title: The impact of age on blastocyst scoring after single and double embryo transfers.
abstract: OBJECTIVE
  The aim of the present study was to assess the putative relationship between patient's age and blastocyst scores, in single (SET) or double (DET) transfer cycles, that resulted in single or twin pregnancy or non-pregnancy. Second, we analyzed the effect of maternal age on clinical gestation and implantation rates after single and double blastocyst transfers.
  
  
  METHODS
  Retrospective analysis of 164 assisted reproduction cycles with embryo transfers.
  
  
  RESULTS
  Data demonstrated that for both, young (<35 years of age) and older (≥35 years of age) women, trophectoderm (TE) score is the most important parameter to assess concerning embryo selection. However, inner cell mass (ICM) also plays an important role on blastocyst selection in the group of older patients. In addition, our data shows that for young women the transfer of a single blastocyst results in similar gestational rates as those for DET.
  
  
  CONCLUSIONS
  We suggest that blastocyst grading for patients aged 35 years or above shall be performed using a strict grading policy, possibly not of a single parameter, but TE, ICM and expansion grades together, to choose the "best combined-score blastocyst". DETs should be considered, particularly after previous cycles with pregnancy failures.
authors.affiliation: Department of Morphological Sciences, ICBS, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.
authors.forename: Adriana
authors.initials: A
authors.lastname: Bos-Mikich
authors.affiliation: Department of Morphological Sciences, ICBS, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.
authors.forename: Marcus S
authors.initials: MS
authors.lastname: Michels
authors.affiliation: Nilo Frantz Human Fertility Center, Porto Alegre, RS, Brazil.
authors.forename: Caroline G
authors.initials: CG
authors.lastname: Dutra
authors.affiliation: Nilo Frantz Human Fertility Center, Porto Alegre, RS, Brazil.
authors.forename: Norma P
authors.initials: NP
authors.lastname: Oliveira
authors.affiliation: Department of Morphological Sciences, ICBS, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.
authors.forename: Marcelo O
authors.initials: MO
authors.lastname: Ferreira
authors.affiliation: Department of Morphological Sciences, ICBS, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.
authors.forename: Douglas C
authors.initials: DC
authors.lastname: Aquino
authors.affiliation: Nilo Frantz Human Fertility Center, Porto Alegre, RS, Brazil.
authors.forename: Nilo
authors.initials: N
authors.lastname: Frantz
mesh_terms: D000328:Adult; D000375:Aging; D001755:Blastocyst / Q000145:classification* / Q000166:cytology; D015925:Cryopreservation; D004624:Embryo Transfer / Q000706:statistics & numerical data*; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D008423:Maternal Age; D011247:Pregnancy; D012189:Retrospective Studies; D056826:Single Embryo Transfer
keywords: DET; Maternal age; SET; blastocyst score