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Poor morphology of inner cell mass increases birth weight and large for gestational age

  • Jinliang Zhu
    Affiliations
    Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, 49, North Huayuan Road, Haidian District, Beijing 100191, China

    National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China

    Key Laboratory of Assisted Reproduction, Ministry of Education, Beijing 100191, China

    Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing 100191, China
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  • Ying Lian
    Affiliations
    Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, 49, North Huayuan Road, Haidian District, Beijing 100191, China

    National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China

    Key Laboratory of Assisted Reproduction, Ministry of Education, Beijing 100191, China

    Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing 100191, China
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  • Xinjie Zhuang
    Affiliations
    Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, 49, North Huayuan Road, Haidian District, Beijing 100191, China

    National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China

    Key Laboratory of Assisted Reproduction, Ministry of Education, Beijing 100191, China

    Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing 100191, China
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  • Shengli Lin
    Affiliations
    Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, 49, North Huayuan Road, Haidian District, Beijing 100191, China

    National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China

    Key Laboratory of Assisted Reproduction, Ministry of Education, Beijing 100191, China

    Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing 100191, China
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  • Xiaoying Zheng
    Affiliations
    Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, 49, North Huayuan Road, Haidian District, Beijing 100191, China

    National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China

    Key Laboratory of Assisted Reproduction, Ministry of Education, Beijing 100191, China

    Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing 100191, China
    Search for articles by this author
  • Junsheng Li
    Affiliations
    Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, 49, North Huayuan Road, Haidian District, Beijing 100191, China

    National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China

    Key Laboratory of Assisted Reproduction, Ministry of Education, Beijing 100191, China

    Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing 100191, China
    Search for articles by this author
  • Rong Li
    Affiliations
    Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, 49, North Huayuan Road, Haidian District, Beijing 100191, China

    National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China

    Key Laboratory of Assisted Reproduction, Ministry of Education, Beijing 100191, China

    Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing 100191, China
    Search for articles by this author
  • Ping Liu
    Correspondence
    Corresponding author.
    Affiliations
    Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, 49, North Huayuan Road, Haidian District, Beijing 100191, China

    National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China

    Key Laboratory of Assisted Reproduction, Ministry of Education, Beijing 100191, China

    Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing 100191, China
    Search for articles by this author

      Abstract

      Research question

      Can inner cell mass (ICM) and trophectoderm morphological grading, especially ICM and trophectoderm graded C, affect perinatal outcomes?

      Design

      A retrospective review of medical records of 8946 singletons delivered from vitrified–warmed single blastocyst transfer cycles between January 2009 and December 2020.

      Results

      Inner cell mass graded C had a higher adjusted birth weight than ICM graded A (0.61 ± 1.06 versus 0.48 ± 1.06; P = 0.025). Large for gestational age (LGA) increased with decreasing ICM morphological grading (18.96%, 21.88% and 23.38%; grade B versus grade A, P = 0.013; grade C versus grade A, P = 0.036) (P < 0.025 was considered statistically significant for multiple pairwise comparisons). Linear regression analysis suggested that ICM morphological grading was significantly associated with adjusted birth weight, with grade C increasing adjusted birth weight compared with grade A (β 0.13, 95% CI 0.00 to 0.25, P = 0.043) (P < 0.05 was considered statistically significant for linear regression). Logistic regression analysis suggested that ICM morphological grading was significantly associated with LGA, with grade C increasing LGA compared with grade A (adjusted OR 1.37, 95% CI 1.03 to 1.81). Moreover, blastocysts with ICM graded C had a higher chance of being a male infant compared with ICM graded A (adjusted OR 1.32, 95% CI 1.04 to 1.68).

      Conclusions

      Inner cell mass morphological grading was significantly associated with adjusted birth weight and LGA. Poor ICM graded C increased birth weight and LGA.

      Keywords

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      Biography

      Jinliang Zhu completed his doctoral training at the Institute of Zoology, Chinese Academy of Sciences, majoring in reproductive biology. Since 2011, he has worked as a clinical embryologist at Peking University Third Hospital. Research areas include oocyte maturation in vitro and the safety of assisted reproductive technology.
      Key message
      Poor inner cell mass (ICM) graded C increased the likelihood of male infant and large for gestational age (LGA) in vitrified–warmed single blastocyst transfer cycles. Occurrence of LGA may be partially avoided by excluding the transfer of blastocysts with poor ICM morphology graded C.