Prognostic value of blastocyst grade after frozen euploid embryo transfer in patients with recurrent pregnancy loss

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VOLUME 1, ISSUE 2, P113-118, SEPTEMBER 01, 2020

Authors:

Gayathree Murugappan, M.D., Julia G. Kim, M.D., Jonathan D. Kort, M.D., Brent M. Hanson, M.D., Shelby A. Neal, M.D., Ashley W. Tiegs, M.D., Emily K. Osman, M.D., Richard T. Scott, M.D., Ruth B. Lathi, M.D.

Abstract:

Objective

To determine whether trophectoderm (TE) grade or inner cell mass (ICM) grade have predictive value after euploid frozen embryo transfer (euFET) among recurrent pregnancy loss (RPL) patients.


Design

Retrospective cohort study.


Setting

Single fertility center.


Patient(s)

Women with ≥2 prior pregnancy losses with ≥1 euploid embryo for transfer undergoing preimplantation genetic testing for aneuploidy.


Intervention(s)

Intracytoplasmic sperm injection, TE biopsy, blastocyst grading and vitrification, and single euFET, with first transfer outcome recorded.


Main Outcome Measure(s)

Live birth and clinical miscarriage rates.


Result(s)

The study included 660 euFET cycles. In a binomial logistic regression analysis accounting for age, body mass index, antimüllerian hormone level, and day of blastocyst biopsy, or ICM grade C was not significantly associated with odds of live birth, miscarriage, or biochemical pregnancy loss. TE grade C was significantly associated with odds of live birth and was not associated with odds of miscarriage or biochemical pregnancy loss. Blastocyst grade CC had significantly lower live birth rate compared with all other blastocyst grades.


Conclusion(s)

Embryo grade CC and TE grade C are associated with decreased odds of live birth after euFET in RPL patients. Embryo grade is not associated with odds of clinical miscarriage in this cohort of RPL patients, suggesting that additional embryonic or uterine factors may influence the risk of pregnancy loss.

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. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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