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Reproductive Biology and Endocrinology
Published in: Reproductive Biology and Endocrinology 1/2020

01-12-2020 | Miscarriage | Research

Association between the quality of inner cell mass and first trimester miscarriage after single blastocyst transfer

Authors: Dayuan Shi, Jiawei Xu, Meixiang Zhang, Wenbin Niu, Hao Shi, Guidong Yao, Ying Li, Nan Zhang, Yingpu Sun

Published in: Reproductive Biology and Endocrinology | Issue 1/2020

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Abstract

Background

The blastocyst morphology provided valuable roles for predicting pregnancy and live birth, but was still not fully understood for evaluating miscarriage. The aim of this study was to explore the association between blastocyst morphologic evaluation and first trimester miscarriage combined with karyotype of miscarried conceptus.

Methods

This retrospective cohort study included a total of 2873 clinical pregnancy cycles with single blastocyst transfer performed from January 2013 to April 2019. Chromosome karyotype of miscarried conceptus was analyzed via single nucleotide polymorphism array analysis. Miscarriage and karyotype of miscarried conceptus associated with blastocyst morphology were analyzed by chi-square and logistic regression analysis.

Results

A total of 354 (12.3%) cycles resulted in first trimester miscarriage. Miscarriage rates increased with trophectoderm (TE) grade from A to C (P = 0.012), while three morphologic parameters (blastocoele expansion degree, inner cell mass (ICM) and TE) showed no statistical significance with miscarriage after multivariable analysis. The rate of aneuploidy was 47.7% (83 of 174) in total miscarried conceptuses. For euploid miscarriages, the grade B of ICM occupied a higher proportion compared with aneuploidy, with OR of 2.474, (95% CI, 1.311–4.699), P = 0.005.

