Day 3 morphology is a poor predictor of blastocyst quality in extended culture

被引:115
作者
Graham, J [1 ]
Han, T [1 ]
Porter, R [1 ]
Levy, M [1 ]
Stillman, R [1 ]
Tucker, MJ [1 ]
机构
[1] Shady Grove Reprod Sci Ctr, Rockville, MD USA
关键词
extended culture; blastocyst transfer; embryo quality; morphology;
D O I
10.1016/S0015-0282(00)00689-0
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Objective: To determine how the quality of blastocysts formed on day 5/6 of extended culture compares with their morphology on day 3. Design: Retrospective observational study of IVF laboratory records. Setting: Private assisted reproduction clinic. Patient(s): 101 IVF cycles in which 5 to 25 embryos were produced. The average maternal age was 33.1 years. Intervention(s): Embryos were individually cultured in vitro in sequential media for an extended time to enable use of blastocysts for fresh transfer or cryopreservation. Main Outcome Measure(s): Comparison of embryo quality for putative ET or cryopreservation on day 3 with quality of embryos used for actual ET and cryopreservation on day 5/6. Result(s): Of 1,263 cleaving embryos, 559 were judged to have been suitable for use on day 3; 355 would have been used for ET (average per ET, 3.5) and 204 would have been frozen (equivalent to 44% utilization). In actuality, 471 blastocysts were used on day 5/6, of which 234 were transferred (average per ET, 2.3), and 237 were frozen (equivalent to 37% utilization). Only 48% embryos that would have been chosen for ET and/or cryopreservation on day 3 were eventually used in such a manner at the blastocyst stage. Historically, the rate of viable pregnancy from day 3 transfers was 30.5% per transfer; this rate increased to 45% with routine day 5/6 transfers. Conclusion(s): Extended culture of human embryos seems to increase discrimination of potential embryonic viability. Criteria for embryo selection on day 3 seem to be inadequate. Extended in vitro culture may therefore be an effective means of optimizing IVF clinical success. (Fertil Steril(R) 2000,74.495-7. (C) 2000 by American Society for Reproductive Medicine.).
引用
收藏
页码:495 / 497
页数:3
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