Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA.
J Assist Reprod Genet. 2013 Apr;30(4):563-7. doi: 10.1007/s10815-013-9932-1. Epub 2013 Feb 20.
Prior studies have validated the ability of the SART embryo scoring system to correlate with outcomes in cleavage stage embryo transfers. However, this scoring system has not been evaluated in blastocyst transfers. The objective of this study was to estimate the correlation between the simplified SART embryo scoring system and ART cycle outcomes in single blastocyst transfers.
All fresh, autologous single blastocyst transfers cycles from a large ART center from 2010 were analyzed. Blastocysts were given a single grade of good, fair, or poor based upon SART criteria which combines the grading of the inner cell mass and trophectoderm. Multiple logistic regression assessed the predictive value of the SART grade on embryo implantation and live birth.
Seven hundred seventeen fresh, autologous single blastocyst transfers cycles were included in the analysis. The live birth rate was 52 % and included both elective and non-elective SBT. Chi square analysis showed higher live birth in good grade embryos as compared to fair (p=0.03) and poor (p=0.02). Univariate binary logistic regression analysis demonstrated SART embryo grading to be significantly correlated with both implantation and live birth (p<0.01). This significance persisted when patient age, BMI, and the stage of the blastocyst were controlled for with multiple logistic regression. In five patients with a poor blastocyst score, there were no live births.
These data demonstrate that the SART embryo scoring system is highly correlated to implantation and live birth in single blastocyst transfers. Patients with a good grade embryo are excellent candidates for a single blastocyst transfer.
先前的研究已经验证了 SART 胚胎评分系统在卵裂期胚胎移植中与结局相关的能力。然而,该评分系统尚未在囊胚移植中进行评估。本研究的目的是评估简化的 SART 胚胎评分系统与单个囊胚移植的 ART 周期结局之间的相关性。
分析了来自一个大型 ART 中心的 2010 年所有新鲜的、自体的单个囊胚移植周期。根据 SART 标准,将囊胚评为良好、中等或差,该标准结合了内细胞团和滋养层的分级。多变量逻辑回归评估了 SART 等级对胚胎着床和活产的预测价值。
共纳入 717 例新鲜、自体的单个囊胚移植周期。活产率为 52%,包括选择性和非选择性 SBT。卡方分析显示,良好等级的胚胎活产率高于中等(p=0.03)和差(p=0.02)。单变量二项逻辑回归分析表明,SART 胚胎分级与着床和活产均显著相关(p<0.01)。当控制患者年龄、BMI 和囊胚阶段时,这种显著性在多变量逻辑回归中仍然存在。在 5 名囊胚评分较差的患者中,没有活产。
这些数据表明,SART 胚胎评分系统与单个囊胚移植中的着床和活产高度相关。具有良好等级胚胎的患者是单个囊胚移植的优秀候选者。