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In this study, we aimed to investigate which clinical/embryological factors function as independent predictors of embryonic euploidy in preimplantation genetic testing cycles. This retrospective cohort study included 377 couples with normal parental karyotypes undergoing their first preimplantation genetic testing cycle, yielding 1105 embryos for analysis. The primary outcome was embryonic euploidy. Associations were evaluated using multivariable generalized linear mixed-effects models with patient-level random intercepts. Maternal age and blastocyst morphology emerged as independent predictors of euploidy. Each additional year of maternal age reduced the odds of euploidy (adjusted odds ratio aOR: 0.88, 95% confidence interval CI: 0.84–0.93; P < .001). Better trophectoderm morphology was strongly associated with euploidy (Grade B: aOR 2.43, 95% CI: 1.71–3.46; Grade A: aOR 4.42, 95% CI: 2.78–7.04; both P < .001). Similarly, Grade A inner cell mass showed a significant independent association (aOR: 1.69, 95% CI: 1.01–2.82; P = .045), while Grade B was borderline ( P = .065). Anti-Müllerian hormone showed a modest independent association (aOR: 1.10 per ng/mL, 95% CI: 1.01–1.20; P = .033), while estradiol on trigger day was statistically significant but with negligible effect size (aOR: 0.99; P = .025); therefore, these parameters were considered of limited clinical relevance. Maternal age and blastocyst morphology, specifically trophectoderm and inner cell mass grades, were robust independent predictors of euploidy, with higher morphological grades associated with higher euploidy rates. These findings support morphology- and age-based embryo selection strategies.
Huang et al. (Fri,) studied this question.