Utsuno Hiroki, Ishimaru Tomoko, Matsumoto Miho, Sasamori Chiharu, Takahashi Hikaru, Kimura Hiroko, Kamijo Shintaro, Yamada Mitsutoshi, Tanaka Mamoru, Hamatani Toshio
Clinical Laboratory, Keio University Hospital, Tokyo, Japan.
Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan.
F S Rep. 2022 Nov 11;4(1):85-92. doi: 10.1016/j.xfre.2022.11.001. eCollection 2023 Mar.
To explore a morphometric grading system for blastocysts that is associated with ongoing pregnancy.
Cross-sectional study.
None.
All consecutive vitrified blastocysts at our center from July 2018 to November 2021 that were transferred in single blastocyst transfer cycles until January 2022.
None.
The ongoing pregnancy rate after a single vitrified-warmed blastocyst transfer. Interobserver agreement on morphometric values among embryologists.
Three morphometric variables (blastocyst diameter, area of inner cell mass [ICM], and the estimated trophectoderm cell count) were used to evaluate the expansion, ICM, and trophectoderm morphology. During the study period, 585 blastocysts were involved in this study. Of the 3 morphometric variables, ICM area (per 500 μm, adjusted odds ratio, 1.19; 95% confidence interval, 1.09-1.30) and estimated trophectoderm cell count (per 10 cells, adjusted odds ratio, 1.25; 95% confidence interval, 1.12-1.39) were significantly associated with the ongoing pregnancy rate after adjustment for confounding factors. The ongoing pregnancy rate was 2.0% (1/49) with an ICM area of <2,500 μm and the estimated trophectoderm cell count <70. The ongoing pregnancy rate reached 47.8% (22/46) when the ICM area and the estimated trophectoderm cell count were >3,500 μm and >110, respectively. Interobserver agreement on the blastocyst diameter, ICM area, and the estimated trophectoderm cell count was excellent-to-good among 5 embryologists (intraclass correlation coefficients: 0.99, 0.87, and 0.91, respectively).
Morphometric values of ICM and trophectoderm are promising predictors of pregnancy success. The high reproducibility suggests that the morphometric variables will contribute to identifying blastocysts with the highest developmental potential as well as those that will not result in a successful pregnancy.
探索一种与持续妊娠相关的囊胚形态计量学分级系统。
横断面研究。
无。
2018年7月至2021年11月在本中心接受单囊胚移植周期移植的所有连续玻璃化囊胚，直至2022年1月。
无。
单次玻璃化-解冻囊胚移植后的持续妊娠率。胚胎学家之间对形态计量学值的观察者间一致性。
使用三个形态计量学变量（囊胚直径、内细胞团[ICM]面积和滋养外胚层细胞估计数）来评估囊胚的扩张、ICM和滋养外胚层形态。在研究期间，585个囊胚参与了本研究。在这三个形态计量学变量中，调整混杂因素后，ICM面积（每500μm，调整比值比，1.19；95%置信区间，1.09 - 1.30）和滋养外胚层细胞估计数（每10个细胞，调整比值比，1.25；95%置信区间，1.12 - 1.39）与持续妊娠率显著相关。ICM面积<2500μm且滋养外胚层细胞估计数<70时，持续妊娠率为2.0%（1/49）。当ICM面积和滋养外胚层细胞估计数分别>3500μm和>110时，持续妊娠率达到47.8%（22/46）。5名胚胎学家之间对囊胚直径、ICM面积和滋养外胚层细胞估计数的观察者间一致性良好（组内相关系数分别为：0.99、0.87和0.91）。
ICM和滋养外胚层的形态计量学值是妊娠成功的有前景的预测指标。高再现性表明，形态计量学变量将有助于识别具有最高发育潜力的囊胚以及那些不会导致妊娠成功的囊胚。
