OBJECTIVE: Currently, there is no reliable morphological marker for chromosome aneuploidies during preimplantation embryo development that could be used as selection criteria for transfer. The aim of this study was to investigate D5 blastocyst morphology in association with comprehensive chromosome constitution of all 23 pairs of chromosomes.DESIGN: Retrospective study.MATERIALS AND METHODS: A total of 1,492 blastocysts (≥Grade 3BB) were biopsied and vitrified on either D5 or D6 of embryo development. D6 biopsied blastocysts were considered morphologically slow in development on D5 (morula, Grade 1 or Grade 2). Biopsied TE cells were analyzed for comprehensive chromosome screening (CCS) by mCGH (Reprogenetics) or SNP microarray (RMA-NJ). Analysis was performed based on D5 morphology regardless of the day of biopsy.RESULTS: In relation to D5 morphology, similarities in aneuploidy were observed for morula (55%), Grade 1 (56%), Grade 2 (59%) and Grade 3 (57%) blastocysts. In contrast, a significant decrease in aneuploidy was observed for Grade 4 (48%) (P<0.05) and Grade 5 (33%) (P<0.01) D5 blastocysts relative to earlier stages. A significant decrease in aneuploidy was also observed when more TE cells formed a cohesive epithelium compared to fewer TE cells (P<0.05). No significant differences were observed with inner cell mass grading. Ongoing clinical pregnancy rate following a frozen blastocyst transfer with euploid D5 biopsied blastocysts (63/79=79.8%) was significantly higher than with euploid D6 biopsied blastocysts (35/62=56.5%) (P<0.05). The CCS technique employed had no bearing on results when analyzed separately.CONCLUSION: Evaluation of D5 blastocyst morphology in relation to comprehensive chromosome constitution has revealed expanded and hatching D5 blastocysts to more likely be euploid. Nevertheless, this morphology indicator was not absolute. In addition, euploid D6 biopsied blastocysts exhibited poorer outcome following transfer, indicating multiple variables influence embryo viability and implantation. OBJECTIVE: Currently, there is no reliable morphological marker for chromosome aneuploidies during preimplantation embryo development that could be used as selection criteria for transfer. The aim of this study was to investigate D5 blastocyst morphology in association with comprehensive chromosome constitution of all 23 pairs of chromosomes. DESIGN: Retrospective study. MATERIALS AND METHODS: A total of 1,492 blastocysts (≥Grade 3BB) were biopsied and vitrified on either D5 or D6 of embryo development. D6 biopsied blastocysts were considered morphologically slow in development on D5 (morula, Grade 1 or Grade 2). Biopsied TE cells were analyzed for comprehensive chromosome screening (CCS) by mCGH (Reprogenetics) or SNP microarray (RMA-NJ). Analysis was performed based on D5 morphology regardless of the day of biopsy. RESULTS: In relation to D5 morphology, similarities in aneuploidy were observed for morula (55%), Grade 1 (56%), Grade 2 (59%) and Grade 3 (57%) blastocysts. In contrast, a significant decrease in aneuploidy was observed for Grade 4 (48%) (P<0.05) and Grade 5 (33%) (P<0.01) D5 blastocysts relative to earlier stages. A significant decrease in aneuploidy was also observed when more TE cells formed a cohesive epithelium compared to fewer TE cells (P<0.05). No significant differences were observed with inner cell mass grading. Ongoing clinical pregnancy rate following a frozen blastocyst transfer with euploid D5 biopsied blastocysts (63/79=79.8%) was significantly higher than with euploid D6 biopsied blastocysts (35/62=56.5%) (P<0.05). The CCS technique employed had no bearing on results when analyzed separately. CONCLUSION: Evaluation of D5 blastocyst morphology in relation to comprehensive chromosome constitution has revealed expanded and hatching D5 blastocysts to more likely be euploid. Nevertheless, this morphology indicator was not absolute. In addition, euploid D6 biopsied blastocysts exhibited poorer outcome following transfer, indicating multiple variables influence embryo viability and implantation.