When using donor oocytes, does embryo stage matter? An analysis of blastocyst versus cleavage stage embryo transfers using a cryopreserved donor oocyte bank

2021 ◽  
Author(s):  
Sarah M. Capelouto ◽  
Audrey J. Gaskins ◽  
Zsolt Peter Nagy ◽  
Daniel B. Shapiro ◽  
Jessica B. Spencer ◽  
...  
Keyword(s):  
Cleavage Stage ◽  
Donor Oocyte ◽  
Cleavage Stage Embryo ◽  
Stage Embryo ◽  
Embryo Stage ◽  
Donor Oocytes

scholarly journals Thin Endometrium and Cleavage Embryo Transfer Are Associated With Ectopic Pregnancy After in Vitro Fertilization‑embryo Transfer Cycles: a Matched Case–control Study Using Propensity Score Matching

2021 ◽  
Author(s):  
Ying Zhao ◽  
Dong'e Liu ◽  
Nenghui Liu ◽  
Yumei Li ◽  
Zhongyuan Yao ◽  
...  
Keyword(s):  
Embryo Transfer ◽  
Case Control Study ◽  
Case Control ◽  
Cleavage Stage ◽  
Cleavage Stage Embryo ◽  
Stage Embryo ◽  
Matched Case ◽  
Embryo Stage ◽  
Matched Case Control Study ◽  
Control Study

Abstract Objective: To evaluate the relationship between the endometrial features (endometrial thickness(EMT), pattern and endometrium growth amplitude and rate) and the embryo stage transferred and ectopic pregnancy after IVF-ET based on the data of 628 matched cases. Methods: This was a 1:1 matched case-control study that enrolled 314 EP patients and 314 matched IUP patients from the ART center of Xiangya Hospital of Central South University from January 2014 to April 2020. Univariate analysis and multiple-stepwise logistic regression analysis was used to analyze the risk factors of EP, and a receiver-operating characteristic (ROC) curve was generated to predict EP. Results: 1. The EP group had a higher cleavage stage embryo transfer rate(94.57% vs 86.22%), a thinner endometrium on transformation day(the day when progesterone was added in the frozen embryo cycle or the trigger day in the fresh embryo cycle) (9.40(2.60) mm vs 9.80(2.60)mm) compared with IUP group. In fresh embryo cycles, the EP group had a higher endometrium pattern C proportion on transformation day, a smaller endometrium increment, and a slower endometrial growth rate compared with the IUP group. 2.The ROC curves were used to analyze the cut-off values of the EMT on transformation day, the endometrial growth amplitude and rate in fresh cycles, the results were 9.35mm, 4.90mm and 0.491 mm/d, respectively. The incidence of EP was significantly different between groups according to cut-off values. 3.The transferred embryo stage and EMT on transformation day were independent factors affecting outcome in the general population. The area under the curve(AUC) of the EMT and the stage of embryos transferred for EP prediction was 0.604, sensitivity was 0.702, and specificity was 0.465. The EMT on trigger day was an independent factor affecting outcome in the fresh cycles. The AUC of the EMT for EP prediction in fresh cycles was 0.605, sensitivity was 0.805, and specificity was 0.420. Conclusions: 1. Transferring cleavage stage embryo, and thin EMT on the transformation day were risk factors for EP. 2. Thin EMT and pattern C on transformation day may be related to abnormal endometrial receptivity and endometrial peristaltic waves. 3.The combined indicator of EMT and embryonic development stage could not well predict the occurrence of EP after ET.

scholarly journals Thin endometrium and cleavage embryo transfer are associated with ectopic pregnancy after in vitro fertilization‑embryo transfer cycles: a matched case–control study using propensity score matching

2021 ◽  
Author(s):  
Ying Zhao ◽  
Dong'e Liu ◽  
Nenghui Liu ◽  
Yumei Li ◽  
Zhongyuan Yao ◽  
...  
Keyword(s):  
Embryo Transfer ◽  
Case Control Study ◽  
Case Control ◽  
Cleavage Stage ◽  
Cleavage Stage Embryo ◽  
Stage Embryo ◽  
Matched Case ◽  
Embryo Stage ◽  
Matched Case Control Study ◽  
Control Study

