Predictive value of female age and third day embryo quality on blastocyst culture outcome
Objective To explore the relationship between the female age,the quality of cleavage D3 embryos and blastocyst culture outcome,and to provide predictive value for blastocyst culture outcome and embryonic developmental potential.Methods A retrospective analysis was performed on 1 478 embryos in 531 cycles of blastocyst cultured in our hospital from 2015 to 2021.They were grouped according to different age,D3 embryo cell number,D3 embryo grade,fragmentation and unevenness,and compared the blastocyst formation rate,blastocyst formation time,transplantable blastocyst formation rate and high-quality blastocyst formation rate.The correlation between each factor and blastocyst culture outcome was analyzed.Results A total of 352 embryos were cultured in blastocysts aged 35-years,and the blastocyst formation rate(64.8％),available blastocyst formation rate(43.5％),high-quality blastocyst formation rate(29.8％)and D5 blastocyst formation rate(13.4％)were significantly lower than other age groups of female(x2=9.563,16.359,18.236,61.838;all P＜0.05).Compared with other embryo grades,the blastocyst formation rate(48.5％),available blastocyst formation rate(17.8％),and high-quality blastocyst formation rate(6.9％)and D5 blastocyst formation rate(7.9％)of 202 Ⅳ grade D3 embryo were significantly decreased(x2=116.201,254.999,270.792,69.110;all P＜0.05).The blastocyst formation rate(40.0％),transplantable blastocyst formation rate(10.0％),high-quality blastocyst formation rate(5.0％)and D5 blastocyst formation rate(10.0％)of 40 D3 embryo with blastomere cell number＜7 cells were significantly decreased(x2=68.537,83.187,47.130,24.986;all P＜0.05).The blastocyst formation rate(52.8％),transplantable blastocyst formation rate(41.7％),high-quality blastocyst formation rate(11.1％)and D5 blastocyst formation rate(8.3％)of the 72 high-quality embryos with uneven blastomeres and fragments,were significantly decreased(x2=73.733,90.886,114.835,39.387;all P＜0.05).Logistic analysis showed that the female age,the number of blastomere cells,the grade of D3 embryo cells,the presence of fragmentation and unevenness were all significantly correlated with the outcome of blastocyst culture(P＜0.05).Conclusion The female age of 35 years and above,the lower the grade of D3 embryo,D3 embryo cell number less than 7 cells,unevenness and high fragmentation rate could lead to the reduction of blastocyst formation rate and high-quality blastocyst formation rate,and delay of blastocyst formation time,all of which affected the blastocyst formation rate and blastocyst quality,and had clinical value in predicting the outcome of blastocyst culture.
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