Work

Impact of euploid blastocyst developmental stage and morphological grading on pregnancy outcomes in young recurrent pregnancy loss patients: association with parental chromosomal status

Year: 2025

Type: article

Abstract: Objective This study investigated the impact of blastocyst developmental stage and morphological grading on pregnancy outcomes following single euploid frozen-thawed blastocyst transfer (SE-FBT) in young patients with recurrent pregnancy loss (RPL) and balanced chromosomal translocations (BCTs), compared to patients with normal karyotypes. Methods A retrospective cohort analysis was performed on 449 SE-FBT cycles (2017–2023), comprising 177 cycles from patients with BCT and 272 cycles from patients with normal karyotypes. Blastocysts were categorized according to their developmental stage (day 5 [D5] versus day 6 [D6]) and morphological grading (good versus poor). Multivariable logistic regression models were used to adjust for potential confounders. Results Among BCT carriers, D5 blastocysts exhibited significantly higher clinical pregnancy rates (CPR: 83.33% vs. 62.86%; adjusted odds ratio [aOR] = 2.90, P = 0.005) and live birth rates (LBR: 75.00% vs. 51.43%; aOR = 2.6, P = 0.010) compared to D6 blastocysts, whereas morphological grading showed no significant association after adjustment. Among normokaryotypic patients, however, blastocyst morphological grading was the primary prognostic factor, with good-grade blastocysts yielding superior CPR (74.13% vs. 54.26%, aOR = 2.46, P = 0.001) and LBR (56.64% vs. 40.31%, aOR = 1.76, P = 0.039), while developmental stage had no significant effect. Conclusions These findings suggest that the developmental stage of the blastocyst is the primary determinant of successful outcomes in BCT-associated RPL, whereas embryo morphological grading predominantly influences pregnancy outcomes in RPL patients with normal karyotypes. These results highlight the importance of personalized embryo selection strategies based on parental chromosomal status and embryological characteristics to optimize reproductive outcomes in distinct RPL.

Source: Frontiers in Endocrinology

DOI: 10.3389/fendo.2025.1644773

Authors: Ruixiao Zhang, Tangmiao Luo, Chenchen Cui, Cuilian Zhang

Institutions: Zhengzhou University, Henan Provincial People's Hospital

Language: English

Topic: Reproductive Biology and Fertility

Subfield: Public Health, Environmental and Occupational Health

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,801