ABSTRACT
<p><b>Background</b>Despite recent advances that have improved the pregnancy success rates that can be achieved via in vitro fertilization (IVF) therapy, it is not yet clear which blastocyst morphological parameters best predict the outcomes of single blastocyst transfer. In addition, most of the previous studies did not exclude the effect of embryo aneuploidy on blastocysts transfer. Thus, the present study investigated the predictive value of various parameters on the pregnancy outcomes achieved via the transfer of frozen euploid blastocysts.</p><p><b>Methods</b>The study retrospectively analyzed 914 single euploid blastocyst transfer cycles that were performed at the Peking University Third Hospital Reproductive Medical Center between June 2011 and May 2016. The expansion, trophectoderm (TE), and inner cell mass (ICM) quality of the blastocysts were assessed based on blastocyst parameters, and used to differentiate between "excellent", "good", "average", and "poor"-quality embryos. The relationship between these embryo grades and the achieved pregnancy outcomes was then analyzed via the Chi-square and logistic regression tests.</p><p><b>Results</b>For embryo grades of excellent, good, average and poor, the clinical pregnancy rates were 65.0%, 59.3%, 50.3% and 33.3%, respectively; and the live-birth rates were 50.0%, 49.7%, 42.3% and 25.0%, respectively. Both the clinical pregnancy rate (χ = 21.28, P = 0.001) and live-birth rate (χ = 13.50, P < 0.001) increased with the overall blastocyst grade. Both rates were significantly higher after the transfer of a blastocyst that exhibited either an A-grade or B-grade TE, and similarly, an A-grade ICM, than after the transfer of a blastocyst that exhibited a C-grade TE and/or ICM. The degree of blastocyst expansion had no apparent effect on the clinical pregnancy or live-birth rate. All odds ratio were adjusted for patient age, body mass index, length (years) of infertility history, and infertility type.</p><p><b>Conclusions</b>A higher overall euploid blastocyst quality is shown to correlate most strongly with optimal pregnancy outcomes. The study thus supports the use of the described TE and ICM morphological grades to augment current embryo selection criteria.</p>
Subject(s)
Female , Humans , Pregnancy , Blastocyst , Cell Biology , Physiology , Chi-Square Distribution , Embryo Transfer , Logistic Models , Odds Ratio , Pregnancy Outcome , Retrospective StudiesABSTRACT
Objective: to evaluate the effects of pre- and/or postnatal exposure to particulate air pollution on fertilization, embryo development, and cell lineage segregation in preimplantation blastocysts during late-life reproductive period, using the in vitro fertilization (IVF) mouse model. Materials and methods: five-month-old mice underwent superovulation and were pre- and/or postnatally exposed to filtered air (FA-FA), filtered-ambient air (FA-AA), or ambient air (AA-AA) in exposure chambers, 24 hours per day, during six months. Results: ovarian response was not affected by the exposure protocol. A multivariate effect for pre- and/or postnatal exposure to ambient air on blastocyst differential staining, but not on IVF and embryo development, was found. Cell counts in inner cell mass (ICM) and ICM/trophectoderm ratios in blastocysts produced in FA-FA protocol were significantly higher than in blastocysts produced in FA-AA and AA-AA protocols. Conclusions: our study suggests that the exposure to particulate air pollution of a large urban center does not affect ovarian function but may negatively affect the female reproductive health in the late-life period by disrupting the lineage specification at the blastocyst stage.
Objetivo: avaliar os efeitos da exposição pré e/ou pós-natal ao ar ambiente no final da vida reprodutiva sobre a fertilização, desenvolvimento embrionário e segregação das linhagens celulares em blastocistos pré-implantacionais, utilizando o modelo de fertilização in vitro (FIV) de camundongo. Material e métodos: fêmeas de camundongo com idade de cinco meses tiveram a ovulação estimulada e, no período pré e/ou pós-natal, foram expostas ao arfiltrado (AF-AF), ar filtrado-ar ambiente (AF-AA) ou ar ambiente-ar ambiente (AA-AA) em câmaras de exposição, 24 horas por dia durante seis meses. Resultados: a resposta ovariana não foi afetada pelo protocolo de exposição. Um efeito multivariável para a exposição pré e/ou pós-natal ao material particulado fino ambiente sobre coloração diferencial dos blastocistos, mas não sobre a FIV e o desenvolvimento embrionário, foi observado. A contagem celular na massa celular interna (MCI) e a razão MCI/trofoectoderma dos blastocistos produzidos no protocolo AF-AF foram significativamente maioresdo que aquelas em blastocistos produzidos nos protocolos FA-AA e AA-AA. Conclusões: nosso estudo sugere que a exposição à poluição ambiental particulada de um grande centro urbano não altera a função ovariana, mas pode afetar negativamente a saúde reprodutiva feminina no período final do menacme, em razão da alteração da especificação das linhagens celulares do embrião no estágio de blastocisto.