The effect of blastocyst morphological scores on pregnancy outcomes and neonatal birth outcomes during frozen-thaw blastocyst transfer
Objective To investigate the effect of blastocyst morphological grading during frozen-thawed embryo transfer(FET)cycles on pregnancy outcomes and neonatal birth outcomes in order to provide a basis for assessing the clinical safety and efficacy of blastocyst transfer.Methods A total of 2,576 cycles of patients who underwent blastocyst FET for assisted conception from May 2016 to December 2021 in our hospital were retrospectively analyzed.Cycles were categorized into group A,B,C and D according to intracytoplasmic mass(ICM)and trophectoderm(TE)scores.The group A had108 cycles transferred with≥4AA blastocysts.The group B had 370 cycles transferred with 4-6 AB and 4-6 BA blastocysts.The group C had 1,170 cycles transferred with 4-6 BB and 4-6 CA blastocysts.The group D had 928 cycles transferred with 4-6 BC,4-6 CB and 4-6 CC blastocysts.The pregnancy outcomes and neonatal birth outcomes were compared among the four groups.Results There was no significant differences in age,BMI,years of in-fertility,basal ovarian reserve function and total amount and days of gonadotropins among the four groups(P>0.05).The clinical pregnancy rate after blastocyst transfer in the group A was higher than that in the groups B,C and D,and the clinical pregnancy rate in the group B was higher than that in the groups C and D(P<0.05).However,there was no statistically significant difference between the groups A and B.There was a statistically significant difference in implantation rate among the four groups,and as the ICM and TE scores decreased,the implantation rate also decreased(P<0.05).There were no significant difference in the rates of ectopic pregnancy,early and mid-term pregnancy abortion,and multiple pregnancies among the four groups.There was no significant difference in the twin pregnancy rate between the groups A and B,between the groups A and C,and between the groups C and D(P>0.5).There was no statistical difference in neonatal birth sex between the groups A,B,and C,but the birth rate of male infants was slightly higher in the group A compared with the group D(P<0.05).There was no statistical difference between the groups A,B and C for neonatal birth weight,but the birth weight of the group D was slightly heavier than that of group A(P<0.05).Multivariate regression analysis showed that blastocyst morphology grading was an independent factor affecting clinical pregnancy rate and live birth rate(P<0.05).Conclusions ICM and TE scores of blastocysts can be an important parameter in predicting post-transfer pregnancy outcome and neonatal birth outcome in frozen-thawed blastocyst transfer cycles.
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