Journal of Assisted Reproduction and Genetics

, Volume 30, Issue 12, pp 1577–1581 | Cite as

Blastocyst expansion score and trophectoderm morphology strongly predict successful clinical pregnancy and live birth following elective single embryo blastocyst transfer (eSET): a national study

  • Stephanie Marshall ThompsonEmail author
  • Ndidiamaka Onwubalili
  • Kelecia Brown
  • Sangita K. Jindal
  • Peter G. McGovern
Assisted Reproduction Technologies



To determine which characteristics of blastocyst embryo morphology may predict clinical pregnancy and live birth rates.


A retrospective analysis of data from 3,151 cycles of fresh, non-donor eSET cycles from 2008 to 2009 was performed. Data were obtained from the Society for Assisted Reproductive Technologies (SART) underwent. All eSET were performed at the blastocyst stage. Main outcome measures were clinical pregnancy and live birth rates.


Trophectoderm morphology, embryo stage and patient age are highly significant independent predictors of both clinical pregnancy and live birth. Neither inner cell mass morphology nor embryo grade predicted clinical pregnancy or live birth.


Better trophectoderm morphology, younger patient age and further blastocyst progression all result in higher clinical pregnancy and live birth rates. Therefore, trophectoderm morphology and blastocyst stage should preferentially be used as the most important factors in choosing the best embryo for transfer.


Trophectoderm morphology Embryo grading Inner cell mass SART IVF 


Conflicts of interest

S.M.T, N.O., and K.B. have no conflicts of interests or financial disclosures. P.M. has grant funding from EMD Serono, Ferring Pharmaceuticals and Merck Pharmaceuticals unrelated to this study. S.J. has grant funding from Ferring Pharmaceuticals unrelated to this study.

Financial disclosures

This study has no financial support.

Preliminary data from this study was presented at the Society for Gynecologic Investigators, March 2012. San Diego, Ca.


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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Stephanie Marshall Thompson
    • 1
    Email author
  • Ndidiamaka Onwubalili
    • 3
  • Kelecia Brown
    • 4
  • Sangita K. Jindal
    • 2
  • Peter G. McGovern
    • 5
  1. 1.Division of Reproductive Endocrinology and Infertility, Department of Obstetrics, Gynecology and Women’s HealthNew Jersey Medical SchoolNewarkUSA
  2. 2.Division of Reproductive Endocrinology & Infertility, Department of Obstetrics, Gynecology & Women’s HealthAlbert Einstein College of MedicineBronxUSA
  3. 3.The Diamond Institute for Infertility and MenopauseMillburnUSA
  4. 4.Division of Perinatology, Department of Obstetrics and GynecologyLong Island Jewish Medical CenterNew Hyde ParkUSA
  5. 5.Department of Obstetrics and GynecologySt Luke’s Roosevelt HospitalNew YorkUSA

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