{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T08:48:49Z","timestamp":1776674929001,"version":"3.51.2"},"reference-count":0,"publisher":"The Korean Society for Reproductive Medicine","content-domain":{"domain":["ecerm.org"],"crossmark-restriction":true},"short-container-title":["Clin Exp Reprod Med"],"abstract":"Objective: This study investigated whether changes in embryonic morphological scores can predict pregnancy outcomes to support optimal blastocyst selection.Methods: This retrospective dual-center study analyzed 1,492 single blastocyst transfers. Blastocysts were categorized according to day 3 and day 5 scores (excellent, good, or poor) and their day 3\u20135 morphological changes (improvement, stability, or deterioration). The primary outcomes were clinical pregnancy rate (CPR) and live birth rate (LBR).Results: No statistically significant differences were observed in CPR or LBR among the Excellent-D3, Good-D3, and Poor-D3 embryo-quality groups. However, both CPR and LBR were significantly higher in the Excellent-D5 group compared with the Poor-D5 group (CPR: 58.64% vs. 46.34%, <i>p<\/i>=0.014; LBR: 45.97% vs. 33.54%, <i>p<\/i>=0.012). Temporal trends in developmental outcomes from day 3 to day 5 showed no significant differences across the improvement, stability, and deterioration groups for either CPR (57.95%, 55.28%, and 55.87%; <i>p<\/i>=0.615) or LBR (43.74%, 44.54%, and 40.84%; <i>p<\/i>=0.648). In stratified analysis, Poor-D3 embryos that reached Excellent-D5 status had a significantly lower LBR than Excellent-D5 embryos (40.52% vs. 48.81%: odds ratio, 0.714; 95% confidence interval, 0.513 to 0.994; <i>p<\/i>=0.046). No other subgroup comparisons demonstrated significant differences in clinical outcomes.Conclusion: Day 5 morphology is the primary predictor of CPR and LBR, with Excellent-D5 embryos demonstrating superior outcomes. Although day 3\u20135 morphological changes were not associated with CPR or LBR, day 3 quality contributed supplemental predictive value for distinguishing among top-tier day 5 embryos, thereby aiding embryo selection.<\/jats:p>","DOI":"10.5653\/cerm.2025.08179","type":"journal-article","created":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T08:01:58Z","timestamp":1776672118000},"update-policy":"https:\/\/doi.org\/10.5653\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Relationships between morphological score changes during embryonic development and pregnancy outcomes"],"prefix":"10.5653","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-4248-2464","authenticated-orcid":true,"given":"Qiuying","family":"Gan","sequence":"first","affiliation":[{"name":"Reproductive Medicine Center, the First Affiliated Hospital of Guangxi Medical University, Nanning, China"},{"name":"Reproductive Medicine Center, Nanning Maternity and Child Health Hospital, Nanning, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6552-5583","authenticated-orcid":true,"given":"Wenhong","family":"Ma","sequence":"additional","affiliation":[{"name":"Reproductive Medicine Center, Nanning Maternity and Child Health Hospital, Nanning, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0369-8200","authenticated-orcid":true,"given":"Lidan","family":"Liu","sequence":"additional","affiliation":[{"name":"Reproductive Medicine Center, the First Affiliated Hospital of Guangxi Medical University, Nanning, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qianyi","family":"Huang","sequence":"additional","affiliation":[{"name":"Reproductive Medicine Center, the First Affiliated Hospital of Guangxi Medical University, Nanning, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-3110-9684","authenticated-orcid":true,"given":"Fang","family":"Lu","sequence":"additional","affiliation":[{"name":"Reproductive Medicine Center, Nanning Maternity and Child Health Hospital, Nanning, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9847-5693","authenticated-orcid":true,"given":"Lang","family":"Qin","sequence":"additional","affiliation":[{"name":"Reproductive Medicine Center, the First Affiliated Hospital of Guangxi Medical University, Nanning, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3853-5003","authenticated-orcid":true,"given":"Liang","family":"Ren","sequence":"additional","affiliation":[{"name":"Reproductive Medicine Center, the First Affiliated Hospital of Guangxi Medical University, Nanning, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-8808-1762","authenticated-orcid":true,"given":"Zhibing","family":"Deng","sequence":"additional","affiliation":[{"name":"Reproductive Medicine Center, the First Affiliated Hospital of Guangxi Medical University, Nanning, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-0101-6957","authenticated-orcid":true,"given":"Chao","family":"Yang","sequence":"additional","affiliation":[{"name":"Reproductive Medicine Center, the First Affiliated Hospital of Guangxi Medical University, Nanning, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0536-6197","authenticated-orcid":true,"given":"Bo","family":"Liu","sequence":"additional","affiliation":[{"name":"Reproductive Medicine Center, the First Affiliated Hospital of Guangxi Medical University, Nanning, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5371-3843","authenticated-orcid":true,"given":"Yihua","family":"Yang","sequence":"additional","affiliation":[{"name":"Reproductive Medicine Center, the First Affiliated Hospital of Guangxi Medical University, Nanning, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3624","published-online":{"date-parts":[[2026,4,20]]},"container-title":["Clinical and Experimental Reproductive Medicine"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/ecerm.org\/upload\/pdf\/cerm-2025-08179.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T08:01:58Z","timestamp":1776672118000},"score":1,"resource":{"primary":{"URL":"http:\/\/ecerm.org\/journal\/view.php?doi=10.5653\/cerm.2025.08179"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,20]]},"references-count":0,"URL":"https:\/\/doi.org\/10.5653\/cerm.2025.08179","relation":{},"ISSN":["2233-8233","2233-8241"],"issn-type":[{"value":"2233-8233","type":"print"},{"value":"2233-8241","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,20]]},"assertion":[{"value":"2025-05-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-04","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-20","order":2,"name":"published","label":"Published online","group":{"name":"publication_history","label":"Publication History"}}]}}