title: A quantitative approach to blastocyst quality evaluation: morphometric analysis and related IVF outcomes.
abstract: OBJECTIVE
  To quantify blastocyst morphologic parameters with a feasible and standardized tool, investigating their predictive value on implantation outcome.
  
  
  METHODS
  The study retrospectively analyzes 124 blastocysts from 75 patients. Quantitative measurements of blastocyst expansion, inner cell mass and trophoectoderm were taken using digital image analysis software.
  
  
  RESULTS
  Blastocysts areas were found to be ranging from 11626.2 up to 35076.4 μm(2). The area of an early blastocyst is A ≤ 18500 μm(2) with a mean diameter d = 140 ± 9 μm, and the area of an expanded blastocyst is A ≥ 24000 with d = 190 ± 9 μm. While blastocyst mean area was not related to implantation rate, more expanded blastocysts displayed a significantly higher implantation rate. Trophoectoderm cell number is a predictor of positive outcome: since a higher of cells (25.6 ± 11.3 vs 16.3 ± 12.8) `forming a tightly knit epithelium is prognostic of implantation potential. Conversely, inner cell mass size is significantly related to implantation only in expanded blastocysts (3122.7 ± 739.0 vs. 2978.1 ± 366.0 μm(2)).
  
  
  CONCLUSIONS
  Evaluation of blastocyst morphology with a digital image system could be a valuable tool to standardize blastocyst grading based on quantitative parameters. Therefore, digital analysis may be helpful in identifying the best blastocyst to transfer.
authors: Tecnobios Procreazione, Centre for Reproductive Health, 40125 via Dante 15, Bologna, Italy.
authors: Cristina
authors: C
authors: Lagalla
authors: Marzia
authors: M
authors: Barberi
authors: Giovanna
authors: G
authors: Orlando
authors: Raffaella
authors: R
authors: Sciajno
authors: Maria Antonietta
authors: MA
authors: Bonu
authors: Andrea
authors: A
authors: Borini
mesh_terms: D000328:Adult; D001755:Blastocyst / Q000166:cytology*; D002452:Cell Count; D010064:Embryo Implantation; D004622:Embryo, Mammalian / Q000166:cytology*; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D010062:Ovulation Induction; D011786:Quality Control; D012189:Retrospective Studies