Trophectoderm grade predicts outcomes of single blastocyst transfers

Trophectoderm grading, but not inner cell mass grading, significantly correlates with implantation and live birth for single-embryo transfers.

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Micah J. Hill, D.O., Kevin S. Richter, Ph.D., Ryan J. Heitmann, D.O., James R. Graham, M.S., Michael J. Tucker, Ph.D., Alan H. DeCherney, M.D., Paulette E. Browne, M.D., Eric D. Levens, M.D.

Volume 99, Issue 5, Pages 1283-1289.e1, April 2013



To estimate the effect of the embryo stage, trophectoderm (TE) morphology grade, and inner cell mass (ICM) morphology grade on live birth in single blastocyst transfers.


Retrospective cohort study.


Large private ART practice.


Fresh autologous ART cycles.



Main outcome measures:

Live birth.


A total of 694 single blastocyst transfers met inclusion criteria. Univariate regression analysis showed embryo stage and TE score to be correlated with implantation and live birth. Live birth rates were 57%, 40%, and 25% for TE grades A, B, and C respectively. There was no significant association with ICM grade and implantation or live birth. Live birth rates were 53%, 52%, and 0% for ICM grades A, B, and C respectively. Multiple logistic regression analysis showed that only patient age and TE grade were significantly associated with implantation and live birth, while ICM grade was not significantly associated with outcome. The TE score had the strongest correlation with live birth.


TE grading, but not ICM grading, significantly correlated with implantation and live birth for single blastocyst transfers.

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Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility┬« is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders.