Barbara Luke1, Morton B Brown2, Judy E Stern3, Sangita K Jindal4, Catherine Racowsky5, G David Ball6. 1. Department of Obstetrics, Gynecology, and Reproductive Biology, Michigan State University, East Lansing, Michigan. Electronic address: lukeb@msu.edu. 2. Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, Michigan. 3. Department of Obstetrics and Gynecology, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire. 4. Montefiore's Institute for Reproductive Medicine and Health, Albert Einstein College of Medicine, Hartsdale, New York. 5. Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, Massachusetts. 6. Seattle Reproductive Medicine, Seattle, Washington.
Abstract
OBJECTIVE: To model morphological assessments of embryo quality that are predictive of live birth. DESIGN: Longitudinal cohort using cycles reported in the Society for Assisted Reproductive Technology Clinic Outcomes Reporting System (SART CORS) between 2007 and 2011. SETTING: Clinic-based data. PATIENT(S): Fresh autologous assisted reproductive technology (ART) cycles with ETs on day 3 or day 5 and morphological assessments reported (25,409 cycles with one embryo transferred and 96,093 cycles with two embryos transferred). Live-birth rates were modeled by morphological assessments using backward-stepping logistic regression for cycle 1 and over five cycles, separately for day 3 and day 5 transfers and number of embryos transferred (1 or 2). Additional models for each day of transfer also included the number of oocytes retrieved and the number of embryos cryopreserved. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Live births. RESULT(S): Morphological assessments of grade, stage, fragmentation, and symmetry were significant for the day 3 models; grade, stage, and trophectoderm were significant in the day 5 model; inner-cell mass was significant in the models when two embryos were transferred. Number of oocytes retrieved and number of embryos cryopreserved were significant for both day 3 and day 5 models. CONCLUSION(S): These findings confirm the significant association between embryo quality parameters reported to SART CORS and live-birth rate after ART.
OBJECTIVE: To model morphological assessments of embryo quality that are predictive of live birth. DESIGN: Longitudinal cohort using cycles reported in the Society for Assisted Reproductive Technology Clinic Outcomes Reporting System (SART CORS) between 2007 and 2011. SETTING: Clinic-based data. PATIENT(S): Fresh autologous assisted reproductive technology (ART) cycles with ETs on day 3 or day 5 and morphological assessments reported (25,409 cycles with one embryo transferred and 96,093 cycles with two embryos transferred). Live-birth rates were modeled by morphological assessments using backward-stepping logistic regression for cycle 1 and over five cycles, separately for day 3 and day 5 transfers and number of embryos transferred (1 or 2). Additional models for each day of transfer also included the number of oocytes retrieved and the number of embryos cryopreserved. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Live births. RESULT(S): Morphological assessments of grade, stage, fragmentation, and symmetry were significant for the day 3 models; grade, stage, and trophectoderm were significant in the day 5 model; inner-cell mass was significant in the models when two embryos were transferred. Number of oocytes retrieved and number of embryos cryopreserved were significant for both day 3 and day 5 models. CONCLUSION(S): These findings confirm the significant association between embryo quality parameters reported to SART CORS and live-birth rate after ART.
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