scholarly journals Elevated Serum Estradiol Levels Have Different Effects on Pregnancy Outcomes Depending on Whether Cleavage-stage or Blastocyst-stage Embryo Transfer Is Performed During Artificial Frozen Embryo Transfer Cycles

2020 ◽  
Author(s):  
Qing Li ◽  
Liming Ruan ◽  
Lingling Zhu ◽  
Zengyu Yang ◽  
Maoling Zhu ◽  
...  
Keyword(s):  
Embryo Transfer ◽  
Pregnancy Outcomes ◽  
Blastocyst Stage ◽  
Frozen Embryo Transfer ◽  
Serum Estradiol ◽  
Cleavage Stage ◽  
Significant Difference ◽  
Cleavage Stage Embryo ◽  
Stage Embryo ◽  
The Impact

Abstract Objective: The aim of this study was to evaluate the association between serum estradiol (E2) and pregnancy outcomes of cleavage- or blastocyst-stage frozen embryo transfer (FET) cycles using hormone replacement therapy.Methods: A total of 776 FET cycles (669 couples) performed from January 2016 to December 2019 were included in the present retrospective cohort study. The impact of progesterone-initiation-day serum E2 levels on the ongoing pregnancy/live birth (OP/LB) rates was determined, and cleavage-stage embryo transfers and blastocyst-stage embryo transfers were analyzed separately. Results: Regarding cleavage-stage embryo transfer cycles, serum E2 levels on progesterone initiation day were significantly lower in the OP/LB group than in the non-OP/LB group (214.75 ± 173.47 vs. 253.20 ± 203.30 pg/ml; P = 0.023). In addition, there were downward trends in implantation, clinical pregnancy and OP/LB rates with increasing E2 levels. However, in blastocyst-stage embryo transfer cycles, such trends were not observed, and there was no significant difference between the OP/LB group and the non-OP/LB group. Logistic regression analysis revealed that E2 levels on progesterone initiation day in cleavage-stage embryo transfer cycles were independently associated with OP/LB (odds ratio = 1.000, 95% confidence interval: 1.000-1.001, P = 0.008). The areas under the receiver operating characteristic curve were 0.55 in cleavage-stage embryo transfer cycles and 0.53 in blastocyst-stage embryo transfer cycles.Conclusions: The association of low OP/LB rates with elevated E2 levels on the progesterone initiation day in cleavage-stage embryo transfer cycles suggests that E2 levels should be monitored during artificial cleavage-stage embryo transfer cycles. However, it is not necessary to monitor serum E2 levels when transferring blastocysts in artificial FET cycles.

scholarly journals Perinatal outcomes in singleton live births after fresh blastocyst-stage embryo transfer: a retrospective analysis of 67 147 IVF/ICSI cycles

2019 ◽  
Vol 34 (9) ◽  
pp. 1716-1725 ◽  
Author(s):  
Nicola Marconi ◽  
Edwin Amalraj Raja ◽  
Siladitya Bhattacharya ◽  
Abha Maheshwari
Keyword(s):  
Birth Weight ◽  
Embryo Transfer ◽  
Group Analysis ◽  
Perinatal Outcomes ◽  
Blastocyst Stage ◽  
Blastocyst Transfer ◽  
High Birth Weight ◽  
Cleavage Stage ◽  
Cleavage Stage Embryo ◽  
Stage Embryo

