Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Journal of Assisted Reproduction and Genetics
Published in: Journal of Assisted Reproduction and Genetics 9/2015

01-09-2015 | Assisted Reproduction Technologies

Is the presence of an uncleaved embryo on day 3 a useful predictor of outcomes following day 5 transfer?

Authors: Clara J. Men, Charles L. Bormann, Brian W. Walsh, Catherine Racowsky

Published in: Journal of Assisted Reproduction and Genetics | Issue 9/2015

Login to get access

Abstract

Purpose

This study aimed to determine whether the presence of an uncleaved embryo on day 3 is predictive of cycle outcome after day 5 transfer (D5 ET).

Methods

In vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) cycles from January 2013 to November 2014 with D5 ET were analyzed for the presence of at least one uncleaved embryo on day 3 (D3). Each index cycle (n = 70) was compared with two matched control cycles without uncleaved embryos. The main outcome measures included embryo quality, implantation rate, and clinical pregnancy rate.

Results

Fifty-nine of 3896 total embryos in this study were uncleaved on D3 (1.5 %). Cycles with uncleaved embryos had more oocytes retrieved (20.6 vs. 17.5), lower proportions of good quality embryos on D3 (52.4 vs. 66.1 %), and fewer usable embryos (transferred or frozen) on D5 (42.4 vs. 50.8 %). However, there were no significant differences in the incidence of cycles with a positive hCG, or in the rates of implantation, clinical pregnancy, or live birth.

