Morphological analysis at compacting stage is a valuable prognostic tool for ICSI patients

Area of Science:

• Embryology
• Reproductive Medicine
• In Vitro Fertilization

Background:

• Day-4 embryo morphology has limited prognostic value for treatment outcomes.
• Current embryo assessment methods may not fully capture developmental potential.

Purpose of the Study:

• To develop and validate a modified day-4 embryo scoring system.
• To assess the prognostic power of this score for blastocyst formation, quality, and pregnancy rates.

Main Methods:

• A day-4 embryo score was applied to 56 patients, categorizing embryos based on compaction.
• Embryos were graded (C1-C4) based on compaction status and morphological features like cytoplasm loss or incomplete incorporation of blastomeres.
• Blastulation rates, blastocyst quality, and pregnancy rates were compared across different embryo grades.

Main Results:

• Non-compacting embryos had significantly lower blastulation rates (28.8%) compared to compacting (68.8%) and fully compacted embryos (84.6%).
• Optimal quality grade C1 embryos showed superior blastocyst formation (94.4%) and top-quality blastocyst rates compared to C3 (68.2%) and C2 embryos.
• Blastocysts from grade C1/C4 embryos resulted in higher pregnancy rates than those from C2/C3 embryos.

Conclusions:

• The modified day-4 embryo scoring system effectively predicts blastocyst formation, quality, and pregnancy outcomes.
• This score enhances the prognostic capability of early-stage embryo assessment in IVF.
• The system offers a valuable tool for optimizing patient selection and treatment planning in assisted reproduction.