Document Detail

The graduated embryo score predicts the outcome of assisted reproductive technologies better than a single day 3 evaluation and achieves results associated with blastocyst transfer from day 3 embryo transfer.
MedLine Citation:
PMID:  14667868     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To evaluate the graduated embryo score (GES) for predicting assisted reproductive technology (ART) outcome compared to a single morphologic evaluation on day 3 of culture (grade A: > or =7 cells; <20% fragmentation). DESIGN: Prospective cohort analysis. SETTING: Private practice. PATIENT(S): Women aged <40 years with a normal uterine cavity treated with ART (n = 106). INTERVENTION(S): Embryos were graded by GES and by day 3 morphologic characteristics alone before ET. Cycle outcomes were compared with embryo grade. MAIN OUTCOME MEASURE(S): Ongoing gestation and implantation rates. RESULT(S): Overall ongoing gestation and implantation rates were 48% and 26%, respectively. With 1+ embryo GES > or =70 (n = 77), the rates were 62% and 36%, respectively, which were significantly higher than for those with 0 embryos GES > or =70 (n = 29). With 1+ grade A embryo (n = 102), the rates were 50% and 27%, respectively. Transfer of more than one embryo GES > or =70 did not improve the pregnancy rate, but did increase the risk of multiple gestations. A single day 3 evaluation had an extremely low specificity (7%) compared to GES (47%). Graduated embryo scoring (GES) was an excellent predictor of pregnancy and implantation rates from blastocyst transfer. Day of transfer did not affect pregnancy rates, although implantation was higher from day 5 embryo transfer (ET) than from day 3 ET, as fewer embryos were transferred. CONCLUSION(S): Transfer of one or more embryo GES > or =70 predicts pregnancy and implantation rates better than a single morphologic evaluation on day 3 and achieves ART outcomes associated with blastocyst transfer from day 3 ET, making extended culture unnecessary for most patients.
Jeffrey D Fisch; Geoffrey Sher; Mark Adamowicz; Levent Keskintepe
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Fertility and sterility     Volume:  80     ISSN:  0015-0282     ISO Abbreviation:  Fertil. Steril.     Publication Date:  2003 Dec 
Date Detail:
Created Date:  2003-12-11     Completed Date:  2004-01-21     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0372772     Medline TA:  Fertil Steril     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1352-8     Citation Subset:  IM    
Sher Institute for Reproductive Medicine, Las Vegas, Nevada 89109, USA.
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MeSH Terms
Blastocyst / cytology*
Embryo Transfer*
Fertilization in Vitro*
Pregnancy Outcome*
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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