Skip to main content
SpringerLink
Log in

Prognostic value of growth of 4-cell embryos on the day of transfer in fresh IVF-ET cycles

  • Assisted Reproduction Technologies
  • Published:
Journal of Assisted Reproduction and Genetics Aims and scope Submit manuscript

Abstract

Purpose

To investigate the prognostic value of growth of 4-cell embryos on the day of transfer in determining clinical pregnancy and live birth rates after fresh in vitro fertilization (IVF)-embryo transfer (ET) cycles.

Methods

Retrospective cohort study of all patients between January 2008 and January 2013 initiating fresh IVF-ET cycles resulting in embryos that were not more than 4 cells 72 h after oocyte retrieval in the morning of their transfer. Patients were stratified into 2 groups based on whether embryos did or did not grow more than the 4-cell stage on the afternoon of ET. The odds of clinical pregnancy and live birth were considered as primary outcomes. Student’s t-tests and Chi-square (χ2) tests were used as inidicated, with logistic regression controlling for maternal age and number of embryos transferred.

Results

Three hundred forty three patients were identified for inclusion: 165 and 178 patients had 4-cell embryos with and without growth on the afternoon of ET, respectively. The demographic and baseline IVF cycle characteristics of the study cohort were comparable. Patients with embryo growth had higher clinical pregnancy (13.9 % vs. 4.49 %) and live birth (10.9 % vs. 3.37 %) rates compared to patients without embryo growth. This represented an overall increased odds of clinical pregnancy [Odds ratio (OR) = 3.44; 95 % Confidence Intervals (CI) 1.49–7.93; P = 0.004)] and live birth (OR = 3.51; 95 % CI 1.36–9.07; P = 0.01). The increased odds remained unchanged after adjusting for maternal age and number of embryos transferred.

Conclusions

Transfer of 4-cell embryos 3 days after oocyte retrieval can result in clinical pregnancies and live births, albeit at a low rate. Growth of an embryo more than the 4-cell stage on the afternoon of ET may serve as a positive prognostic factor for IVF-ET cycle outcome.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Zhao P, Li M, Lian Y, Zheng X, Liu P, Qiao J. The clinical outcomes of day 3 4-cell embryos after extended in vitro culture. J Assist Reprod Genet. 2015;32(1):55–60.

    Article  PubMed  Google Scholar 

  2. Desai NN, Goldstein J, Rowland DY, Goldfarb JM. Morphological evaluation of human embryos and derivation of an embryo quality scoring system specific for day 3 embryos: a preliminary study. Hum Reprod. 2000;15(10):2190–6.

    Article  CAS  PubMed  Google Scholar 

  3. Ertzeid G, Storeng R, Tanbo T, Dale PO, Bjercke S, Abyholm T. Cycle characteristics of day 3 embryo transfers with 4-cell embryos only. J Assist Reprod Genet. 2003;20(9):352–7.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  4. Cummins JM, Breen TM, Harrison KL, Shaw JM, Wilson LM, Hennessey JF. A formula for scoring human embryo growth rates in in vitro fertilization: its value in predicting pregnancy and in comparison with visual estimates of embryo quality. J In Vitro Fert Embryo Transf. 1986;3(5):284–95.

    Article  CAS  PubMed  Google Scholar 

  5. Trounson AO, Mohr LR, Wood C, Leeton JF. Effect of delayed insemination on in-vitro fertilization, culture and transfer of human embryos. J Reprod Fertil. 1982;64(2):285–94.

    Article  CAS  PubMed  Google Scholar 

  6. Claman P, Armant DR, Seibel MM, Wang TA, Oskowitz SP, Taymor ML. The impact of embryo quality and quantity on implantation and the establishment of viable pregnancies. J In Vitro Fert Embryo Transf. 1987;4(4):218–22.

    Article  CAS  PubMed  Google Scholar 

  7. Reichman DE, Chung P, Meyer L, Greenwood E, Davis O, Rosenwaks Z. Consecutive gonadotropin-releasing hormone-antagonist in vitro fertilization cycles: does the elapsed time interval between successive treatments affect outcomes? Fertil Steril. 2013;99:1277–82.

