Morphology of inner cell mass: a better predictive biomarker of blastocyst viability

PeerJ

article

Sargunadevi Sivanantham¹  Mahalakshmi Saravanan²  Nidhi Sharma³  Jayashree Shrinivasan³  Ramesh Raja⁴ 

[1]Department of IVF, ARC International Fertility and Research Centre

[2]Department of Reproductive Medicine, ARC International Fertility and Research Centre

[3]Department of Obstetrics and Gynaecology, Saveetha Medical College

[4]Department of Andrology and Reproductive Medicine, Chettinad Hospital and Research Institute

关键词: Inner cell mass;    Blastocyst;    Morphology;    Biomarker;    Viability;    Implantation;    Clinical pregnancy;    Embryo selection;    Trophectoderm;   

DOI  :  10.7717/peerj.13935

学科分类：社会科学、人文和艺术（综合）

来源: Inra

【 摘 要 】

BackgroundTransfer of embryos at the blastocyst stage is one of the best approaches for achieving a higher success rate in In vitro fertilization (IVF) treatment as it demonstrates an improved uterine and embryonic synchrony at implantation. Despite novel biochemical and genetic markers proposed for the prediction of embryo viability in recent years, the conventional morphological grading of blastocysts remains the classical way of selection in routine practice. This study aims to investigate the association between the morphological features of blastocysts and pregnancy outcomes.MethodsThis prospective study included women undergoing single or double frozen blastocyst transfers following their autologous cycles in a period between October 2020 and September 2021. The morphological grades (A—good, B—average, and C—poor) of inner cell mass (ICM) and trophectoderm (TE) of blastocysts with known implantation were compared to assess their predictive potential of pregnancy outcome. It was further explored by measuring the relationship between the two variables using logistic regression and receiver operating characteristic (ROC) analysis.ResultsA total of 1,972 women underwent frozen embryo transfer (FET) cycles with a total of 3,786 blastocysts. Known implantation data (KID) from 2,060 blastocysts of 1,153 patients were subjected to statistical analysis, the rest were excluded. Implantation rates (IR) from transfer of ICM/TE grades AA, AB, BA, BB were observed as 48.5%, 39.4%, 23.4% and 25% respectively. There was a significantly higher IR observed in blastocysts with ICM grade A (p < 0.001) than those with B irrespective of their TE scores. The analysis of the interaction between the two characteristics confirmed the superiority of ICM over TE as a predictor of the outcome. The rank biserial correlation value for ICM was also greater compared to that of TE (0.11 vs 0.05).ConclusionThis study confirms that the morphology of ICM of the blastocyst is a stronger predictor of implantation and clinical pregnancy than that of TE and can be utilized as a biomarker of viability.

【 授权许可】

CC BY