Good-quality blastocysts derived from vacuolized morulas show reduced viability

Late onset of vacuolization around compaction stage is a negative predictor of blastocyst formation and outcome.
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Volume 109, Issue 6, Pages 1025–1029

Authors:

Richard B. Mayer, M.D., Omar Shebl, M.D., Peter Oppelt, M.D., Elisabeth Reiter, M.D., Reinhard Altmann, M.D., S. Enengl, M.D., Christina Allerstorfer, M.D., Thomas Ebner, Ph.D.

Abstract:

Objective

To study whether late spontaneous vacuolization on day 4 is an artefact or an alternate means of blastocele formation and to analyze its impact on pregnancy outcome and live birth.

Design

Prospective observational study.

Setting

University teaching hospital.

Patient(s)

A total of 424 patients who fulfilled inclusion criteria were subgrouped according to the spontaneous vacuolization on day 4: Group 1 had all morulas affected, group 2 showed no signs of vacuoles, and group 3 was mixed (some day 4 embryos had vacuoles and others did not).

Intervention(s)

Screening for the presence of vacuoles on day 4 and fresh single-blastocyst transfer.

Main Outcome Measure(s)

Morula and blastocyst scoring, utilization rate, pregnancy and live birth rates.

Result(s)

Patients of group 1 had a reduced blastocyst formation rate on day 5 (P<.01) and significantly fewer good-quality blastocysts for usage (P<.05). In addition, pregnancy (P<.001) and live birth (P<.01) rate were significantly worse in group 1 compared with groups 2 and 3.

Conclusion(s)

Late onset of vacuolization around compaction stage is a negative predictor of blastocyst formation and outcome.


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