INDIVIDUAL CULTURE LEADS TO DECREASED BLASTULATION BUT DOES NOT AFFECT PREGNANCY OUTCOMES IN THE SETTING OF A SINGLE, VITRIFIED-WARMED EUPLOID BLASTOCYST TRANSFER

Abstract Background High-quality single blastocyst transfer (SBT) is increasingly recommended to patients because of its acceptable pregnancy outcomes and significantly reduced multiple pregnancy rate compared to double blastocyst transfer (DBT). However, there is no consensus on whether this transfer strategy is also suitable for poor-quality blastocysts. Moreover, the effect of the development speed of poor-quality blastocysts on pregnancy outcomes has been controversial. Therefore, this study aimed to explore the effects of blastocyst development speed and morphology on pregnancy and neonatal outcomes during the frozen embryo transfer (FET) cycle of poor-quality blastocysts and to ultimately provide references for clinical transfer strategies. Methods A total of 2,038 FET cycles of poor-quality blastocysts from patients 40 years old or less were included from January 2014 to December 2019 and divided based on the blastocyst development speed and number of embryos transferred: the D5-SBT (n = 476), D5-DBT (n = 365), D6-SBT (n = 730), and D6-DBT (n = 467) groups. The SBT group was further divided based on embryo morphology: D5-AC/BC (n = 407), D5-CA/CB (n = 69), D6-AC/BC (n = 580), and D6-CA /CB (n = 150). Results When blastocysts reach the same development speed, the live birth and multiple pregnancy rates of DBT were significantly higher than those of SBT. Moreover, there was no statistical difference in the rates of early miscarriage and live birth between the AC/BC and CA/CB groups. When patients in the SBT group were stratified by blastocyst development speed, the rates of clinical pregnancy (42.44 % vs. 20.82 %) and live birth (32.35 % vs. 14.25 %) of D5-SBT group were significantly higher than those of D6-SBT group. Furthermore, for blastocysts in the same morphology group (AC/BC or CA/CA group), the rates of clinical pregnancy and live birth in the D5 group were also significantly higher than those of D6 group. Conclusions For poor-quality D5 blastocysts, SBT can be recommended to patients because of acceptable pregnancy outcomes and significantly reduced multiple pregnancy rate compared with DBT. For poor-quality D6, the DBT strategy is recommended to patients to improve pregnancy outcomes. When blastocysts reach the same development speed, the transfer strategy of selecting blastocyst with inner cell mass “C” or blastocyst with trophectoderm “C” does not affect the pregnancy and neonatal outcomes.

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The effect of Day 3 cell number on pregnancy outcomes in vitrified-thawed single blastocyst transfer cycles

Human Reproduction ◽

10.1093/humrep/deaa209 ◽

2020 ◽

Vol 35 (11) ◽

pp. 2478-2487

Author(s):

Jiayi Wu ◽

Jie Zhang ◽

Yanping Kuang ◽

Qiuju Chen ◽

Yun Wang

Keyword(s):

Pregnancy Rate ◽

Live Birth ◽

Young Women ◽

Pregnancy Outcomes ◽

Cell Number ◽

Blastocyst Transfer ◽

Cell Group ◽

Single Blastocyst Transfer ◽

Significant Difference ◽

Blastomere Number

Abstract STUDY QUESTION Does cell number on Day 3 have an impact on pregnancy outcomes in vitrified-thawed single blastocyst transfer cycles? SUMMARY ANSWER A low Day 3 cell number (≤5 cells) was independently associated with decreased live birth rate (LBR) during single blastocyst transfer cycles in young women. WHAT IS KNOWN ALREADY Day 3 cell number is an effective predictor of IVF success rates when transferring cleavage stage embryos. However, the association between Day 3 blastomere number and pregnancy outcomes after blastocyst transfer is still unknown. STUDY DESIGN, SIZE, DURATION A retrospective cohort study of 3543 patients who underwent frozen-thawed single blastocyst transfers from January 2013 to June 2018 at a tertiary-care academic medical center. PARTICIPANTS/MATERIALS, SETTING, METHODS Patients were grouped into six groups according to the Day 3 cell number: ≤4 cells, 5 cells, 6 cells, 7 cells, 8 cells and >8 cells. The primary outcome measure was LBR. A logistic regression analysis was performed to explore the independent association between Day 3 blastomere number and LBR after adjustment for some potential confounders. MAIN RESULTS AND THE ROLE OF CHANCE In women <35 years old, the LBR varied significantly according to Day 3 cell number, with the rate of 31.2%, 34.4%, 41.9%, 45.1%, 48.1% and 48.2% for the ≤4-cell, 5-cell, 6-cell, 7-cell, 8-cell and >8-cell groups, respectively (P < 0.001). This significant difference was also observed in the high- and low-quality blastocyst subgroups of young women. However, for women ≥35 years old, the rate of live birth was similar between groups. Furthermore, after accounting for confounding factors, the LBR was significantly decreased in the ≤4-cell (adjusted odds ratio (aOR): 0.62, 95% CI: 0.48–0.80, P < 0.001) and 5-cell (aOR: 0.73, 95% CI: 0.57–0.92, P = 0.009) groups as compared to the 8-cell group. Likewise, the blastocysts arising from ≤4-cell (aOR: 0.73, 95% CI: 0.57–0.93, P = 0.010) or 5-cell (aOR: 0.77, 95% CI: 0.61–0.97, P = 0.024) embryos were associated with lower clinical pregnancy rate than those from 8-cell embryos. No significant differences were observed in biochemical pregnancy rate and miscarriage rate. LIMITATIONS, REASONS FOR CAUTION A limitation of the current study was its retrospective design. Future prospective studies are needed to confirm our findings. WIDER IMPLICATIONS OF THE FINDINGS Our observations suggested that a low Day 3 cell number was related to decreased LBR after blastocyst transfer in young women, which provided vital information for clinicians in selecting blastocyst during IVF treatment. STUDY FUNDING/COMPETING INTEREST(S) This study was supported by the National Natural Science Foundation of China (NSFC) (31770989 to Y.W.; 81671520 to Q.C.) and the Shanghai Ninth People’s Hospital Foundation of China (JYLJ030 to Y.W.). The authors have no conflicts of interest to declare. TRIAL REGISTRATION NUMBER N/A.

