Abstract

I. BACKGROUND AND AIMS: Many studies have shown predicted value for embryo development potential or morpho-kinetic parameters. This study aims to determine the correlation between the embryo morpho-kinetic parameters up to the cleavage stage and blastocyst implantation capability in frozen embryo transfer (FET) cycles. II. METHODS: A retrospective cohort study was conducted on 383 good-quality blastocysts of FET cycles from March 2020 to December 2022 at Tam Anh General Hospital. The study evaluated the differences in parameters, including tPNa, tPNf, t2 - t8, cc1, cc2, cc3, s2, s3, and abnormal division (direct, reverse cleavage) between the implant and non-implant groups. Using R’s rpart package, a hierarchical implantation model was created using the decision tree approach. The prognostic value of the model was assessed using ROC. III. RESULTS: 383 blastocysts from 368 FET cycles were examined in our study, of which 222 (57.9%) were implanted and 161 (42.1%) were not. Timing parameters of implanted embryos tended to be longer than that in the non-implanted group, and the division process of blastomeres was more synchronized, however not statistically. Embryos with direct cleavage had a significantly reduced implantation rate compared with non-direct groups (29.0% and 61.0%, p < 0.05) Analysis of morpho-kinetic parameters enabled us to develop a hierarchical model that places the direct cleavage, tPNa, and cc1 as the variables with the best prognosis of implantation. The AUC value of the model was 0.641. IV. CONCLUSION: The study showed that morpho-kinetic parameters at the early division stage have the predictive value of blastocyst implantation and can supplement traditional morphological assessment in embryo selection.

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