Salim ERKAYA, Cavidan GÜLERMAN, Nafiye YILMAZ, Ayten TÜRKKANI, Meryem KURU PEKCAN, Yeşim BARDAKÇI, Yaprak ENGİN ÜSTÜN

Tek Blastokist Transfer Sikluslarında Morfolojik Parametrelerin IVF Sonuçlarına Etkisi

Amaç: Biz bu çalışmada tek blastokist transferi yapılan hastalarda 3 morfolojik parametrenin (blastosöl genişlemesi, trofektoderm (TE) morfolojik evrelemesi, iç hücre kütlesi (ICM)) klinik gebelik oranlarına etkisini araştırmayı amaçladık. Yöntem: Çalışmaya iki yıl içinde 75 taze 5. gün embriyo transferi yapılan hasta dahil edildi. IVF-ICSI işlemi sonrası klinik gebeliği olan hastalar grup 1 (n=30) ve işlem sonrası gebelik elde edilememiş hastalar grup 2 (n=44) olmak üzere ikiye ayrıldı. Blastokistler, Gardner ve Schoolcraft sınıflamasına göre evrelendirildi. Çiftlerin yaşları, vücut kitle indeksi, infertilite süresi, 3.gün folikül stimüle edici hormonu, lüteinize edici hormonu, gonadotropin uygulama süresi, toplam gonadotropin dozu, HCG uygulama günündeki östrojen düzeyi, toplanan oosit sayısı, metafaz 2’deki oosit sayısı, 2PN sayısı, TE morfolojisi, ICM morfolojisi, blastosöl genişlemesi kaydedilerek bu veriler iki grup arasında karşılaştırıldı. İstatistiksel karşılaştırmalar Ki-Kare testi ve student t test ile yapılarak, p değeri

The Effect of Morphological Parameters on IVF Outcomes in Single Blastocyst Transfer Cycles

Aim: Our aim is to evaluate the effect of three morphological parameters(Blastocoel expansion, trophectoderm (TE) morphology grade, and inner cellmass (ICM) morphology grade) on clinical pregnancy in single blastocysttransfers.Methods: The study included 74 fresh day 5 single blastocyst transfers in atwo-year period. There were 30 women with clinical pregnancy (Group 1).Women that failed to get pregnant after IVF/ICSI procedure were included inthe non-pregnant group (n = 44) (Group 2). The blastocysts were gradedaccording to Gardner and Schoolcraft. Age of the couple, body mass index,infertility duration, day 3 follicle stimulating hormone, luteinizing hormone,number of days of gonadotropin stimulation, total gonadotropin dose,estradiol level on the day of hCG administration, number of oocytesretrieved, number of metaphase II oocytes, number of 2PN, TE morphology,ICM morphology, blastocoel expansion were recorded. These outcomes werecompared between the two groups. Statistical comparisons were carried outby Chi-square test and Student “t” test. Regardless of the statistical test, onlya p value ≤ 0.05 was considered significant.Results: During the study period, 702 embryo transfers were performed; ofthese 74 (10.5%) were on Day 5. While number of oocytes retrieved, numberof metaphase II oocytes and 2PN increased in pregnant group, estradiol levelon the day of hCG administration, total gonadotropin dose, blastocoelexpansion were similar in both groups. ICM and TE morphology weresignificantly associated with pregnancy (p

PDF

___

Blake DA, Farquhar CM, Johnson N, Proctor M. Cleavage stage versus blastocyst stage embryo transfer in assisted conception. Cochrane Database Syst Rev 2007;4:CD002118.
Gardner DK, Schoolcraft WB. In vitro culture of human blastocyst. In: Mortimer JR, editor. Toward Reproductive Certainty: Infertility and Genetics Beyond 1999. Carnforth, UK, Parthenon Press; 1999: 378-88.
Dokras A, Sargent IL, Barlow DH. Human blastocyst grading: an indicator of developmental potential? Hum Reprod 1993;8:2119-27.
Shapiro BS, Harris DC, Richter KS. Predictive value of 72-hour blastomere cell number on blastocyst development and success of subsequent transfer based on the degree of blastocyst development. Fertil Steril 2000;73:582–6.
Yoon HJ, Yoon SH, Son WY, Im KS, Lim JH. High implantation and pregnancy rates with transfer of human hatching day 6 blastocysts. Fertil Steril 2001;75:832–3.
Richter KS, Harris DC, Daneshmand ST, Shapiro BS. Quantitative grading of a human blastocyst: optimal inner cell mass size and shape. Fertil Steril 2001;76:1157–67.
Shapiro BS, Richter KS, Harris DC, Daneshmand ST. A comparison of day 5 and day 6 blastocyst transfers. Fertil Steril 2001;75:1126–30.
Zaninovic N, Berrios R, Clarke RN, Bodine R, Ye Z, Veeck LL. Blastocyst expansion, inner cell mass (ICM) formation, and trophectoderm (TM) quality: is one more important for implantation? Fertil Steril 2001;76:S8.
Zhang H, Zhou Y, Li Y, Zheng Y, Xiao S, Wu Y, et al. Prediction of clinical pregnancy in vitrified-warmed single blastocyst transfer cycles by prefreeze morphology. Iran J Reprod Med. 2014;12:567–72.
Richter KS, Harris DC, Daneshmand ST, Shapiro BS. Quantitative grading of a human blastocyst: optimal inner cell mass size and shape. Fertil Steril 2001; 76: 1157-67.
Kovacic B, Vlaisavljevic V, Reljic M, Cizek-Sajko M. Developmental capacity of different morphological types of day 5 human morulae and blastocysts. Reprod Biomed Online 2004; 8: 687-94.
Ahlstrom A, Westin C, Reismer E, Wikland M, Hardarson T. Trophectoderm morphology: an important parameter for predicting live birth after single blastocyst transfer. Hum Reprod 2011;12:3289–96.
Van den Abbeel E, Balaban B, Ziebe S, Lundin K, Cuesta MJ, Klein BM, Helmgaard L, Arce JC. Association between blastocyst morphology and outcome of single-blastocyst transfer. Reprod Biomed Online. 2013;27:353-61.