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Morbid obesity and pregnancy outcomes after single blastocyst transfer: a retrospective, North American study

Journal of Assisted Reproduction and Genetics ◽

10.1007/s10815-017-0883-9 ◽

2017 ◽

Vol 34 (4) ◽

pp. 451-457 ◽

Cited By ~ 8

Author(s):

Miguel Russo ◽

Senem Ates ◽

Talya Shaulov ◽

Michael H. Dahan

Keyword(s):

Morbid Obesity ◽

North American ◽

Pregnancy Outcomes ◽

Blastocyst Transfer ◽

American Study ◽

North American Study ◽

Single Blastocyst Transfer

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Which is better for mothers and babies, fresh or frozen thawed blastocyst transfer?

10.21203/rs.3.rs-16648/v1 ◽

2020 ◽

Author(s):

Meiling Yang ◽

li Lin ◽

Chunli Sha ◽

Taoqiong Li ◽

Wujiang Gao ◽

...

Keyword(s):

Pregnancy Rate ◽

Pregnancy Outcomes ◽

Meta Analysis ◽

Neonatal Outcomes ◽

Blastocyst Transfer ◽

Cochrane Library ◽

Maternal Complications ◽

Ongoing Pregnancy Rate ◽

Vitro Fertilization

Abstract Background: In recent years, there have been emerging many reports on the pregnancy outcomes of fresh blastocyst transfer (BT) and freeze-thaw BT, but these couclusions are controversial and incomplete. To compare the pregnancy outcomes, maternal complications and neonatal outcomes of fresh and frozen-thawed BT in vitro fertilization or intracytoplasmic sperm injection (IVF/ICSI) cycles, we conducted a meta-analysis. Methods: A meta-analysis was conducted by searching PubMed, Embase, and Cochrane Library until January 2020. Data were extracted independently by two authors. Results: 42 studies, including 12 randomized controlled trials (RCT) met the inclusion criteria. Fresh BT showed lower implantation rate (IR), pregnancy rate (PR), ongoing pregnancy rate (OPR) and higher eptopic pregnancy rate (EPR) compared with frozen-thawed BT consistent with the results of RCT. The risks of moderate or severe ovarian hyperstimulation syndrome (OHSS), placental abruption (PA) and preterm were higher in fresh BT than in the frozen-thawed BT. The risk of pregnancy-induced hypertension (PIH) and pre-eclampsia was decreased in fresh BT , however, no significant differences of risks for PIH, pre-eclampsia, OHSS, and preterm was found between the two group in the 2 RCT included. Compared with frozen-thawed BT, fresh BT appears to be associated with small for gestational age (SGA) and low birth weight (LBW). No differences in the incidences of neonatal mortality and neonatal malformations were observed between fresh and frozen-thawed BT. Conclusions: In summary, Considering the higher IR, PR, OPR, lower EPR, and the decreased risks of OHSS, PA and preterm, as well as the incidences of SGA and LBW in frozen-thawed BT, this meta-analysis indicates that frozen-thawed BT may be a better choice for mothers and babies compared with fresh BT. Key words: Fresh blastocyst transfer, frozen thawed blastocyst transfer, pregnancy outcome, maternal complications, neonatal outcomes

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Evaluation of Pregnancy Outcomes of Vitrified-Warmed Blastocyst Transfer before and after Endometrial Receptivity Analysis in Identical Patients with Recurrent Implantation Failure

Fertility & Reproduction ◽

10.1142/s2661318221500043 ◽

2021 ◽

pp. 1-7

Author(s):

Yuta Kasahara ◽

Tomoko Hashimoto ◽

Ryo Yokomizo ◽

Yuya Takeshige ◽

Koki Yoshinaga ◽

...

