The predictive value of post-warming morphometric changes parameters for embryo implantation.

Authors

Daniela Braga, Amanda Souza Setti, Melissa Cavagnoli, Maite de Collado, Assumpto Iaconelli, Edson Borges

Published in

JBRA assisted reproduction. Sep 28, 2026. Epub Sep 28, 2026.

Abstract

To investigate whether post-warming blastocyst morphometric dynamics assessed by time-lapse imaging (TLI) are associated with implantation in intracytoplasmic sperm injection cycles with deferred embryo transfer.
This observational cohort study included 822 vitrified-warmed high-quality blastocysts with known implantation outcomes, evaluated between January and October 2024 at a private university-affiliated in vitro fertilization centre. Post-warming morphometric parameters were recorded during a 4-hour incubation period, including initial blastocyst area, maximum blastocyst area (MXBA), initial zona pellucida thickness, minimum zona pellucida thickness (MZP), and blastocyst re-expansion. Associations with implantation were assessed using multivariable logistic regression. A composite weighted score incorporating MXBA, MZP, and blastocyst re-expansion was developed from the regression coefficients and analysed as a continuous variable. Restricted cubic spline modelling was used to assess potential non-linear associations.
MXBA (OR=1.078; 95% CI 1.029-1.198; p=0.048), MZP (OR=0.923; 95% CI 0.856-0.995; p=0.038), and blastocyst re-expansion (OR=1.183; 95% CI 1.010-1.386; p=0.036) were independently associated with implantation. Each one-standard-deviation increase in the composite weighted score was associated with a 21.6% increase in the odds of implantation (OR=1.216; 95% CI 1.055-1.403; p=0.007). Spline analysis showed a progressive increase in implantation probability across the score range, without strong evidence of non-linearity.
Quantitative post-warming morphometric assessment provides clinically relevant information on blastocyst implantation potential. A composite score integrating MXBA, MZP, and blastocyst re-expansion may support embryo selection in frozen-thawed embryo transfer cycles.

PMID:
42804681
Bibliographic data and abstract were imported from PubMed on 29 Sep 2026.

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