Frontiers in Endocrinology (Oct 2022)

Vacuolization in embryos on days 3 and 4 of in vitro development: Association with stimulation protocols, embryo development, chromosomal status, pregnancy and neonatal outcomes

  • Longbin Chen,
  • Shuoping Zhang,
  • Yifan Gu,
  • Yifan Gu,
  • Yifan Gu,
  • Yangqin Peng,
  • Zenghui Huang,
  • Zenghui Huang,
  • Fei Gong,
  • Fei Gong,
  • Fei Gong,
  • Ge Lin,
  • Ge Lin,
  • Ge Lin

DOI
https://doi.org/10.3389/fendo.2022.985741
Journal volume & issue
Vol. 13

Abstract

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Study questionIs vacuolization in embryos on Days 3 and 4 associated with parent-related factors, stimulation protocols, embryo development, embryo ploidy, pregnancy and neonatal outcomes?Study design, size, durationThis is a retrospective cohort study that comprised 5,703 embryos from 611 patients who underwent preimplantation genetic testing and time-lapse monitoring of their embryos from August 2017 to September 2021.Main resultsEmbryo vacuolization on Days 3 and 4 is associated with the LH level on the day of the hCG trigger and the number of retrieved oocytes. Compared to vacuole-negative embryos, the rates of blastocyst formation and good-blastocyst formation was significantly lower in vacuole-positive embryos. We observed no significant difference in the rates of euploidy, implantation, ongoing pregnancy, and live birth between vacuole-positive and vacuole-negative embryos. In vacuole-positive embryos, the embryos of which the vacuole-positive blastomeres were involved in embryo compaction exhibited significantly higher mosaicism rate compared with those of which the vacuole-positive blastomeres were not involved in embryo compaction.ConclusionVacuolization in embryos on Days 3 and 4 is associated with reduced blastocyst formation rate and high-quality blastocyst rate. Blastocysts had a low mosaicism rate if the vacuole-containing cells were rejected in compaction process, which supports the hypothesis that exclusion of abnormal blastomeres from compaction is a self-correction mechanism.

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