Developmental stage and morphology of the competent blastocyst are associated with sex of the child but not with other obstetric outcomes: a multicenter cohort study

Abstract STUDY QUESTION Are transfer day, developmental stage and morphology of the competent blastocyst in pregnancies leading to live birth associated with preterm birth, birthweight, length at birth and sex of the child? SUMMARY ANSWER A high score in blastocyst developmental stage and in trophec...

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Published in:Human reproduction (Oxford) 2021-12, Vol.37 (1), p.119-128
Main Authors: Borgstrøm, M B, Kesmodel, U S, Klausen, T W, Danielsen, A K, Thomsen, T, Gabrielsen, A, Englund, A L M, Zedeler, A, Povlsen, B B, Troest, B, Almind, G J, Fedder, J, Kirk, J, Hindkjær, J, Lemmen, J G, Petersen, K, Haahr, K, Petersen, M R, Laursen, S, Knudsen, U B, Bentin-Ley, U, Larsen, T, Grøndahl, M I
Format: Article
Language:English
Subjects:
Blastocyst
Cohort Studies
Embryo Transfer - methods
Female
Humans
Infant, Newborn
Male
Pregnancy
Premature Birth
Retrospective Studies
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Summary:Abstract STUDY QUESTION Are transfer day, developmental stage and morphology of the competent blastocyst in pregnancies leading to live birth associated with preterm birth, birthweight, length at birth and sex of the child? SUMMARY ANSWER A high score in blastocyst developmental stage and in trophectoderm (TE) showed a significant association with the sex of the child, while no other associations with obstetric outcomes were observed. WHAT IS KNOWN ALREADY The association between blastocyst assessment scores and obstetric outcomes have been reported in small single-center studies and the results are conflicting. STUDY DESIGN, SIZE, DURATION Multicenter historical cohort study based on exposure data (transfer day (blastocyst developmental stage reached by Day 5 or Day 6)) blastocyst developmental stage (1–6) and morphology (TE and inner cell mass (ICM): A, B, C)) and outcome data (preterm birth, birthweight, length at birth, and sex of the child) from women undergoing single blastocyst transfer resulting in a singleton pregnancy and live birth. PARTICIPANTS/MATERIALS, SETTING, METHODS Data from 16 private and university-based facilities for clinical services and research were used. A total of 7246 women, who in 2014–2018 underwent fresh-embryo transfer with a single blastocyst or frozen-thawed embryo transfer (FET) with a single blastocyst resulting in a singleton pregnancy were identified. Linking to the Danish Medical Birth Registry resulted in a total of 4842 women with a live birth being included. Cycles with pre-implantation genetic testing and donated gametes were excluded. The analyses were adjusted for female age (n = 4842), female BMI (n = 4302), female smoking (n = 4290), parity (n = 4365), infertility diagnosis (n = 4765), type of treatment (n = 4842) and center (n = 4842); some analyses additionally included gestational age (n = 4368) and sex of the child (n = 4833). MAIN RESULTS AND THE ROLE OF CHANCE No statistically significant associations between blastocyst assessment scores (transfer day, developmental stage, TE, ICM) and preterm birth (8.3%) or birthweight (mean 3461.7 g) were found. The adjusted association between blastocysts with a TE score of C and a TE score of A and length at birth (mean 51.6 cm) were statistically significant (adjusted mean difference 0.4 cm (95% CI: 0.02; 0.77)). Blastocysts transferred with developmental stage score 5 compared to blastocysts transferred with score 3 had a 34% increased probability of being a boy
ISSN:0268-1161
1460-2350
DOI:10.1093/humrep/deab242