Conclusions

Chromosomal aberration of embryo is an important genetic factor for first trimester miscarriage, and the quality of ICM is a potential indicator for euploid miscarriage. Blastocysts with grade A of ICM should be given priority during single blastocyst transfer to reduce potential miscarriage.
Literature
1.
Gardner DK, Lane M, Stevens J, Schlenker T, Schoolcraft WB. Blastocyst score affects implantation and pregnancy outcome towards a single blastocyst transfer. Fertil Steril. 2000;73:1155–8.CrossRef
2.
Balaban B, Urman B, Ata B, Isiklar A, Larman MG, Hamilton R, et al. A randomized controlled study of human day 3 embryo cryopreservation by slow freezing or vitrification: vitrification is associated with higher survival, metabolism and blastocyst formation. Hum Reprod. 2008;23:1976–82.CrossRef
3.
Cooke S, Quinn P, Kime L, Ayres C, Tyler JPP, Driscoll GL. Improvement in early human embryo development using new formulation sequential stage-specific culture media. Fertil Steril. 2002;78:1254–60.CrossRef
4.
Papanikolaou EG, Kolibianakis EM, Tournaye H, Venetis CA, Fatemi H, Tarlatzis B, et al. Live birth rates after transfer of equal number of blastocysts or cleavage-stage embryos in IVF. A systematic review and meta-analysis. Hum Reprod. 2008;23:91–9.CrossRef
5.
6.
Kalu E, Thum MY, Abdalla H. Reducing multiple pregnancy in assisted reproduction technology: towards a policy of single blastocyst transfer in younger women. BJOG. 2008;115:1143–50.CrossRef
7.
Irani M, Reichman D, Robles A, Melnick A, Davis O, Zaninovic N, et al. Morphologic grading of euploid blastocysts influences implantation and ongoing pregnancy rates. Fertil Steril. 2017;107:664–70.CrossRef
8.
Thompson SM, Onwubalili N, Brown K, Jindal SK, McGovern PG. Blastocyst expansion score and trophectoderm morphology strongly predict successful clinical pregnancy and live birth following elective single embryo blastocyst transfer (eSET): a national study. J Assist Reprod Genet. 2013;30:1577–81.CrossRef
9.
Du QY, Wang EY, Huang Y, Guo XY, Xiong YJ, Yu YP, et al. Blastocoele expansion degree predicts live birth after single blastocyst transfer for fresh and vitrified/warmed single blastocyst transfer cycles. Fertil Steril. 2016;105:910–9 e1.CrossRef
10.
Bakkensen JB, Brady P, Carusi D, Romanski P, Thomas AM, Racowsky C. Association between blastocyst morphology and pregnancy and perinatal outcomes following fresh and cryopreserved embryo transfer. J Assist Reprod Genet. 2019;36:2315–24.CrossRef
11.
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;26:3289–96.CrossRef
12.
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.CrossRef
13.
Honnma H, Baba T, Sasaki M, Hashiba Y, Ohno H, Fukunaga T, et al. Trophectoderm morphology significantly affects the rates of ongoing pregnancy and miscarriage in frozen-thawed single-blastocyst transfer cycle in vitro fertilization. Fertil Steril. 2012;98:361–7.CrossRef
14.
Van den Abbeel E, Balaban B, Ziebe S, Lundin K, Cuesta MJ, Klein BM, et al. Association between blastocyst morphology and outcome of single-blastocyst transfer. Reprod Biomed Online. 2013;27:353–61.CrossRef
15.
Hill MJ, Richter KS, Heitmann RJ, Graham JR, Tucker MJ, DeCherney AH, et al. Trophectoderm grade predicts outcomes of single-blastocyst transfers. Fertil Steril. 2013;99:1283–9 e1.CrossRef
16.
Chen X, Zhang J, Wu X, Cao S, Zhou L, Wang Y, et al. Trophectoderm morphology predicts outcomes of pregnancy in vitrified-warmed single-blastocyst transfer cycle in a Chinese population. J Assist Reprod Genet. 2014;31:1475–81.CrossRef
17.
Nazem TG, Sekhon L, Lee JA, Overbey J, Pan S, Duke M, et al. The correlation between morphology and implantation of euploid human blastocysts. Reprod Biomed Online. 2019;38:169–76.CrossRef
18.
Capalbo A, Rienzi L, Cimadomo D, Maggiulli R, Elliott T, Wright G, et al. Correlation between standard blastocyst morphology, euploidy and implantation: an observational study in two centers involving 956 screened blastocysts. Hum Reprod. 2014;29:1173–81.CrossRef
19.
Minasi MG, Colasante A, Riccio T, Ruberti A, Casciani V, Scarselli F, et al. Correlation between aneuploidy, standard morphology evaluation and morphokinetic development in 1730 biopsied blastocysts: a consecutive case series study. Hum Reprod. 2016;31:2245–54.CrossRef
20.
Mukaida T, Oka C, Goto T, Takahashi K. Artificial shrinkage of blastocoeles using either a micro-needle or a laser pulse prior to the cooling steps of vitrification improves survival rate and pregnancy outcome of vitrified human blastocysts. Hum Reprod. 2006;21:3246–52.CrossRef
21.
Kuwayama M, Vajta G, Kato O, Leibo SP. Highly efficient vitrification method for cryopreservation of human oocytes. Reprod Biomed Online. 2005;11:300–8.CrossRef
22.
Bu Z, Hu L, Su Y, Guo Y, Zhai J, Sun Y-P. Factors related to early spontaneous miscarriage during IVF/ICSI treatment: an analysis of 21,485 clinical pregnancies. Reprod Biomed Online. 2020;40:201–6.CrossRef
23.
Hipp H, Crawford S, Kawwass JF, Chang J, Kissin DM, Jamieson DJ. First trimester pregnancy loss after fresh and frozen in vitro fertilization cycles. Fertil Steril. 2016;105:722–8.CrossRef
24.
Edwards RG. Clinical approaches to increasing uterine receptivity during human implantation. Hum Reprod. 1995;10:60–6.CrossRef
25.
Ruan HC, Zhu XM, Luo Q, Liu AX, Qian YL, Zhou CY, et al. Ovarian stimulation with GnRH agonist, but not GnRH antagonist, partially restores the expression of endometrial integrin beta3 and leukaemia-inhibitory factor and improves uterine receptivity in mice. Hum Reprod. 2006;21:2521–9.CrossRef
26.
Barash OO, Ivani KA, Willman SP, Rosenbluth EM, Wachs DS, Hinckley MD, et al. Association between growth dynamics, morphological parameters, the chromosomal status of the blastocysts, and clinical outcomes in IVF PGS cycles with single embryo transfer. J Assist Reprod Genet. 2017;34:1007–16.CrossRef
27.
Practice Committee of the American Society for Reproductive M, Practice Committee of the Society for Assisted Reproductive T. Role of assisted hatching in in vitro fertilization: a guideline. Fertil Steril. 2014;102:348–51.CrossRef
Metadata
Title
Association between the quality of inner cell mass and first trimester miscarriage after single blastocyst transfer
Authors
Dayuan Shi
Jiawei Xu
Meixiang Zhang
Wenbin Niu
Hao Shi
Guidong Yao
Ying Li
Nan Zhang
Yingpu Sun
Publication date
01-12-2020
Publisher
BioMed Central
Keyword
Miscarriage
Published in
Reproductive Biology and Endocrinology / Issue 1/2020
Electronic ISSN: 1477-7827
DOI
https://doi.org/10.1186/s12958-020-00595-y

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