Analysis of Morphology of Single-Embryo Transfers and Correlation With Antepartum Biomarkers and Obstetric Outcomes [353]. (May 2015) - Rekawek, Patricia
Abstract : INTRODUCTION: Embryo morphology during in vitro fertilization has previously been studied in association with rates of implantation and live birth rates. The objective of this project is to evaluate the effect of embryo morphology on antepartum biomarkers and obstetric outcomes after single-embryo transfer. METHODS: At a single reproductive endocrinology and infertility center, 17, 768 embryo transfers were performed between July 1, 2001, and June 30, 2013. Of those, 2, 882 were single-embryo transfers performed on day 3, 5, or 6. After obtaining institutional review board consent to correlate embryo morphology with perinatal outcomes, we identified 78 patients who delivered at a single institution. We compared embryo morphology, using the Garner and Schoolcraft system of grading including embryo expansion, inner cell mass, and trophectoderm to antepartum biomarkers and pregnancy outcomes. Statistical analysis was performed using t tests for parametric data and Kruskal-Wallis, as indicated. RESULTS: Complete embryologic, serologic, and obstetric outcomes were available for fresh (n=55) and frozen (n=23) single-embryo transfers. Standard biomarkers and obstetric outcomes were correlated with cleavage stage (n=23) and blastocyst (n=55) morphology scores. Embryos with a higher quality inner cell mass demonstrated higher second-trimester maternal serum α-fetoprotein ( P <.044). No other differences in standard biomarkers (first and second trimesters) or perinatal outcomes were observed. CONCLUSION: In this retrospective pilot study we demonstrated that embryo morphokinetics did not correlate with perinatal outcome or the majority of placental biomarkers. Patients should be reassured that embryos of lower morphologic quality that implant result in comparable biomarkers and obstetric outcomes similar to those from higher quality embryos.