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Updated: Jan 1, 2026
Human Blastocyst Biopsy and Vitrification
Published on: July 26, 2019
Time of morulation and trophectoderm quality are predictors of a live birth after euploid blastocyst transfer: a
Laura Rienzi1, Danilo Cimadomo1, Arantxa Delgado2
1Clinica Valle Giulia, G.EN.E.R.A. Centers for Reproductive Medicine, Rome, Italy.
Objective:
To investigate whether the morphodynamic characterization of a euploid blastocyst's development allows a higher prediction of a live birth after single-embryo-transfer (SET).
Design:
Observational cohort study conducted in two phases: training and validation.
Setting:
Private in vitro fertilization centers.
Patient(S):
Euploid blastocysts: 511 and 319 first vitrified-warmed SETs from 868 and 546 patients undergoing preimplantation genetic testing for aneuploidies (PGT-A) in the training and validation phase, respectively.
Intervention(S):
Data collected from time of polar body extrusion to time of starting blastulation, and trophectoderm and inner-cell-mass static morphology in all embryos cultured in a specific time-lapse incubator with a continuous medium. Logistic regressions conducted to outline the variables showing a statistically significant association with live birth. In the validation phase, these variables were tested in an independent data set.
Main Outcome Measure(S):
Live births per SET.
Result(S):
The average live birth rate (LBR) in the training set was 40% (N = 207/511). Only time of morulation (tM) and trophectoderm quality were outlined as putative predictors of live birth at two IVF centers. In the validation set, the euploid blastocysts characterized by tM <80 hours and high-quality trophectoderm resulted in a LBR of 55.2% (n = 37/67), while those with tM ≥ 80 hours and a low-quality trophectoderm resulted in a LBR of 25.5% (N = 13/51).
Conclusion(S):
Time of morulation and trophectoderm quality are better predictors of a euploid blastocyst's reproductive competence. Our evidence was reproducible across different centers under specific culture conditions. These data support the crucial role of morulation for embryo development, a stage that involves massive morphologic, cellular, and molecular changes and deserves more investigation.
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