Conclusions

Although an uncleaved embryo on D3 is associated with reduced conversion of sibling embryos to the blastocyst stage on D5, overall quality of those embryos forming blastocysts is not markedly decreased and clinical outcomes are not compromised.
Literature
1.
Edwards RG, Steptoe PC, Purdy JM. Establishing full-term human pregnancies using cleaving embryos grown in vitro. Br J Obstet Gynaecol. 1980;87(9):737–56.CrossRefPubMed
2.
Bolton VN, Wren ME, Parsons JH. Pregnancies after in vitro fertilization and transfer of human blastocysts. Fertil Steril. 1991;55:830–2.PubMed
3.
Gardner DK, Vella P, Lane M, Wagley L, Schlenker T, Schoolcraft WB. Culture and transfer of human blastocysts increases implantation rates and reduces the need for multiple embryo transfers. Fertil Steril. 1998;69:84–8.CrossRefPubMed
4.
Adler A, Lee HL, McCulloh DH, Ampeloquio E, Clarke-Williams M, Wertz BH, et al. Blastocyst culture selects for euploid embryos: comparison of blastomere and trophectoderm biopsies. Reprod Biomed Online. 2014;28(4):485–91.CrossRefPubMed
5.
Vega M, Breborowicz A, Moshier EL, McGovern PG, Keltz MD. Blastulation rates decline in a linear fashion from euploid to aneuploid embryos with single versus multiple chromosomal errors. Fertil Steril. 2014;102(2):394–8.CrossRefPubMed
6.
Dokras A, Sargent IL, Barlow DH. Human blastocyst grading: an indicator of developmental potential? Hum Reprod. 1993;8:2119–27.PubMed
7.
Gardner DK, Schoolcraft WB. In vitro culture of human blastocysts. In: Jansen R, Mortimer D, editors. Towards reproductive certainty: fertility and genetics beyond. London: Parthenon Publishing; 1999. p. 378–88.
8.
Gardner DK, Schoolcraft WB. Culture and transfer of human blastocysts. Curr Opin Obstet Gynecol. 1999;11:307–11.CrossRefPubMed
9.
Gardner D, Lane M, Stevens J, Schlenker T, Schoolcraft WB. Blastocyst score affects implantation and pregnancy outcome: towards a single blastocyst transfer. Fertil Steril. 2000;73:1155–58.CrossRefPubMed
10.
Balaban B, Urman B, Sertac A, Alatas C, Aksoy S, Mercan R. Blastocyst quality affects the success of blastocyst-stage embryo transfer. Fertil Steril. 2000;74:282–7.CrossRefPubMed
11.
Balaban B, Yakin K, Urman B. Randomized comparison of two different blastocyst grading systems. Fertil Steril. 2006;85:559–63.CrossRefPubMed
12.
Richter K, Harris D, Daneshmand S, Shapiro B. Quantitative grading of a human blastocyst: optimal inner cell mass size and shape. Fertil Steril. 2001;76:1157–67.CrossRefPubMed
13.
Treff NR, Tao X, Ferry KM, Su J, Taylor D, Scott Jr RT. Development and validation of an accurate quantitative real-time polymerase chain reaction-based assay for human blastocyst comprehensive chromosomal aneuploidy screening. Fertil Steril. 2012;97(4):819–24.CrossRefPubMed
14.
Scott Jr RT, Upham KM, Forman EJ, Hong KH, Scott KL, Taylor D, et al. Blastocyst biopsy with comprehensive chromosome screening and fresh embryo transfer significantly increases in vitro fertilization implantation and delivery rates: a randomized controlled trial. Fertil Steril. 2013;100(3):697–703.CrossRefPubMed
15.
Wells D, Kaur K, Grifo J, Glassner M, Taylor JC, Fragouli E, et al. Clinical utilization of a rapid low-pass whole genome sequencing technique for the diagnosis of aneuploidy in human embryos prior to implantation. J Med Genet. 2014;51(8):553–62.PubMedCentralCrossRefPubMed
16.
Valbuena D, Martin J, de Pablo JL, Remohi J, Pellicer A, Simon C. Increasing levels of estradiol are deleterious to embryonic implantation because they directly affect the embryo. Fertil Steril. 2001;76(5):962–8.CrossRefPubMed
17.
Fanchin R, Ayoubi JM. Uterine dynamics: impact on the human reproduction process. Reprod Biomed Online. 2009;18 Suppl 2:57–62.CrossRefPubMed
18.
Kawachiya S, Bodri D, Shimada N, Kato K, Takehara Y, Kato O. Blastocyst culture is associated with an elevated incidence of monozygotic twinning after single embryo transfer. Fertil Steril. 2011;95(6):2140–2.CrossRefPubMed
19.
Glujovsky D, Blake D, Bardach A, Farquhar C. Cleavage stage versus blastocyst stage embryo transfer in assisted reproductive technology. Cochrane Database Syst Rev. 2012;7:CD002118.PubMed
20.
Skiadas CC, Missmer SA, Benson CB, Gee RE, Racowsky C. Risk factors associated with pregnancies containing a monochorionic pair following assisted reproductive technologies. Hum Reprod. 2008;23(6):1366–71.CrossRefPubMed
21.
Papanikolaou EG, Kolibianakis EM, Tournaye H, Venetis C, Fatemi H, Tarlatzis B, et al. Live birth rates after transfer of equal number of blastocysts and cleavage stage embryos in IVF. A systematic review and meta-analysis. Hum Reprod. 2008;23:91–9.CrossRefPubMed
22.
Thomas MR, Sparks AE, Ryan GL, van Voorhis BJ. Clinical predictors of human blastocyst formation and pregnancy after extended culture and transfer. Fertil Steril. 2010;94:543–8.CrossRefPubMed
23.
Dessolle L, Freour T, Barriere P, Darai E, Ravel C, Jean M, et al. A cycle-based model to predict blastocyst transfer cancellation. Hum Reprod. 2010;25:598–604.CrossRefPubMed
24.
Braga DP, Setti AS, de Cássia S, Figueira R, Machado RB, Iaconelli Jr A, et al. Patient selection criteria for blastocyst transfers in extended embryo culture programs. J Assist Reprod Genet. 2012;29(12):1357–62.PubMedCentralCrossRefPubMed
25.
Kaser DJ, Racowsky C. Clinical outcomes following selection of human preimplantation embryos with time-lapse monitoring: a systematic review. Hum Reprod Update. 2014;20(5):617–31.CrossRefPubMed
26.
Kirkegaard K, Ahlstrom A, Ingerslev HJ, Hardarson T. Choosing the best embryo by time lapse versus standard morphology. Fertil Steril. 2015;103(2):323–32.CrossRefPubMed
27.
Braga DP, Setti AS, Figueira RC, Iaconelli Jr A, Borges Jr E. The importance of the cleavage stage morphology evaluation for blastocyst transfer in patients with good prognosis. J Assist Reprod Genet. 2014;31(8):1105–10.PubMedCentralCrossRefPubMed
28.
Reichman DE, Jackson KV, Racowsky C. Incidence and development of zygotes exhibiting abnormal pronuclear disposition after identification of two pronuclei at the fertilization check. Fertil Steril. 2010;94:965–70.CrossRefPubMed
29.
Racowsky C, Jackson KV, Cekleniak NA, Fox JH, Hornstein MD, Ginsburg ES. The number of eight-cell embryos is a key determinant for selecting day 3 or day 5 transfer. Fertil Steril. 2000;73(3):558–64.CrossRefPubMed
30.
Ceyhan ST, Jackson KV, Racowsky C. Selecting the most competent embryo. In: Carrell DT, Racowsky C, Schlegel PN, Van Voorhis BJ, editors. Biennial Review of Infertility, vol. 1. New York: Humana Press; 2009. p. 143–69.CrossRef
Metadata
Title
Is the presence of an uncleaved embryo on day 3 a useful predictor of outcomes following day 5 transfer?
Authors
Clara J. Men
Charles L. Bormann
Brian W. Walsh
Catherine Racowsky
Publication date
01-09-2015
Publisher
Springer US
Published in
Journal of Assisted Reproduction and Genetics / Issue 9/2015
Print ISSN: 1058-0468
Electronic ISSN: 1573-7330
DOI
https://doi.org/10.1007/s10815-015-0532-0

Other articles of this Issue 9/2015

Journal of Assisted Reproduction and Genetics 9/2015 Go to the issue

Genetics

Association between IL-6 −174 G/C, IL-6 −634 G/C, and IFN-γ +874 A/T polymorphisms and susceptibility to recurrent pregnancy loss: a meta-analysis

Case Report

Birth of a healthy child after preimplantation genetic screening of embryos from sperm of a man with non-mosaic Down syndrome

Genetics

Association of WNT4 polymorphisms with endometriosis in infertile patients

Events

A special thanks to JARG’s reviewers

Gamete Biology

Phospholipase C-zeta deficiency as a cause for repetitive oocyte fertilization failure during ovarian stimulation for in vitro fertilization with ICSI: a case report

Embryo Biology

Slow freezing should not be totally substituted by vitrification when applied to day 3 embryo cryopreservation: an analysis of 5613 frozen cycles