Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology · 2025
Implantation in single euploid embryo transfers: the role of blastocyst expansion grade and early serum β-hCG levels.
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Arcaz Arthur C, Hernandez-Nieto Carlos, Lee Joseph A, Mukherjee Tanmoy, Copperman Alan B
Аннотация
OBJECTIVE: Is there an association between blastocyst expansion grade and early serum β-hCG levels in pregnancies after single euploid embryo transfer?
METHODS: This retrospective cohort study included 8394 SEETs performed at a single center. Blastocysts were categorized as CHBs (n = 1677) or PHBs (n = 4612) based on their expansion grade. Serum β-hCG levels were measured on days 9 and 11 post-transfer. A multivariate logistic regression model adjusted for confounders, including maternal age, ovarian reserve, embryo morphology, year of treatment, and day of biopsy.
UNLABELLED: On day 9 post-transfer, the median β-hCG level was significantly lower in CHBs (118 mIU/mL, IQR = 129.2) compared to PHBs (133 mIU/mL, IQR = 129.8; p < 0.0001). The difference persisted on day 11 post-transfer (CHBs: 290.2 mIU/mL, IQR = 357 vs. PHBs: 327.3 mIU/mL, IQR 358.6; p = 0.018). In multivariate regression, CHB status remained significantly associated with lower β-hCG on day 9 post-transfer (aOR = 0.998, 95% CI: 0.997-0.999), but not on day 11 post-transfer (aOR = 0.999, 95% CI: 0.999-1.0002).
CONCLUSIONS: Completely hatched blastocysts (CHBs) with an expansion grade 6 were associated with lower early serum β-hCG levels compared to partially hatched blastocysts (PHBs) with expansion grades 4 and 5. Incorporating expansion grade into prediction models could enhance decision support tools for IVF patients.
METHODS: This retrospective cohort study included 8394 SEETs performed at a single center. Blastocysts were categorized as CHBs (n = 1677) or PHBs (n = 4612) based on their expansion grade. Serum β-hCG levels were measured on days 9 and 11 post-transfer. A multivariate logistic regression model adjusted for confounders, including maternal age, ovarian reserve, embryo morphology, year of treatment, and day of biopsy.
UNLABELLED: On day 9 post-transfer, the median β-hCG level was significantly lower in CHBs (118 mIU/mL, IQR = 129.2) compared to PHBs (133 mIU/mL, IQR = 129.8; p < 0.0001). The difference persisted on day 11 post-transfer (CHBs: 290.2 mIU/mL, IQR = 357 vs. PHBs: 327.3 mIU/mL, IQR 358.6; p = 0.018). In multivariate regression, CHB status remained significantly associated with lower β-hCG on day 9 post-transfer (aOR = 0.998, 95% CI: 0.997-0.999), but not on day 11 post-transfer (aOR = 0.999, 95% CI: 0.999-1.0002).
CONCLUSIONS: Completely hatched blastocysts (CHBs) with an expansion grade 6 were associated with lower early serum β-hCG levels compared to partially hatched blastocysts (PHBs) with expansion grades 4 and 5. Incorporating expansion grade into prediction models could enhance decision support tools for IVF patients.