The effect of trophoectoderm morphology on obstetric outcomes of ivf patients with blastocyst transfer on day 5.

TE (trophoectordem), which forms the outer epithelial layer of blastocyst, is the first cell type that differentiates in embryo development and has epithelial feature. The blastocyst is thought to require healthy TE cells for implantation, which is a complex process requiring endometrial invasion in the early stages of embryonic development. TE cells accompany the implantation of the blastocyst into the uterine wall while contributing to the formation of the placenta. In this study, the 5 th day blastocyst transferred to the pregnant women with moderate or poor quality of pregnancy and obstetric complications during this process (PE, Eclampsia, FGR, Oligohydroamnios, Polyhydroamnios, PB, GDM, and etc. ) will be evaluated. Akdeniz University, Faculty of Medicine, Department of Obstetrics and Gynecology, IVF (in vitro fertilization) unit. A retrospective study was carried out using data from all patients who applied blastocyst transfer by IVF method between January 2015 and March 2019 at the Reproductive Health and Infertility Center of Akdeniz University Faculty of Medicine, Department of Obstetrics and Gynecology. Embryo quality, expansion, ICM and TE morphology, age of the patients, live birth rate, pregnancy complications and pregnancy outcome parameters of the patients who underwent blastocyst transfer on the 5th day were compared In the study, ICM and TE groups were evaluated separately for implantation, pregnancy rates, pregnancy outcomes and obstetric complications, grade A, B and C. Since there were no significant differences between grade A and B results in both groups, they were evaluated in one group and compared with grade C. In terms of general characteristics paternal age (p = 0.047) and body mass index (p = 0.041) were found to be significant in the ICM grade C group, while maternal age was found to be significant in the TE grade C group (p=0.005). When compared with the general characteristics of the patients in terms of obstetric complications, there is no difference between the groups. According to the results, the relationship between sociodemographic features and obstetric complications was not statistically significant. When ICM and TE groups were compared, biochemical pregnancy TE group was seen more in grade C and found statistically significant (p =0.021). Low birth weight baby (<2500 g) number was seen more in the grade C group of TE and it was found statistically very limited but meaningless in this respect (p = 0.051). When obstetric complications were compared between groups, no significant difference was observed in ICM grade C, while in TE grade C there was a statistically significant difference in terms PE, PD and Antenatal Bleeding rates (p = 0.041, p = 0.021, p = 0.037, respectively). While TE morphology, implantation, ongoing pregnancy rate, abortion rate and pregnancy complications showed a statistically significant relationship, ICM and blastocyst expansion did not show a statistically significant relationship. The main feature of our study was that the morphological appearance and quality of TE cells for the transferred blastocysts was the most important morphological parameter in predicting the live birth result and obstetric complications that may develop during pregnancy.