Objective: To investigate whether the morphodynamic characterization of a euploid blastocyst's development allows a higher prediction of a live birth after single-embryo-transfer (SET).Design: Observational cohort study conducted in two phases: training and validation.Setting: Private in vitro fertilization centers.Patient(s): Euploid blastocysts: 511 and 319 first vitrified-warmed SETs from 868 and 546 patients undergoing preimplantation genetic testing for aneuploidies (PGT-A) in the training and validation phase, respectively.Intervention(s): Data collected from time of polar body extrusion to time of starting blastulation, and trophectoderm and inner-cellmass static morphology in all embryos cultured in a specific time-lapse incubator with a continuous medium. Logistic regressions conducted to outline the variables showing a statistically significant association with live birth. In the validation phase, these variables were tested in an independent data set.Main Outcome Measure(s): Live births per SET.Result(s): The average live birth rate (LBR) in the training set was 40% (N = 207/511). Only time of morulation (tM) and trophectoderm quality were outlined as putative predictors of live birth at two IVF centers. In the validation set, the euploid blastocysts characterized by tM <80 hours and high-quality trophectoderm resulted in a LBR of 55.2% (n = 37/67), while those with tM >= 80 hours and a low-quality trophectoderm resulted in a LBR of 25.5% (N = 13/51).Conclusion(s): Time of morulation and trophectoderm quality are better predictors of a euploid blastocyst's reproductive competence. Our evidence was reproducible across different centers under specific culture conditions. These data support the crucial role of morulation for embryo development, a stage that involves massive morphologic, cellular, and molecular changes and deserves more investigation. (C) 2019 by American Society for Reproductive Medicine.c
Time of morulation and trophectoderm quality are predictors of a live birth after euploid blastocyst transfer: a multicenter study
Capalbo, Antonio;
2019-01-01
Abstract
Objective: To investigate whether the morphodynamic characterization of a euploid blastocyst's development allows a higher prediction of a live birth after single-embryo-transfer (SET).Design: Observational cohort study conducted in two phases: training and validation.Setting: Private in vitro fertilization centers.Patient(s): Euploid blastocysts: 511 and 319 first vitrified-warmed SETs from 868 and 546 patients undergoing preimplantation genetic testing for aneuploidies (PGT-A) in the training and validation phase, respectively.Intervention(s): Data collected from time of polar body extrusion to time of starting blastulation, and trophectoderm and inner-cellmass static morphology in all embryos cultured in a specific time-lapse incubator with a continuous medium. Logistic regressions conducted to outline the variables showing a statistically significant association with live birth. In the validation phase, these variables were tested in an independent data set.Main Outcome Measure(s): Live births per SET.Result(s): The average live birth rate (LBR) in the training set was 40% (N = 207/511). Only time of morulation (tM) and trophectoderm quality were outlined as putative predictors of live birth at two IVF centers. In the validation set, the euploid blastocysts characterized by tM <80 hours and high-quality trophectoderm resulted in a LBR of 55.2% (n = 37/67), while those with tM >= 80 hours and a low-quality trophectoderm resulted in a LBR of 25.5% (N = 13/51).Conclusion(s): Time of morulation and trophectoderm quality are better predictors of a euploid blastocyst's reproductive competence. Our evidence was reproducible across different centers under specific culture conditions. These data support the crucial role of morulation for embryo development, a stage that involves massive morphologic, cellular, and molecular changes and deserves more investigation. (C) 2019 by American Society for Reproductive Medicine.cI documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
