Morphological parameters of the blastocyst to predict embryo quality: a systematic review and meta-analysis.

IF 2.7 3区医学 Q2 GENETICS & HEREDITY

Journal of Assisted Reproduction and Genetics Pub Date : 2025-06-01 Epub Date: 2025-04-24 DOI:10.1007/s10815-025-03424-6

Lingying Zhang, Chengyu Li, Na Zhu, Emeli Chatterjee, Jie Chen, Tong Liang, Shannan Song, Zulihumaer Yakupu, Mairepati Mahemuti, Baligen Sailikebai, Rongxin Zhu, Xin Zhang, Ji Lei, Guoping Li, Zeyidan Jiapaer

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引用次数: 0

Abstract

Purpose: In assisted reproductive technology (ART), the morphological assessment of blastocyst quality is the crucial step that determines the success of embryo transfer. But the relative importance of three blastocyst components-blastocyst expansion (EH), inner cell mass (ICM), and trophectoderm (TE)-for embryos is still a matter of controversy. Therefore, the aim of this meta-analysis is to compare and rank the effects of blastocyst scoring on producing live births.

Methods: We systematically searched CINAHL, Cochrane, Embase, MEDLINE, PubMed, Scopus, and the Chinese Medicine database from inception to February 26, 2023. This research includes original articles reporting neonatal outcomes after in vitro fertilization (IVF)/ intracytoplasmic sperm injection (ICSI) embryo transfer which contained definitive grading of EH, ICM, and TE characteristics at the blastocyst stage using the Gardner scoring system.

Results: We conducted a meta-analysis of 33 studies encompassing 42,974 ART embryos from 46,099 infertile women, with 19 studies reporting live births in 28,918 women involving 30,651 embryos. The analysis revealed that embryo components were ranked by their suitability for live births, with TE (A) scoring highest, followed by ICM (A) and EH (5), while EH was the least favorable. The most favorable embryo morphologies for higher live birth rates were 5AA, 4AA, 6AA, 5AB, 3AA, 5BA, 4AB, 2AA, and 4BA, with 1CC being the least unfavorable.

Conclusion: Morphological assessment of embryo quality serves as a crucial protocol in the selection of high-quality embryos after ART, and our study may provide a guideline to assist in the selection of high-quality embryos.

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囊胚形态参数预测胚胎质量：系统综述和荟萃分析。

目的：在辅助生殖技术中，囊胚质量的形态学评估是决定胚胎移植成功与否的关键步骤。但是胚泡的三种成分——胚泡膨胀（EH）、内细胞团（ICM）和滋养外胚层（TE）——对胚胎的相对重要性仍然存在争议。因此，本荟萃分析的目的是比较和排名囊胚评分对生产活产的影响。方法：系统检索CINAHL、Cochrane、Embase、MEDLINE、PubMed、Scopus和中国医药数据库，检索时间为2023年2月26日。本研究纳入了报道体外受精(IVF)/胞浆内单精子注射（ICSI）胚胎移植后新生儿结局的原创文章，这些文章使用Gardner评分系统对囊胚期的EH、ICM和TE特征进行了明确分级。结果：我们对33项研究进行了荟萃分析，包括46,099名不孕妇女的42,974个ART胚胎，其中19项研究报告了28,918名妇女的活产，涉及30,651个胚胎。分析显示，胚胎成分对活产的适宜性排序，TE (A)得分最高，其次是ICM (A)和EH(5)，而EH是最不利的。最有利于提高活产率的胚胎形态为5AA、4AA、6AA、5AB、3AA、5BA、4AB、2AA和4BA，最不利的是1CC。结论：胚胎质量形态学评价是ART后优质胚胎选择的重要依据，本研究可为辅助优质胚胎的选择提供指导。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Assisted Reproduction and Genetics 医学-妇产科学

CiteScore

5.70

自引率

9.70%

发文量

286

审稿时长

1 months

期刊介绍： The Journal of Assisted Reproduction and Genetics publishes cellular, molecular, genetic, and epigenetic discoveries advancing our understanding of the biology and underlying mechanisms from gametogenesis to offspring health. Special emphasis is placed on the practice and evolution of assisted reproduction technologies (ARTs) with reference to the diagnosis and management of diseases affecting fertility. Our goal is to educate our readership in the translation of basic and clinical discoveries made from human or relevant animal models to the safe and efficacious practice of human ARTs. The scientific rigor and ethical standards embraced by the JARG editorial team ensures a broad international base of expertise guiding the marriage of contemporary clinical research paradigms with basic science discovery. JARG publishes original papers, minireviews, case reports, and opinion pieces often combined into special topic issues that will educate clinicians and scientists with interests in the mechanisms of human development that bear on the treatment of infertility and emerging innovations in human ARTs. The guiding principles of male and female reproductive health impacting pre- and post-conceptional viability and developmental potential are emphasized within the purview of human reproductive health in current and future generations of our species. The journal is published in cooperation with the American Society for Reproductive Medicine, an organization of more than 8,000 physicians, researchers, nurses, technicians and other professionals dedicated to advancing knowledge and expertise in reproductive biology.