The relationship between blastocyst morphology, chromosomal abnormality, and embryo gender.
OBJECTIVE
To assess correlation between blastocyst morphology and chromosomal status.


METHODS
Observational research study.


METHODS
An IVF clinic and a specialist preimplanation genetic diagnosis (PGD) laboratory.


METHODS
Ninety-three couples undergoing IVF treatment in combination with chromosome screening of embryos.


METHODS
Five hundred blastocysts underwent trophectoderm biopsy and comprehensive chromosome screening using comparative genomic hybridization (CGH). The morphology of the embryos was evaluated using standard methods.


METHODS
Association of aneuploidy and morphologic score.


RESULTS
A total of 56.7% of blastocysts were aneuploid. One-half of the grade 5/6 blastocysts were euploid, compared with only 37.5% of embryos graded 1/2, suggesting an effect of aneuploidy on blastocyst development. Aneuploidy also had a negative effect on inner cell mass and trophectoderm grades. Morphologically poor blastocysts had a higher incidence of monosomy and abnormalities affecting several chromosomes. The gender ratio was significantly skewed in relation to morphology. A total of 72% of blastocysts attaining the highest morphologic scores (5AA and 6AA) were found to be male, compared with only 40% of grade 3 embryos.


CONCLUSIONS
Morphology and aneuploidy are linked at the blastocyst stage. However, the association is weak, and consequently, morphologic analysis cannot be relied on to ensure transfer of chromosomally normal embryos. A significant proportion of aneuploid embryos are capable of achieving the highest morphologic scores, and some euploid embryos are of poor morphology. Gender was associated with blastocyst grading, male embryos developing at a significantly faster rate than females.
Alfarawati
Samer
S
Nuffield Department of Obstetrics and Gynaecology, John Radcliffe Hospital, Oxford, United Kingdom.
Fragouli
Elpida
E
Colls
Pere
P
Stevens
John
J
Gutiérrez-Mateo
Cristina
C
Schoolcraft
William B
WB
Katz-Jaffe
Mandy G
MG
Wells
Dagan
D
D000328:Adult; D000782:Aneuploidy; D001755:Blastocyst / Q000166:cytology* / Q000502:physiology; D002869:Chromosome Aberrations / Q000196:embryology; D055028:Comparative Genomic Hybridization; D004622:Embryo, Mammalian / Q000166:cytology / Q000502:physiology*; D047108:Embryonic Development / Q000235:genetics / Q000502:physiology; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D008297:Male; D011247:Pregnancy; D019836:Preimplantation Diagnosis / Q000379:methods; D012727:Sex Characteristics; D012744:Sex Ratio