Blastocoele re-expansion at time of frozen embryo transfer affects clinical outcome following vitrification and warming
Bibliographic record
Abstract
INTRODUCTION: While previous studies have correlated blastocyst expansion with pregnancy, there is limited evidence regarding post-warming characteristics and specifically the capability of the vitrified and warmed blastocyst to re-expand fully to the pre-vitrification state. OBJECTIVE: This study aimed to examine the effect of blastocyst re-expansion on clinical pregnancy rates (CPRs) in frozen embryo transfer (FET) cycles. MATERIALS AND METHODS: In this retrospective cohort, FET patients were stratified into "collapsed" and "re-expanded" groups and further categorized into good (≥ 3BB) or low (<3BB) embryo quality at time of vitrification. Patients were age-matched on a 1:2 ratio for comparison between the collapsed (n=165) and re-expanded (n=330) groups. The primary outcome of clinical pregnancy rate (CPR), in addition to secondary pregnancy outcomes, was reported. Chi-square tests of independence and Cramer's V test were performed to examine the association between CPR of collapsed versus re-expanded blastocysts; embryo quality; and age (< 38 years vs ≥ 38 years). Odds ratios with 95% confidence intervals were reported. RESULTS: A total of 5,996 patients underwent frozen embryo transfer (FET) between 2005 and 2012, of whom 165 (2.8%) received a collapsed blastocyst. Patients were age-matched in a 1:2 ratio in comparison to patients who implanted a re-expanded blastocyst (n = 330). Clinical pregnancy rate (CPR) was 28.5% in the re-expanded group compared with 15.8% in the collapsed group (OR = 2.145, 95% CI [1.324, 3.473]). There was a significant association between CPR and blastocyst expansion, χ²(1, N = 496) = 9.901, p = .002, with a small effect size (V = 0.14). CPR was also significantly associated with embryo quality (p = .017) and age (p < .001), regardless of embryo expansion. CONCLUSION: Our findings suggest that the transfer of a collapsed blastocyst during FET is associated with a lower CPR than a re-expanded blastocyst. Despite these differences, a viable pregnancy can be achieved after the transfer of a collapsed blastocyst, especially in younger patients with good quality embryos at the time of vitrification.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".