst development rate influences implantation and live birth rates of similarly graded euploid blastocysts. Fertil Steril 2018;110:95-102.e1.
  • 18. Gordon CE, Lanes A, Thomas A, Racowsky C. Day of trophectoderm biopsy and embryo quality are associated with outcomes following euploid embryo transfer. J Assist Reprod Genet 2022;39:2539-46.
  • 19. Li N, Guan Y, Ren B, Zhang Y, Du Y, Kong H, et al. Effect of blastocyst morphology and developmental rate on euploidy and live birth rates in preimplantation genetic testing for aneuploidy cycles with single-embryo transfer. Front Endocrinol (Lausanne) 2022;13:858042.
  • 20. Peng X, Yu M, Li L, Fu W, Chen H, Sun X, et al. Effects of euploid blastocyst morphological development on reproductive outcomes. Reprod Biol 2020;20:496-500.
  • 21. Yanez LZ, Han J, Behr BB, Pera RAR, Camarillo DB. Human oocyte developmental potential is predicted by mechanical properties within hours after fertilization. Nat Commun 2016;7:10809.
  • 22. Zhang WY, Johal JK, Gardner RM, Bavan B, Milki AA. The impact of euploid blastocyst morphology and maternal age on pregnancy and neonatal outcomes in natural cycle frozen embryo transfers. J Assist Reprod Genet 2022;39:647-54.
  • 23. Zhao YY, Yu Y, Zhang XW. Overall blastocyst quality, trophectoderm grade, and inner cell mass grade predict pregnancy outcome in euploid blastocyst transfer cycles. Chin Med J (Engl) 2018;131:1261-7.
  • 24. Shenoy CC, Bader A, Walker DL, Fredrickson JR, Weaver AL, Zhao Y. Embryo blastomere exclusion identified in a time-lapse culture system is associated with embryo ploidy. Reprod Sci 2023;30:1911-6.
  • 25. Kovacic B, Vlaisavljevic V, Reljic M, Cizek-Sajko M. Developmental capacity of different morphological types of day 5 human morulae and blastocysts. Reprod Biomed Online 2004;8:687-94.
  • 26. Ebner T, Vanderzwalmen P, Shebl O, Urdl W, Moser M, Zech NH, et al. Morphology of vitrified/warmed day-5 embryos predicts rates of implantation, pregnancy and live birth. Reprod Biomed Online 2009;19:72-8.
  • 27. Wang YJ, Liu WJ, Fan L, Li ZT, Huang YQ, Chen CQ, et al. The impacts of the number of prefreeze and postthaw blastomeres on embryo implantation potential: a systematic analysis. Medicine (Baltimore) 2020;99:e19591.
Year 2023, Volume: 9 Issue: 5 - September 2023, 1215 - 1223, 04.09.2023
https://doi.org/10.18621/eurj.1346766

