Predictive value of good morphology on days 2, 3 and 5 for blastocyst implantation

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ObjectiveThe question of whether to examine embryos every day to assess developmental potential or minimize assessment to limit environmental disruptions is a critical dilemma in the IVF laboratory. The objective of this study was to determine if good morphology on day 2, 3, or 5, either singly or in combination, is predictive of implantation.DesignRetrospective data analysis.Materials and MethodsEmbryos were assessed on Days 2 and 3 by analyzing cell number and fragmentation. Multinucleate embryos and those with > 20% fragmentation were excluded. Embryos were considered good quality if they had 4-6 blastomeres on day 2 and 7-12 blastomeres on day 3. Day 5 blastocysts were considered high quality if they had a well-developed blastocoele, inner cell mass and trophectoderm (3BB or better on the Gardner scale). Implantation rates were calculated for embryos with good morphology on days 2, 3, 5 and in combination. P-values of implantation rates were computed by X2 analysis and P values <0.05 were considered significant.ResultsTabled 1Culture Day#embryos with good morphology# embryos implanted%233414443.1 (b)331413442.7 (b)523111750.6 (a)2 and 329713244.4 (b)2 and 521111152.6 (a)3 and 520310752.7 (a)2 and 3 and 519810452.5 (a)(a) significantly greater than (b) but not from each other. Open table in a new tab ConclusionGood morphology at the blastocyst stage (3BB or better on the Gardner scale) is significantly more predictive of implantation than morphology assessments on day 2 or 3. Combinations of day 2 and 3 with day 5 will increase predictive value but not significantly more than a single day 5 assessment. ObjectiveThe question of whether to examine embryos every day to assess developmental potential or minimize assessment to limit environmental disruptions is a critical dilemma in the IVF laboratory. The objective of this study was to determine if good morphology on day 2, 3, or 5, either singly or in combination, is predictive of implantation. The question of whether to examine embryos every day to assess developmental potential or minimize assessment to limit environmental disruptions is a critical dilemma in the IVF laboratory. The objective of this study was to determine if good morphology on day 2, 3, or 5, either singly or in combination, is predictive of implantation. DesignRetrospective data analysis. Retrospective data analysis. Materials and MethodsEmbryos were assessed on Days 2 and 3 by analyzing cell number and fragmentation. Multinucleate embryos and those with > 20% fragmentation were excluded. Embryos were considered good quality if they had 4-6 blastomeres on day 2 and 7-12 blastomeres on day 3. Day 5 blastocysts were considered high quality if they had a well-developed blastocoele, inner cell mass and trophectoderm (3BB or better on the Gardner scale). Implantation rates were calculated for embryos with good morphology on days 2, 3, 5 and in combination. P-values of implantation rates were computed by X2 analysis and P values <0.05 were considered significant. Embryos were assessed on Days 2 and 3 by analyzing cell number and fragmentation. Multinucleate embryos and those with > 20% fragmentation were excluded. Embryos were considered good quality if they had 4-6 blastomeres on day 2 and 7-12 blastomeres on day 3. Day 5 blastocysts were considered high quality if they had a well-developed blastocoele, inner cell mass and trophectoderm (3BB or better on the Gardner scale). Implantation rates were calculated for embryos with good morphology on days 2, 3, 5 and in combination. P-values of implantation rates were computed by X2 analysis and P values <0.05 were considered significant. ResultsTabled 1Culture Day#embryos with good morphology# embryos implanted%233414443.1 (b)331413442.7 (b)523111750.6 (a)2 and 329713244.4 (b)2 and 521111152.6 (a)3 and 520310752.7 (a)2 and 3 and 519810452.5 (a)(a) significantly greater than (b) but not from each other. Open table in a new tab (a) significantly greater than (b) but not from each other. ConclusionGood morphology at the blastocyst stage (3BB or better on the Gardner scale) is significantly more predictive of implantation than morphology assessments on day 2 or 3. Combinations of day 2 and 3 with day 5 will increase predictive value but not significantly more than a single day 5 assessment. Good morphology at the blastocyst stage (3BB or better on the Gardner scale) is significantly more predictive of implantation than morphology assessments on day 2 or 3. Combinations of day 2 and 3 with day 5 will increase predictive value but not significantly more than a single day 5 assessment.