Human Reproduction, Vol. 17, No. 6, 1513-1518,
June 2002
© 2002 European Society of Human Reproduction and Embryology
The neglected morula/compact stage embryo transfer
1 Arizona Institute of Reproductive Medicine, Phoenix, Arizona and 2 Fertility Treatment Centre, Chandler, Arizona, USA
BACKGROUND: This retrospective study analysed the outcomes of 339 embryo transfers on either day 3 (n = 97) or day 4 (n = 242), and proposed a grading system for morula/compact embryos. METHODS: The morula/compact embryo grading was based on: (i) the proportion of blastomeres undergoing the compaction process; (ii) the morphology of the compacted multicellular mass; (iii) the embryo quality on day 2 and 3; and (iv) the amount of fragmentation. Embryo transfers were classified into groups as follows: group I: transferred with zero `good' embryos; group II: one `good' embryo; group III: two or more `good' embryos. RESULTS: Patients on day 4 were transferred with significantly fewer embryos in groups II and III (2.58 ± 0.9 and 2.35 ± 0.6 respectively) when compared with the correspondent day 3 transfers (3.81 ± 1.4 and 4.07 ± 0.9 respectively) (P < 0.05), but had the same or higher implantation and pregnancy rates. Analysing the patients who had transfers with all `good' embryos, day 4 transfer achieved a significantly higher implantation rate compared with day 3 transfer (46.4 versus 21.4%, P < 0.01), but the number of embryos transferred on day 4 was significantly lower than day 3 (2.1 ± 0.5 versus 3.5 ± 0.9, P < 0.01). CONCLUSIONS: The morula/compact embryos had great value for embryo selection, which significantly reduced the number of embryos needed for transfer.
Key words: compact/embryo grading/implantation/morula/selection
3 Fertility Treatment Centre, 3200 N Dobson Road, Chandler, AZ 85224, USA. E-mail: jtftc{at}aol.com
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