ICM 細胞內質體佔囊胚之半徑比例(ICM/blastocyst diameter ratio)決定懷孕著床率
成功著床之平均比率約0.49,    未成功著床之平均比率約0.34
ICM/blastocyst diameter ratio比率>0.46懷孕率明顯高於<0.46

Fertil Steril. 2016 Aug 24. pii: S0015-0282(16)62678-X. doi: 10.1016/j.fertnstert.2016.08.009. [Epub ahead of print]

The ratio between inner cell mass diameter and blastocyst diameter is correlated with successful pregnancy outcomes of single blastocyst transfers.

Almagor M1, Harir Y2, Fieldust S2, Or Y2, Shoham Z2.

Author information

Abstract

OBJECTIVE:

To evaluate the ability to predict pregnancy outcomes of single-blastocyst transfers by measuring the ratio of inner cell mass (ICM) diameter to blastocyst diameter using time-lapse images.

DESIGN:

Retrospective cohort study.

SETTING:

University-affiliated medical center.

PATIENT(S):

One hundred twenty-seven women undergoing a total of 129 blastocyst transfers with intracytoplasmic sperm injection.

INTERVENTION(S):

Embryo monitoring by time-lapse microscopy.

MAIN OUTCOME MEASURE(S):

The ratio of ICM diameter to blastocyst diameter in single-blastocyst transfers and clinical pregnancy rates.

RESULT(S):

In phase I of the study, 63 women underwent 65 single blastocyst transfers that resulted in 25 pregnancies (40% of the women). The successfully implanted blastocysts had an average ICM/blastocyst diameter ratio of 0.487 ± 0.086, whereas the average ICM/blastocyst ratio of nonimplanted blastocysts was significantly lower (0.337 ± 0.086). The live-birth rate was 29% (18/63). In phase II, 64 single-blastocyst transfers were performed in 64 women. The ICM/blastocyst diameter ratio was measured, and blastocysts with the highest ratios were chosen for transfer. Forty-three women (67%) with an average ICM/blastocyst diameter ratio of 0.46 achieved pregnancy, and 36 of the 43 pregnancies (84%) resulted in the delivery of a healthy baby. In the 21 women (33%) who failed to achieve pregnancy, the average ICM/blastocyst ratio was 0.45. The resultant positive predictive value was 74%, and the negative predictive value was 70%.

CONCLUSION(S):

The ICM-to-blastocyst diameter ratio is a predictor of implantation and live birth in single-blastocyst transfers, offering a simple, noninterfering method to select blastocysts with high developmental capacity.