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Updated: Jan 31, 2026
Protocol for Human Blastoids Modeling Blastocyst Development and Implantation
Published on: August 10, 2022
The correlation between morphology and implantation of euploid human blastocysts
Taraneh Gharib Nazem1, Lucky Sekhon1, Joseph A Lee2
1Reproductive Medicine Associates of New York, 635 Madison Avenue, 10th Floor, New York, NY 10022, USA; Department of Obstetrics and Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, Klingenstein Pavilion, 9th Floor, 1176 Fifth Avenue, New York, NY 10029, USA.
Research Question:
Does the composite morphology score or a particular developmental component (expansion stage, inner cell mass [ICM] or trophectoderm [TE]) of euploid blastocysts undergoing single frozen embryo transfer (FET) impact ongoing pregnancy/live birth (OP/LB) rates?
Design:
Retrospective cohort study including a total of 2236 embryos from 1629 patients who underwent single euploid FET between 2012 and 2017.
Results:
Embryos with an ICM grade of A compared with C had a higher OP/LB rate (55.6% versus 32.3%, P < 0.001). Blastocysts with a TE grade of A or B compared with C had a higher likelihood of OP/LB (A versus C: odds ratio [OR] 1.6, 99% confidence interval [CI] 1.1-2.3, B versus C: OR 1.5, 99% CI 1.1-2.1), and blastocysts with a developmental stage of 4 or 5 compared with 6 had higher odds of OP/LB (4 versus 6: OR 1.6, 99% CI 1.2-2.2, 5 versus 6: OR 1.6, 99% CI 1.2-2.3).
Conclusions:
Among euploid embryos, ICM morphology is the best predictor of sustained implantation; however, a composite score may provide additional guidance. While there is a known benefit in genomic screening prior to embryo selection, morphology provides individualized, prognostic information about implantation potential.
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