Keyword(s):

Pregnancy Rate ◽

Embryo Transfer ◽

Pregnancy Outcomes ◽

Endometrial Receptivity ◽

Pregnancy Rates ◽

Blastocyst Transfer ◽

Implantation Failure ◽

Recurrent Implantation Failure ◽

Clinical Value ◽

Ongoing Pregnancy Rate

Background:The clinical value of personalized embryo transfer (pET) guided by the endometrial receptivity analysis (ERA) tests for recurrent implantation failure (RIF) cases is still unclear. The aim of this study is to clarify the efficacy of ERA leading to personalization of the day of embryo transfer (ET) in RIF patients. Methods: A retrospective study was performed for 94 patients with RIF who underwent ERA between July 2015 and December 2019. Pregnancy outcomes in a previous vitrified-warmed blastocyst transfer (previous VBT) and a personalized vitrified-warmed blastocyst transfer (pVBT) in identical patients were compared. The details of each pVBT were further analyzed between patients in a non-displaced group, which indicated “receptive” cases in ERA results and those who were in the displaced group, which indicated “non-receptive” cases. Results:When the pregnancy rate, both per patient and per transfer cycle, of previous VBT and pVBT were compared, a significant increase in pVBT was observed between the two methods (5.3% vs. 62.8%, 4.4% vs. 47.9%, respectively). The pregnancy rates, implantation rates, and clinical pregnancy rates of the first pVBT were significantly higher in the displaced group than the non-displaced group. The cumulative ongoing pregnancy rate of the displaced group tended to be higher compared to that of the non-displaced group in the first pVBT, although the difference was not statistically significant (51.0% vs. 31.1%, [Formula: see text] = 0.06). Conclusions:Our study demonstrates that pVBT guided by ERA tests may improve pregnancy outcomes in RIF patients whose window of implantation (WOI) is displaced, and its effect may be more pronounced at the first pVBT. The displacement of WOI may be considered to be one of the causes of RIF, and its adjustment may contribute to the improvement of pregnancy outcomes in RIF patients.

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Day-3 quality is not a valuable parameter for predicting pregnancy outcomes after vitrified-warmed single blastocyst transfer

Fertility and Sterility ◽

10.1016/j.fertnstert.2018.07.1030 ◽

2018 ◽

Vol 110 (4) ◽

pp. e369

Author(s):

G. Li ◽

P. Chen ◽

Q. Sun ◽

F. Xiong ◽

C. Wan ◽

...

Keyword(s):

Pregnancy Outcomes ◽

Blastocyst Transfer ◽

Single Blastocyst Transfer

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Which is better for mothers and babies: fresh or frozen-thawed blastocyst transfer?

BMC Pregnancy and Childbirth ◽

10.1186/s12884-020-03248-5 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Meiling Yang ◽

Li Lin ◽

Chunli Sha ◽

Taoqiong Li ◽

Wujiang Gao ◽

...

Keyword(s):

Pregnancy Rate ◽

Pregnancy Outcomes ◽

Current Knowledge ◽

Placenta Previa ◽

Meta Analysis ◽

Blastocyst Transfer ◽

Cochrane Library ◽

Maternal Complications ◽

Ongoing Pregnancy Rate

Abstract Background In recent years, there have been many reports on the pregnancy outcomes of fresh blastocyst transfer (BT) and frozen-thawed BT, but the conclusions are controversial and incomplete. To compare the pregnancy outcomes, maternal complications and neonatal outcomes of fresh and frozen-thawed BT in the context of in vitro fertilization or intracytoplasmic sperm injection (IVF/ICSI) cycles, we conducted a meta-analysis. Methods A meta-analysis was conducted by searching the PubMed, Embase, and Cochrane Library databases through May 2020. Data were extracted independently by two authors. Results Fifty-four studies, including 12 randomized controlled trials (RCTs), met the inclusion criteria. Fresh BT was associated with a lower implantation rate, pregnancy rate, ongoing pregnancy rate, and clinical pregnancy rate and higher ectopic pregnancy rate than frozen-thawed BT according to the results of the RCTs. The risks of moderate or severe ovarian hyperstimulation syndrome, placental abruption, placenta previa and preterm delivery were higher for fresh BT than for frozen-thawed BT. The risk of pregnancy-induced hypertension and pre-eclampsia was lower for fresh BT; however, no significant differences in risks for gestational diabetes mellitus and preterm rupture of membrane were found between the two groups. Compared with frozen-thawed BT, fresh BT appears to be associated with small for gestational age and low birth weight. No differences in the incidences of neonatal mortality or neonatal malformation were observed between fresh and frozen-thawed BT. Conclusions At present there is an overall slight preponderance of risks in fresh cycles against frozen, however individualization is required and current knowledge does not permit to address a defintive response.

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