Can trophectoderm morphology act as a predictor for euploidy?

Area of Science:

• Reproductive Medicine
• Embryology
• Genetics

Background:

• Euploid embryo transfer is associated with higher implantation rates.
• Morphological evaluation is the primary method for embryo selection in Brazil due to the high cost of genetic analysis.
• Preimplantation genetic diagnosis/screening (PGD/PGS) is indicated for certain patients.

Purpose of the Study:

• To investigate the association between trophectoderm morphology and the ploidy status of human blastocysts.
• To determine if visual assessment of embryo quality correlates with genetic normality.

Main Methods:

• 113 blastocysts from 58 in vitro fertilization cycles were analyzed.
• Blastocysts were biopsied and categorized by trophectoderm morphology (grades A, B, C).
• Genetic analysis was performed using CGH array, SNP array, or Next-Generation Sequencing (NGS).

Main Results:

• 38.9% of the analyzed blastocysts were euploid.
• Euploidy rates varied significantly by trophectoderm grade: Grade A (71.43%), Grade B (60%), and Grade C (19.67%).
• A statistically significant difference (p≤0.05) was observed in euploidy rates across morphological grades.

Conclusions:

• While superior trophectoderm morphology correlates with higher euploidy rates, it is insufficient as a sole predictor of embryo genetic health.
• Morphological assessment should be complemented with genetic testing for accurate embryo selection.
• This finding has implications for assisted reproductive technology protocols and patient counseling.