Relationship Between Blastocyst Trophoblast Cell Score and Single Blastocyst Transfer-assisted Live Birth Rate

TAO Shibo; XIANG Yungai

doi:10.3969/j.issn.2096-305X.2025.06.011

Abstract：Objective To investigate the relationship between blastocyst trophoblast cell score and single blastocyst transfer assisted live birth rate.Methods A retrospective selection was made of 350 patients who underwent single blastocyst transfer at the Second Affiliated Hospital of Zhengzhou University from April 2022 to April 2024 as the research subjects.The live birth rate of the patients was recorded;the patients were divided into the live birth group and the non-live birth group based on whether they gave birth,and the general data of the two groups were compared;Binary Logistic Regression analysis was used to analyze the influencing factors of live birth through single blastocyst transfer in assisted pregnancy,and forest plots were used to analyze the effect values of each influencing factor;the predictive efficacy was verified using the ROC curve;and the relationship between the blastocyst trophectoderm cell score and the live birth rate after single blastocyst transfer was analyzed through Pearson correlation analysis.Results The live birth rate of 350 patients during childbirth was 46.00％.General data showed that the levels of anti-müllerian hormone(AMH),antral follicle count(AFC),trophoblast grading(TE),endometrial thickness,number of metaphase Ⅱ oocytes(MⅡ),and the proportion of fresh cycle transplantation in the live birth group were significantly higher than those in the non-live birth group.Meanwhile,the proportion of fresh cycle transplantation,basal estradiol(E2),follicle-stimulating hormone(FSH)levels,and patient age were significantly lower(P＜0.05);the multivariate analysis of binary Logistic regression showed that the advanced age of the patient during pregnancy(OR=1.364,95％CI:1.113-1.615)was a risk factor for non-viability of pregnancy after single blastocyst transfer,while high levels of AMH(OR=0.595,95％CI:0.344-0.846),TE grade(OR=0.367,95％CI:0.116-0.618),and recovery cycle(OR=0.431,95％CI:0.218-0.682)were protective factors(P＜0.05).The ROC curve indicated that the independent influencing factors had better predictive efficacy for the live birth of single blastocyst transfer assisted pregnancy;the cutoff values of patient age and AMH were 31.502 years and 5.341 ng/mL respectively(P＜0.05);and the Pearson correlation analysis showed that the score of blastocyst trophoblast cells was positively correlated with the live birth rate of single blastocyst transfer assisted pregnancy.Conclusion When single blastocyst transfer is used for assisted pregnancy and leads to live birth,the AMH level,TE grade,and the proportion of the recovery cycle are relatively high.The patient's age(＞31.502 years old)is an independent risk factor for single blastocyst transfer-assisted pregnancy that fails to result in live birth.However,AMH(＞5.341 ng/mL),TE grade,and the recovery cycle are protective factors,and they have a good predictive effect on the live birth rate of single blastocyst transfer-assisted pregnancy,providing a theoretical reference for improving the live birth rate of single blastocyst transfer-assisted pregnancy in clinical practice.