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Fertil Steril. 2009 Feb;91(2):401-6. doi: 10.1016/j.fertnstert.2007.11.083. Epub 2008 Mar 4.

The value of fast blastocoele re-expansion in the selection of a viable thawed blastocyst for transfer.

Author information

1
Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Stanford University Medical Center, Stanford, California 94304, USA.

Abstract

OBJECTIVE:

To investigate the role of fast blastocoele re-expansion in the selection of viable thawed blastocysts for transfer.

DESIGN:

Retrospective study.

SETTING:

Academic assisted reproductive program.

PATIENT(S):

Transfer cycles were divided into two groups according to the presence or absence of fast re-expanded blastocysts. In group I (124 cycles), all transferred blastocysts had fast re-expanding blastocoele. In group II (113 cycles), no fast re-expanded blastocysts were included in the transfer.

INTERVENTION(S):

Blastocyst survival was defined as >50% of cells remaining intact after thaw and re-expansion after culture in vitro for 2-4 hours before transfer. Blastocysts with >or=50% re-expansion were designated as fast re-expanded blastocysts.

MAIN OUTCOME MEASURE(S):

Percentage of blastomere loss immediately after thaw, degree of blastocoele re-expansion, and clinical outcomes (pregnancy and implantation rates).

RESULT(S):

The rates of survival and fast blastocoele re-expansion of partially intact blastocysts were significantly reduced as compared with fully intact blastocysts. Significantly higher rates of clinical pregnancy (37.1% vs. 16.8%) and implantation (26.7% vs. 11.3%) were obtained when all transferred blastocysts had fast re-expanding blastocoele as compared with those transfers without fast re-expanded blastocysts included.

CONCLUSION(S):

Our results showed that blastomere loss of thawed blastocyst was associated with a reduced ability to re-expand. As a discriminative morphologic marker of superior embryo viability, a fast re-expanded blastocyst would be given priority for transfer to better utilize the cryopreserved blastocysts.

[Indexed for MEDLINE]

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