Abstract Objective: To evaluate the relationship between the endometrial features (endometrial thickness(EMT), pattern and endometrium growth amplitude and rate) and the embryo stage transferred and ectopic pregnancy after IVF-ET based on the data of 628 matched cases. Methods: This was a 1:1 matched case-control study that enrolled 314 EP patients and 314 matched IUP patients from the ART center of Xiangya Hospital of Central South University from January 2014 to April 2020. Univariate analysis and multiple-stepwise logistic regression analysis was used to analyze the risk factors of EP, and a receiver-operating characteristic (ROC) curve was generated to predict EP. Results: 1. The EP group had a higher cleavage stage embryo transfer rate(94.57% vs 86.22%), a thinner endometrium on transformation day (the day when progesterone was added in the frozen embryo cycle or the trigger day in the fresh embryo cycle) (9.40(2.60) mm vs 9.80(2.60)mm) compared with IUP group. In fresh embryo cycles, the EP group had a higher endometrium pattern C proportion on transformation day, a smaller endometrium increment, and a slower endometrial growth rate compared with the IUP group. 2.The ROC curves were used to analyze the cut-off values of the EMT on transformation day, the endometrial growth amplitude and rate in fresh cycles, the results were 9.35mm, 4.90mm and 0.491 mm/d, respectively. The incidence of EP was significantly different between groups according to cut-off values. 3. The transferred embryo stage and EMT on transformation day were independent factors affecting outcome in the general population. The area under the curve(AUC) of the EMT and the stage of embryos transferred for EP prediction was 0.604, sensitivity was 0.702, and specificity was 0.465. The EMT on trigger day was an independent factor affecting outcome in the fresh cycles. The AUC of the EMT for EP prediction in fresh cycles was 0.605, sensitivity was 0.805, and specificity was 0.420. Conclusions: 1. Transferring cleavage stage embryo , and thin EMT on the transformation day were risk factors for EP. 2. Thin EMT and pattern C on transformation day may be related to abnormal endometrial receptivity and endometrial peristaltic waves. 3.The combined indicator of EMT and embryonic development stage could not well predict the occurrence of EP after ET.

scholarly journals Clinical outcomes for Day 3 double cleavage-stage embryo transfers versus Day 5 or 6 single blastocyst transfer in frozen–thawed cycles: a retrospective comparative analysis

2021 ◽  
Vol 49 (12) ◽  
pp. 030006052110624
Author(s):  
Jinpeng Rao ◽  
Feng Qiu ◽  
Shen Tian ◽  
Ya Yu ◽  
Ying Zhang ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Clinical Outcomes ◽  
Implantation Rate ◽  
Cleavage Stage ◽  
Ongoing Pregnancy Rate ◽  
Group Transfer ◽  
Biochemical Pregnancy ◽  
Single Blastocyst Transfer ◽  
Cleavage Stage Embryo ◽  
Stage Embryo

Objective This study aimed to compare the clinical outcomes for transfer of Day 3 (D3) double cleavage-stage embryos and Day 5/6 (D5/6) single blastocysts in the frozen embryo transfer (FET) cycle to formulate a more appropriate embryo transplantation strategy. Methods We retrospectively analyzed 609 FET cycles from 518 women from April 2017 to March 2021. All FETs were assigned to the D3-DET group (transfer of a Day 3 double cleavage-stage embryo), D5-SBT group (transfer of a Day 5 single blastocyst), or D6-SBT group (transfer of a Day 6 single blastocyst). Clinical outcomes were comparatively analyzed. Results There were no significant differences in the biochemical pregnancy rate, clinical pregnancy rate, or ongoing pregnancy rate between the D3-DET and D5-SBT groups, but these rates in the two groups were all significantly higher compared with those in the D6-SBT group. The implantation rate in the D5-SBT group was significantly higher than that in the D3-DET group. The twin pregnancy rate in the D5-SBT and D6-SBT groups was significantly lower than that in the D3-DET group. Conclusion This study suggests that D5-SBT is the preferred option for transplantation. D6-SBT reduces the pregnancy rate, making it a more cautious choice for transfer of such embryos.

