Beyond appearance: Can morphologically low-grade euploid blastocysts yield successful pregnancies?

Area of Science:

• Reproductive Medicine
• Embryology
• In Vitro Fertilization

Background:

• Preimplantation genetic testing for aneuploidies (PGT-A) identifies euploid embryos.
• Embryo morphology is a key factor in assessing embryo viability.
• The impact of specific morphological parameters on pregnancy outcomes requires further clarification.

Purpose of the Study:

• To evaluate the effect of morphological quality on pregnancy outcomes in euploid embryos.
• To identify specific morphological aspects most influential for pregnancy success.

Main Methods:

• Retrospective analysis of 451 euploid embryo transfer cycles.
• Embryos assessed for blastocyst expansion, ICM, TE morphology, and vitrification day.
• Comparison of outcomes between low-grade and high-grade morphologically assessed embryos.

Main Results:

• Morphologically low-grade blastocysts showed significantly lower pregnancy outcomes compared to high-grade ones.
• Inner cell mass (ICM) assessment was significantly associated with live birth rate.
• Trophectoderm (TE) and expansion grade did not show significant associations with live birth rate.

Conclusions:

• Morphological quality of euploid embryos is critical for In Vitro Fertilization-Embryo Transfer (IVF-ET) success.
• Inner cell mass (ICM) evaluation is a significant predictor of live birth rates.
• Focusing on ICM quality can optimize embryo selection for improved IVF outcomes.