The correlation between morphology and implantation of euploid human blastocysts

Taraneh Gharib Nazem, Lucky Sekhon, Joseph A. Lee, Jessica Overbey, Stephanie Pan, Marlena Duke, Christine Briton-Jones, Michael Whitehouse, Alan B. Copperman, Daniel E. Stein

Research output: Contribution to journalArticlepeer-review

36 Scopus citations


Research question: Does the composite morphology score or a particular developmental component (expansion stage, inner cell mass [ICM] or trophectoderm [TE]) of euploid blastocysts undergoing single frozen embryo transfer (FET) impact ongoing pregnancy/live birth (OP/LB) rates? Design: Retrospective cohort study including a total of 2236 embryos from 1629 patients who underwent single euploid FET between 2012 and 2017. Results: Embryos with an ICM grade of A compared with C had a higher OP/LB rate (55.6% versus 32.3%, P < 0.001). Blastocysts with a TE grade of A or B compared with C had a higher likelihood of OP/LB (A versus C: odds ratio [OR] 1.6, 99% confidence interval [CI] 1.1–2.3, B versus C: OR 1.5, 99% CI 1.1–2.1), and blastocysts with a developmental stage of 4 or 5 compared with 6 had higher odds of OP/LB (4 versus 6: OR 1.6, 99% CI 1.2–2.2, 5 versus 6: OR 1.6, 99% CI 1.2–2.3). Conclusions: Among euploid embryos, ICM morphology is the best predictor of sustained implantation; however, a composite score may provide additional guidance. While there is a known benefit in genomic screening prior to embryo selection, morphology provides individualized, prognostic information about implantation potential.

Original languageEnglish
Pages (from-to)169-176
Number of pages8
JournalReproductive BioMedicine Online
Issue number2
StatePublished - Feb 2019


  • Blastocyst
  • Euploid embryo
  • Frozen embryo transfer
  • Inner cell mass
  • Morphology
  • Single-embryo transfer


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