What is the threshold of mature oocytes to obtain at least one healthy transferable cleavage-stage embryo after preimplantation genetic testing for fragile X syndrome?

2021 ◽  
Author(s):  
C Sonigo ◽  
A Mayeur ◽  
M Sadoun ◽  
M Pinto ◽  
J Benguigui ◽  
...  
Keyword(s):  
Ovarian Reserve ◽  
Fragile X ◽  
Median Number ◽  
Cleavage Stage ◽  
Preimplantation Genetic Testing ◽  
Cutoff Value ◽  
Fmr1 Premutation ◽  
Cleavage Stage Embryo ◽  
Stage Embryo ◽  
Female Carriers

Abstract STUDY QUESTION What are the chances of obtaining a healthy transferable cleavage-stage embryo according to the number of mature oocytes in fragile X mental retardation 1 (FMR1)-mutated or premutated females undergoing preimplantation genetic testing (PGT)? SUMMARY ANSWER In our population, a cycle with seven or more mature oocytes has an 83% chance of obtaining one or more healthy embryos. WHAT IS KNOWN ALREADY PGT may be an option to achieve a pregnancy with a healthy baby for FMR1 mutation carriers. In addition, FMR1 premutation is associated with a higher risk of diminished ovarian reserve and premature ovarian failure. The number of metaphase II (MII) oocytes needed to allow the transfer of a healthy embryo following PGT has never been investigated. STUDY DESIGN, SIZE, DURATION The study is a monocentric retrospective observational study carried out from January 2006 to January 2020 that is associated with a case-control study and that analyzes 38 FMR1 mutation female carriers who are candidates for PGT; 16 carried the FMR1 premutation and 22 had the full FMR1 mutation. PARTICIPANTS/MATERIALS, SETTING, METHODS A total of 95 controlled ovarian stimulation (COS) cycles for PGT for fragile X syndrome were analyzed, 49 in premutated patients and 46 in fully mutated women. Only patients aged ≤38 years with anti-Müllerian hormone (AMH) >1 ng/ml and antral follicle count (AFC) >10 follicles were eligible for the PGT procedure. Each COS cycle of the FMR1-PGT group was matched with the COS cycles of partners of males carrying any type of translocation (ratio 1:3). Conditional logistic regression was performed to compare the COS outcomes. We then estimated the number of mature oocytes needed to obtain at least one healthy embryo after PGT using receiver operating characteristic curve analysis. MAIN RESULTS AND THE ROLE OF CHANCE Overall, in the FMR1-PGT group, the median number of retrieved and mature oocytes per cycle was 11 (interquartile range 7–15) and 9 (6–12), respectively. The COS outcomes of FMR1 premutation or full mutation female carriers were not altered compared with the matched COS cycles in partners of males carrying a balanced translocation in their karyotype. Among the 6 (4–10) Day 3 embryos obtained in the FMR1-PGT group, a median number of 3 (1–6) embryos were morphologically eligible for biopsy, leading to 1 (1–3) healthy embryo. A cutoff value of seven MII oocytes yielded a sensitivity of 82% and a specificity of 61% of having at least one healthy embryo, whereas a cutoff value of 10 MII oocytes led to a specificity of 85% and improved positive predictive value. LIMITATIONS, REASONS FOR CAUTION This study is retrospective, analyzing a limited number of cycles. Moreover, the patients who were included in a fresh PGT cycle were selected on ovarian reserve parameters and show high values in ovarian reserve tests. This information could influence our conclusion. WIDER IMPLICATIONS OF THE FINDINGS The results relate only to the target population of this study, with a correct ovarian reserve of AMH >1 and AFC >10. However, the information provided herein extends knowledge about the current state of COS for FMR1 mutation carriers in order to provide patients with proper counseling regarding the optimal number of oocytes needed to have a chance of transferring an unaffected embryo following PGT. STUDY FUNDING/COMPETING INTEREST(S) None. TRIAL REGISTRATION NUMBER N/A.

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