OBJECTIVE To investigate if blastocysts originating from different follicular cohorts have variable implantation rates, adjusted for oocyte age, morphology and/or ploidy DESIGN: Retrospective cohort SETTING: Academic center SUBJECTS: Patients who underwent one or more cycles of autologous ovarian stimulation and in vitro fertilization/intracytoplasmic sperm injection, followed by elective single frozen blastocyst transfer EXPOSURE: Blastocyst progression rate of a follicular cohort; defined as the total number of expanded blastocyst, euploid blastocyst, Day 5 blastocyst, or Day 5 euploid blastocyst(s) divided by the number of 2 pronuclei (2PN) zygote(s) MAIN OUTCOME MEASURES: Implantation, defined as serum human chorionic gonadotropin >5mIU/ml following elective single embryo transfer (eSET) RESULTS: A total of 4,292 blastocysts were tracked from their follicular cohort origin to their outcome following eSET. The mean age±standard deviation of the study population was 36.2±3.6 years old. The median (interquartile range; IQR) number of oocytes and 2PN zygotes per cohort was 17 (12-24) and 11 (8-16), respectively. The median (IQR) number of total expanded blastocysts and Day 5 blastocysts per cohort was 6 (4-9) and 2 (1-4), respectively. Preimplantation genetic testing for aneuploidy (PGT-A) utilization rate was 63.0%. The median (IQR) number of total euploid blastocysts and Day 5 euploid blastocysts were 2 (1-4) and 1 (0-2), respectively. Median (IQR) overall blastocyst progression rate was 60.0% (43.5-75.0%), euploid blastocyst progression rate 21.4% (13.3-33.3%), Day 5 blastocyst progression rate 20.0% (8.7-35.2%), and Day 5 euploid blastocyst progression rate 9.1% (0.0-18.2%). All blastocyst progression parameters inversely correlated with increasing age. Multivariable mixed-effects logistic regression analyses, adjusting for oocyte age, number of oocytes retrieved, embryo morphology, and PGT-A status, showed a positive association between overall blastocyst progression (adjusted OR 1.04 [95% CI 1.01-1.08], p=0.02), Day 5 blastocyst progression (adjusted OR 1.05 [95% CI 1.01-1.09], p=0.01), and Day 5 euploid blastocyst progression (adjusted OR 1.10 [95% CI 1.03-1.18], p=0.01) and implantation rates. CONCLUSIONS Adjusting for age, oocytes retrieved, morphology, and ploidy status, blastocysts from follicular cohorts with high blastocyst progression rates demonstrate superior implantation potential compared to those from cohorts with lower blastocyst progression rates. This observation suggests the presence of a cohort effect, and offers valuable information for patient counseling on an embryo's implantation potential beyond ploidy/morphology.

中文翻译：

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囊胚的植入潜力与其原始卵母细胞队列的爆破率有关：队列效应的证据。


目的 调查源自不同卵泡队列的囊胚是否具有可变的着床率，根据卵母细胞年龄、形态和/或倍性进行调整 设计： 回顾性队列 地点： 学术中心 主题： 接受一个或多个周期的自体卵巢刺激和体外受精/卵胞浆内单精子注射，然后进行选择性单次冷冻囊胚移植的患者 暴露： 卵泡队列的囊胚进展率;定义为扩大的囊胚、整倍体囊胚、第 5 天囊胚或第 5 天整倍体囊胚的总数除以 2 个原核 （2PN） 受精卵的数量 主要结果指标： 植入，定义为选择性单胚胎移植 （eSET） 后血清人绒毛膜促性腺激素 >5mIU/ml 结果：共有 4,292 个囊胚从滤泡队列起源到 eSET 后的结果进行了跟踪。研究人群的平均年龄±标准差为 36.2±3.6 岁。中位数（四分位距;IQR） 每个队列的卵母细胞数和 2PN 受精卵数分别为 17 （12-24） 和 11 （8-16）。每个队列总扩增囊胚和第 5 天囊胚的中位数 （IQR） 分别为 6 （4-9） 和 2 （1-4）。非整倍体植入前基因检测 （PGT-A） 利用率为 63.0%。总整倍体囊胚和第 5 天整倍体囊胚的中位数 （IQR） 分别为 2 （1-4） 和 1 （0-2）。中位 （IQR） 总体囊胚进展率为 60.0% （43.5-75.0%），整倍体囊胚进展率 21.4% （13.3-33.3%），第 5 天囊胚进展率 20.0% （8.7-35.2%），第 5 天整倍体囊胚进展率 9.1% （0.0-18.2%）。所有囊胚进展参数都与年龄的增长呈负相关。 多变量混合效应 logistic 回归分析，调整卵母细胞年龄、取卵卵数、胚胎形态和 PGT-A 状态，显示总体囊胚进展 （校正 OR 1.04 [95% CI 1.01-1.08]，p=0.02）、第 5 天囊胚进展 （校正 OR 1.05 [95% CI 1.01-1.09]，p=0.01）和第 5 天整倍体囊胚进展 （校正 OR 1.10 [95% CI 1.03-1.18]， p = 0.01）和植入率。结论 调整年龄、取卵卵、形态和倍性状态后，与囊胚进展率较低的队列相比，囊胚进展率高的滤泡队列的囊胚表现出更好的植入潜力。这一观察表明存在队列效应，并为患者咨询胚胎超越倍性/形态的植入潜力提供了有价值的信息。