Abstract

References

  • 1. Pirtea P, De Ziegler D, Tao X, Sun L, Zhan Y, Ayoubi JM, et al. Rate of true recurrent implantation failure is low: results of three successive frozen euploid single embryo transfers. Fertil Steril 2021;115:45-53.
  • 2. Rubio C, Bellver J, Rodrigo L, Castillón G, Guillén A, Vidal C, et al. In vitro fertilization with preimplantation genetic diagnosis for aneuploidies in advanced maternal age: a randomized, controlled study. Fertil Steril 2017;107:1122-9.
  • 3. Scott RT Jr, Upham KM, Forman EJ, Hong KH, Scott KL, Taylor D, et al. Blastocyst biopsy with comprehensive chromosome screening and fresh embryo transfer significantly increases in vitro fertilization implantation and delivery rates: a randomized controlled trial. Fertil Steril 2013;100:697-703.
  • 4. Munné S, Spinella F, Grifo J, Zhang J, Beltran MP, Fragouli E, et al. Clinical outcomes after the transfer of blastocysts characterized as mosaic by high resolution Next Generation Sequencing- further insights. Eur J Med Genet 2020;63:103741.
  • 5. Boynukalin FK, Abalı R, Gultomruk M, Yarkiner Z, Mutlu A, Bahceci M. Which factors affect the likelihood of miscarriage after single euploid blastocyst transfer? Reprod Biomed Online 2021;42:1187-95.
  • 6. Boynukalin FK, Gultomruk M, Cavkaytar S, Turgut E, Findikli N, Serdarogullari M, et al. Parameters impacting the live birth rate per transfer after frozen single euploid blastocyst transfer. PLoS One 2020;15:e0227619.
  • 7. Simon AL, Kiehl M, Fischer E, Proctor JG, Bush MR, Givens C, et al. Pregnancy outcomes from more than 1,800 in vitro fertilization cycles with the use of 24-chromosome single-nucleotide polymorphism-based preimplantation genetic testing for aneuploidy. Fertil Steril 2018;110:113-21.
  • 8. Mantikou E, Wong KM, Repping S, Mastenbroek S. Molecular origin of mitotic aneuploidies in preimplantation embryos. Biochim Biophys Acta 2012;1822:1921-30.
  • 9. Lagalla C, Coticchio G, Sciajno R, Tarozzi N, Zacà C, Borini A. Alternative patterns of partial embryo compaction: prevalence, morphokinetic history and possible implications. Reprod Biomed Online 2020;40:347-54.
  • 10. Coticchio G, Ezoe K, Lagalla C, Shimazaki K, Ohata K, Ninomiya M, et al. Perturbations of morphogenesis at the compaction stage affect blastocyst implantation and live birth rates. Hum Reprod 2021;36:918-28.
  • 11. Hur C, Nanavaty V, Yao M, Desai N. The presence of partial compaction patterns is associated with lower rates of blastocyst formation, sub-optimal morphokinetic parameters and poorer morphologic grade. Reprod Biol Endocrinol 2023;21:12.
  • 12. Zhao J, Yan Y, Huang X, Sun L, Li Y. Blastocoele expansion: an important parameter for predicting clinical success pregnancy after frozen-warmed blastocysts transfer. Reprod Biol Endocrinol 2019;17:15.
  • 13. Du QY, Wang EY, Huang Y, Guo XY, Xiong YJ, Yu YP, et al. Blastocoele expansion degree predicts live birth after single blastocyst transfer for fresh and vitrified/warmed single blastocyst transfer cycles. Fertil Steril 2016;105:910-19.e1.
  • 14. Kim HJ, Park JK, Eum JH, Song H, Lee WS, Lyu SW. Embryo selection based on morphological parameters in a single vitrified-warmed blastocyst transfer cycle. Reprod Sci 2021;28:1060-8.
  • 15. Capalbo A, Rienzi L, Cimadomo D, Maggiulli R, Elliott T, Wright G, et al. Correlation between standard blastocyst morphology, euploidy and implantation: an observational study in two centers involving 956 screened blastocysts. Hum Reprod 2014;29:1173-81.
  • 16. Viñals Gonzalez X, Odia R, Naja R, Serhal P, Saab W, Seshadri S, et al. Euploid blastocysts implant irrespective of their morphology after NGS-(PGT-A) testing in advanced maternal age patients. J Assist Reprod Genet 2019;36:1623-9.
  • 17. Irani M, O'Neill C, Palermo GD, Xu K, Zhang C, Qin X, et al. Blastocyst development rate influences implantation and live birth rates of similarly graded euploid blastocysts. Fertil Steril 2018;110:95-102.e1.
  • 18. Gordon CE, Lanes A, Thomas A, Racowsky C. Day of trophectoderm biopsy and embryo quality are associated with outcomes following euploid embryo transfer. J Assist Reprod Genet 2022;39:2539-46.
  • 19. Li N, Guan Y, Ren B, Zhang Y, Du Y, Kong H, et al. Effect of blastocyst morphology and developmental rate on euploidy and live birth rates in preimplantation genetic testing for aneuploidy cycles with single-embryo transfer. Front Endocrinol (Lausanne) 2022;13:858042.
  • 20. Peng X, Yu M, Li L, Fu W, Chen H, Sun X, et al. Effects of euploid blastocyst morphological development on reproductive outcomes. Reprod Biol 2020;20:496-500.
  • 21. Yanez LZ, Han J, Behr BB, Pera RAR, Camarillo DB. Human oocyte developmental potential is predicted by mechanical properties within hours after fertilization. Nat Commun 2016;7:10809.
  • 22. Zhang WY, Johal JK, Gardner RM, Bavan B, Milki AA. The impact of euploid blastocyst morphology and maternal age on pregnancy and neonatal outcomes in natural cycle frozen embryo transfers. J Assist Reprod Genet 2022;39:647-54.
  • 23. Zhao YY, Yu Y, Zhang XW. Overall blastocyst quality, trophectoderm grade, and inner cell mass grade predict pregnancy outcome in euploid blastocyst transfer cycles. Chin Med J (Engl) 2018;131:1261-7.
  • 24. Shenoy CC, Bader A, Walker DL, Fredrickson JR, Weaver AL, Zhao Y. Embryo blastomere exclusion identified in a time-lapse culture system is associated with embryo ploidy. Reprod Sci 2023;30:1911-6.
  • 25. Kovacic B, Vlaisavljevic V, Reljic M, Cizek-Sajko M. Developmental capacity of different morphological types of day 5 human morulae and blastocysts. Reprod Biomed Online 2004;8:687-94.
  • 26. Ebner T, Vanderzwalmen P, Shebl O, Urdl W, Moser M, Zech NH, et al. Morphology of vitrified/warmed day-5 embryos predicts rates of implantation, pregnancy and live birth. Reprod Biomed Online 2009;19:72-8.
  • 27. Wang YJ, Liu WJ, Fan L, Li ZT, Huang YQ, Chen CQ, et al. The impacts of the number of prefreeze and postthaw blastomeres on embryo implantation potential: a systematic analysis. Medicine (Baltimore) 2020;99:e19591.
There are 27 citations in total.

Details

Primary Language English
Subjects Obstetrics and Gynaecology
Journal Section Original Articles
Authors

Gönül Özer 0000-0003-2900-8623

Gülçin Özkara 0000-0002-4383-6890

Early Pub Date August 31, 2023
Publication Date September 4, 2023
Submission Date August 20, 2023
Acceptance Date August 30, 2023
Published in Issue Year 2023 Volume: 9 Issue: 5 - September 2023

Cite

AMA Özer G, Özkara G. Effects of embryo characteristics in frozen-thawed single euploid blastocyst transfers on pregnancy outcomes: a retrospective cohort study. Eur Res J. September 2023;9(5):1215-1223. doi:10.18621/eurj.1346766

e-ISSN: 2149-3189 


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