Trophectoderm grade predicts outcomes of single-blastocyst transfers

Objective To estimate the effect of the embryo stage, trophectoderm (TE) morphology grade, and inner cell mass (ICM) morphology grade on live birth in single-blastocyst transfers. Design Retrospective cohort study. Setting Large private assisted reproductive technologies (ART) practice. Patient(s) Fresh autologous ART cycles. Intervention(s) None. Main Outcome Measure(s) Live birth. Result(s) A total of 694 single-blastocyst transfers met the inclusion criteria. Univariate regression analysis showed embryo stage and TE score to be correlated with implantation and live birth. Live birth rates were 57%, 40%, and 25% for TE grades A, B, and C, respectively. There was no significant association between ICM grade and implantation or live birth. Live birth rates were 53%, 52%, and 0% for ICM grades A, B, and C respectively. Multiple logistic regression analysis showed that only patient age and TE grade were significantly associated with implantation and live birth, whereas ICM grade was not significantly associated with outcome. The TE score had the strongest correlation with live birth. Conclusion(s) TE grading, but not ICM grading, significantly correlated with implantation and live birth for single-blastocyst transfers.