    Article  CAS  PubMed  Google Scholar 

  8. Veeck LL. An atlas of human gametes and conceptuses. An illustrated reference for assisted reproductive technology; 1999.

  9. Hegde A, Behr B. Embryo culture and selection: morphological criteria. Human Fertility: Methods and Protocols. 1st Edition. Springer; 2014.

  10. Giorgetti C, Terriou P, Auquier P, Hans E, Spach JL, Salzmann J, et al. Embryo score to predict implantation after in-vitro fertilization: based on 957 single embryo transfers. Hum Reprod. 1995;10(9):2427–31.

    Article  CAS  PubMed  Google Scholar 

  11. Ziebe S, Petersen K, Lindenberg S, Andersen AG, Gabrielsen A, Andersen AN. Embryo morphology or cleavage stage: how to select the best embryos for transfer after in-vitro fertilization. Hum Reprod. 1997;12(7):1545–9.

    Article  CAS  PubMed  Google Scholar 

  12. Van Royen E, Mangelschots K, De Neubourg D, Valkenburg M, Van de Meerssche M, Ryckaert G, et al. Characterization of a top quality embryo, a step towards single-embryo transfer. Hum Reprod. 1999;14(9):2345–9.

    Article  PubMed  Google Scholar 

  13. Steer CV, Mills CL, Tan SL, Campbell S, Edwards RG. The cumulative embryo score: a predictive embryo scoring technique to select the optimal number of embryos to transfer in an in-vitro fertilization and embryo transfer programme. Hum Reprod. 1992;7(1):117–9.

    CAS  PubMed  Google Scholar 

  14. Desai NN, Goldstein J, Rowland DY, Goldfarb JM. Morphological evaluation of human embryos and derivation of an embryo quality scoring system specific for day 3 embryos: a preliminary study. Hum Reprod. 2000;15(10):2190–6.

    Article  CAS  PubMed  Google Scholar 

  15. Janny L, Menezo YJ. Maternal age effect on early human embryonic development and blastocyst formation. Mol Reprod Dev. 1996;45(1):31–7.

    Article  CAS  PubMed  Google Scholar 

  16. Tesarik J, Mendoza C, Greco E. Paternal effects acting during the first cell cycle of human preimplantation development after ICSI. Hum Reprod. 2002;17(1):184–9.

    Article  PubMed  Google Scholar 

  17. Tesarik J. Paternal effects on cell division in the human preimplantation embryo. Reprod Biomed Online. 2005;10(3):370–5.

    Article  PubMed  Google Scholar 

  18. Capalbo A, Rienzi L, Cimadomo D, Maggiulli R, Elliott T, Wright G, et al. Correlation between standard blastocyst morphology, euploidy and implantation: an observational study in two centers involving 956 screened blastocysts. Hum Reprod. 2014;29(6):1173–81.

    Article  PubMed  Google Scholar 

Download references

Conflict of Interest

The authors declare that they have no conflict of interest

Author information

Authors and Affiliations

  1. The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medical Center, 1305 York Ave, New York, NY, 10021, USA

    Nigel Pereira, Anate A. Brauer, Alexis P. Melnick, Jovana P. Lekovich & Steven D. Spandorfer

Authors
  1. Nigel Pereira
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Anate A. Brauer
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Alexis P. Melnick
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jovana P. Lekovich
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Steven D. Spandorfer
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Steven D. Spandorfer.

Additional information

Capsule Growth of a day-3 embryo beyond the 4-cell stage on the afternoon of transfer may serve as a positive prognostic factor for IVF-ET cycle outcome.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Pereira, N., Brauer, A.A., Melnick, A.P. et al. Prognostic value of growth of 4-cell embryos on the day of transfer in fresh IVF-ET cycles. J Assist Reprod Genet 32, 939–943 (2015). https://doi.org/10.1007/s10815-015-0478-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10815-015-0478-2

Keywords

Search

Navigation