Take Home Message on Embryo Quality and Frozen Transfer Cycles:
Embryo quality (measured as morphology or shape) remains an important factor for selecting which embryo to transfer.
Some clinics do not keep embryo quality information on their frozen embryos. Thus, they randomly transfer embryos in the frozen cycle and their success rates are not optimized for the patient outcome.
You should check to see if your clinic keeps embryo quality info when they freeze the embryos. Do they then choose the best embryo for transfer at each FET cycle?
Reasons to pay-attention to this embryo quality data:
- it represents a large sample size
- all transfers were single embryos therefore we really do know which embryo created the pregnancy
- the data shows the effect of age and embryo quality
- we also can see the effect of thaw damage
- we see the effect of ICSI verses conventional insemination
A finding that the authors do not discuss in the abstract was that in all age groups the outcomes were lower from ICSI embryos than IVF (conventional insemination) embryos.
I am more and more convinced that while ICSI is a huge technology for treating male factors, it is over used and subtly decreases outcomes. So my current feeling is that if you need ICSI, then there is no substitute but if you do not need it then you should NOT use it.
Older women had fewer high quality blasts (BL-1 & BL-2) than younger women: Age-1 = 62.3%, Age-2 = 56.3% and Age-3 = 41.1%. I suppose this should not be a surprise but we can quantify the effect with this manuscript.
Take home messages:
- age and embryo morphology affect outcomes – nothing new but notice the effect from these SET
- the older the woman the fewer high quality blasts
- thaw damage to embryos also affects outcomes (drops by 10-15%), effect similar in all age groups
- almost half of the embryos sustained a lower score after thaw
- ICSI embryos had a significantly lower success than IVF embryos
Prediction of pregnancy rate by blastocyst morphological score and age, based on 1,488 single frozen-thawed blastocyst transfer cycles
Goto S, Kadowaki T, Tanaka S, Hashimoto H, Kokeguchi S, Shiotani M. ; Hanabusa Women’s Clinic, Kobe, Japan. firstname.lastname@example.org ; Fertil Steril. 2011 Mar 1;95(3):948-52. Epub 2010 Aug 1.