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.