Evidence map›Paper›PMID 40272716›Full record

SynthesisJournal of assisted reproduction and genetics2025

Morphological parameters of the blastocyst to predict embryo quality: a systematic review and meta-analysis.

Lingying Zhang, Chengyu Li, Na Zhu, Emeli Chatterjee, Jie Chen, Tong Liang, Shannan Song, Zulihumaer Yakupu, Mairepati Mahemuti, Baligen Sailikebai and 5 more

Abstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Journal of assisted reproduction and genetics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Lingying ZhangXinjiang Key Laboratory of Biological Resources and Genetic Engineering, College of Life Science & Technology, Xinjiang University, Urumuqi, 830046, Xinjiang, China.
Chengyu LiXinjiang Key Laboratory of Biological Resources and Genetic Engineering, College of Life Science & Technology, Xinjiang University, Urumuqi, 830046, Xinjiang, China.
Na ZhuXinjiang Key Laboratory of Biological Resources and Genetic Engineering, College of Life Science & Technology, Xinjiang University, Urumuqi, 830046, Xinjiang, China.
Emeli ChatterjeeCardiovascular Research Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA, 02114, USA.
Jie ChenNational Clinical Research Center for Geriatrics, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Tong LiangXinjiang Key Laboratory of Biological Resources and Genetic Engineering, College of Life Science & Technology, Xinjiang University, Urumuqi, 830046, Xinjiang, China.
Shannan SongXinjiang Key Laboratory of Biological Resources and Genetic Engineering, College of Life Science & Technology, Xinjiang University, Urumuqi, 830046, Xinjiang, China.
Zulihumaer YakupuXinjiang Key Laboratory of Biological Resources and Genetic Engineering, College of Life Science & Technology, Xinjiang University, Urumuqi, 830046, Xinjiang, China.
Mairepati MahemutiXinjiang Key Laboratory of Biological Resources and Genetic Engineering, College of Life Science & Technology, Xinjiang University, Urumuqi, 830046, Xinjiang, China.
Baligen SailikebaiXinjiang Key Laboratory of Biological Resources and Genetic Engineering, College of Life Science & Technology, Xinjiang University, Urumuqi, 830046, Xinjiang, China.
Rongxin ZhuXinjiang Key Laboratory of Biological Resources and Genetic Engineering, College of Life Science & Technology, Xinjiang University, Urumuqi, 830046, Xinjiang, China.
Xin ZhangSchool of Life Science and Technology, Shanghai Tech University, Shanghai, 200031, China.
Ji LeiCenter for Transplantation Science, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA. jlei2@mgh.harvard.edu.
Guoping LiCardiovascular Research Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA, 02114, USA. gli21@mgh.harvard.edu.
Zeyidan JiapaerXinjiang Key Laboratory of Biological Resources and Genetic Engineering, College of Life Science & Technology, Xinjiang University, Urumuqi, 830046, Xinjiang, China. zeyidan@xju.edu.cn.ORCID http://orcid.org/0000-0001-6447-844X

Funding

National Natural Science Foundation of China 82200901Tianshan Talent Training Program 2023TSYCCX0051
6 · The paper itself

Abstract

purposeIn assisted reproductive technology (ART), the morphological assessment of blastocyst quality is the crucial step that determines the success of embryo transfer. But the relative importance of three blastocyst components-blastocyst expansion (EH), inner cell mass (ICM), and trophectoderm (TE)-for embryos is still a matter of controversy. Therefore, the aim of this meta-analysis is to compare and rank the effects of blastocyst scoring on producing live births.

methodsWe systematically searched CINAHL, Cochrane, Embase, MEDLINE, PubMed, Scopus, and the Chinese Medicine database from inception to February 26, 2023. This research includes original articles reporting neonatal outcomes after in vitro fertilization (IVF)/ intracytoplasmic sperm injection (ICSI) embryo transfer which contained definitive grading of EH, ICM, and TE characteristics at the blastocyst stage using the Gardner scoring system.

resultsWe conducted a meta-analysis of 33 studies encompassing 42,974 ART embryos from 46,099 infertile women, with 19 studies reporting live births in 28,918 women involving 30,651 embryos. The analysis revealed that embryo components were ranked by their suitability for live births, with TE (A) scoring highest, followed by ICM (A) and EH (5), while EH was the least favorable. The most favorable embryo morphologies for higher live birth rates were 5AA, 4AA, 6AA, 5AB, 3AA, 5BA, 4AB, 2AA, and 4BA, with 1CC being the least unfavorable.

conclusionMorphological assessment of embryo quality serves as a crucial protocol in the selection of high-quality embryos after ART, and our study may provide a guideline to assist in the selection of high-quality embryos.

Indexed as

BlastocystEmbryonic DevelopmentEmbryo TransferFertilization in VitroFemaleHumansLive BirthPregnancyPregnancy RateReproductive Techniques, AssistedSperm Injections, IntracytoplasmicAssisted reproductive technology (ART)Embryo qualityLive birthsMorphological assessment

Identifiers

PMID40272716
PMCPMC12229285

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.