JBRA Assisted Reproduction 2025;29(Suppl.2 SBRA 2025):97
Poster Presentation
29^th Annual Congress of the SBRA. São Paulo/SP - Brazil, 2025
doi: 10.5935/1518-0557.20263684

P-85. Evaluation of clinical and laboratory factors for the development of TOP blastocyst during an in vitro fertilization

Julia Janis Santos¹, Bruna Campos Galgaro¹, Luiza Silva Rodrigues¹, João Sabino Lahorgue Cunha-Filho¹

¹ Centro de Reprodução Humana Insemine - Porto Alegre - RS - Brasil

Objective: To determine predictive factors linked to the TOP embryo development (blastocysts AA) in infertile patients undergoing in vitro fertilization (IVF).
Methods: A retrospective study was conducted involving 277 consecutive patients who underwent their first IVF treatment in 2024. All patients presented with both ovaries, hormonal or autoimmune diseases, and endometriosis were excluded. We also excluded severe masculine aetiology. We described all demographic and baseline reproductive data. Moreover, we investigated whether serum LH at day 1, serum LH, progesterone, and estradiol at the hCG day, and follicle output rate (FORT) were associated with the development of a TOP blastocyst. We compared Group 1 (TOP embryo) with Group 2 (non-TOP embryo). The TOP embryo was considered a blastocyst AA according to the Gardner classification. p<5% was considered significant.
Results: The baseline characteristics were (mean±standard deviation) for groups 1 and 2, respectively. Age 34±4 x 37±4 (p<0.001), AFC 14±6 x 10±5 (p<0.001), AMH 3.5±3 x 1.8±2 (p<0.001), mature oocytes 10±6 x 5±3 (p<0.001), FORT 55% x 47% (p=0.113). In addition, day-1 LH and hCG-day progesterone were not different between the groups (p>0.05). However, serum LH (2.8±2 x 4.7±6) and estradiol (3265±4132 x 1569±1241) at hCG day were different between the groups (p<0.05). Moreover, the multivariable analysis showed that, after controlling for age, AMH, number of collected MII, AFC, serum LH, and estradiol at the hCG day, only the number of collected mature oocytes was related to the TOP quality blastocysts (p=0.007, logistic regression analysis).
Conclusion: TOP quality blastocysts were linked to well-determined prognostic factors after IVF (age, ovarian reserve, and number of collected MII oocytes). Moreover, serum LH and estradiol levels on the day of hCG administration were also essential markers and prognostic factors for TOP blastocyst development. Those last parameters seem to be related to the intrinsic hormonal capacity of ovarian response to exogenous gonadotropins. On the other hand, FORT was not linked to the blastocyst quality, confirming previous data. Finally, the number of mature oocytes was the most critical factor related to the development of the TOP blastocyst, controlling for all other variables.