Abstract STUDY QUESTION Are perinatal outcomes different between singleton live births conceived from fresh blastocyst transfer and those following the transfer of fresh cleavage-stage embryos? SUMMARY ANSWER Fresh blastocyst transfer does not increase risks of preterm birth (PTB), low/high birth weight or congenital anomaly and does not alter the sex ratio at birth or prejudice the chance of having a healthy baby. WHAT IS KNOWN ALREADY Extended embryo culture is currently considered the best option for embryo selection, but concerns have been raised about increased risks of preterm delivery and large-for-gestational-age (LGA) babies. STUDY DESIGN, SIZE, DURATION We conducted a retrospective cohort study based on data from the Human Fertilisation and Embryology Authority (HFEA) anonymised and cycle-based dataset in the UK between 1999 and 2011. PARTICIPANTS/MATERIALS, SETTING, METHODS Baseline characteristics were compared between in vitro fertilisation (IVF)/intracytoplasmic sperm injection (ICSI) blastocyst-stage and cleavage-stage embryo transfer cycles using the χ2 test for categorical/dichotomised covariates and the Mann–Whitney test for continuous covariates. Statistical significance was set at <0.005. Poisson regression and multinomial logistic regression were used to establish relationships between perinatal outcomes and blastocyst-stage embryo transfer or cleavage-stage embryo transfer. Risk ratios (RRs), adjusted risk ratios (aRRs) and their 99.5% confidence intervals (CIs) were calculated as a measure of strength of associations. Results were adjusted for clinically relevant covariates. A sub-group analysis included women undergoing their first IVF/ICSI treatment. The level of significance was set at <0.05, and 95% CIs were calculated in the sub-group analysis. MAIN RESULTS AND THE ROLE OF CHANCE Of a total of 67 147 IVF/ICSI cycles, 11 152 involved blastocyst-stage embryo(s) and 55 995 involved cleavage-stage embryo(s). The two groups were comparable with regards to the risk of PTB (aRR, 1.00; 99.5% CI, 0.79–1.25), very-preterm birth (VPTB) (aRR, 1.00; 99.5% CI, 0.63–1.54), very-low birth weight (VLBW) (aRR, 0.84; 99.5% CI, 0.53–1.34), low birth weight (LBW) (aRR, 0.92; 99.5% CI, 0.73–1.16), high birth weight (HBW) (aRR, 0.94; 99.5% CI, 0.75–1.18) and very-high birth weight (VHBW) (aRR, 1.05; 99.5% CI, 0.66–1.65). The risk of congenital anomaly was 16% higher in the blastocyst-stage group than in the cleavage-stage group, but this was not statistically significant (aRR, 1.16; 99.5% CI, 0.90–1.49). The chance of having a healthy baby (born at term, with a normal birth weight and no congenital anomalies) was not altered by extended culture (aRR, 1.00; 99.5% CI, 0.93–1.07). Extended culture was associated with a marginal increase in the chance having a male baby in the main cycle-based analysis (aRR, 1.04; 99.5% CI, 1.01–1.09) but not in the sub-group analysis of women undergoing their first cycle of treatment (aRR, 1.04; 95% CI, 1.00–1.08). In the sub-group analysis, the risk of congenital anomalies was significantly higher after blastocyst-stage embryo transfer (aRR, 1.42; 95% CI, 1.12–1.81). LIMITATIONS, REASONS FOR CAUTION This study is limited by the use of observational data and inability to adjust for key confounders, such as maternal smoking status and body mass index (BMI), which were not recorded in the HFEA dataset. As the main analysis was cycle-based and we were unable to link cycles within women undergoing more than one IVF/ICSI cycle, we undertook a sub-group analysis on women undergoing their first treatment cycle. WIDER IMPLICATIONS OF THE FINDINGS Our findings should reassure women undergoing blastocyst-stage embryo transfer. For the first time, we have shown that babies born after blastocyst transfer have a similar chance of being healthy as those born after cleavage-stage embryos transfer. STUDY FUNDING/COMPETING INTEREST(S) The research activity of Dr Nicola Marconi was funded by the scholarship ‘A. Griffini-J. Miglierina’, Fondazione Comunitaria del Varesotto, Provincia di Varese, Italy. The authors do not have any competing interests to disclose. TRIAL REGISTRATION NUMBER N/A

scholarly journals Reduced live birth rates in frozen versus fresh single cleavage stage embryo transfer cycles: A cross-sectional study

2020 ◽  
Author(s):  
Wan Tinn Teh ◽  
Alex Polyakov ◽  
Claire Garrett ◽  
David Edgar ◽  
Peter Adrian Walton Rogers
Keyword(s):  
Multivariate Analysis ◽  
Embryo Transfer ◽  
Live Birth ◽  
Frozen Embryo Transfer ◽  
Confounding Factors ◽  
Cleavage Stage ◽  
Cross Sectional ◽  
Live Birth Rates ◽  
Cleavage Stage Embryo ◽  
Stage Embryo

Background: Studies have suggested that embryo-endometrial developmental asynchrony caused by slow-growing embryos can be corrected by freezing the embryo and transferring it back in a subsequent cycle. Therefore, we hypothesized that live birth rates (LBR) would be higher in frozen embryo transfer (FET) compared with fresh embryo transfers. Objective: To compare LBR between fresh and FET cycles. Materials and Methods: A cross-sectional analysis of 10,744 single autologous embryo transfer cycles that used a single cleavage-stage embryo was performed. Multivariate analysis was performed to compare LBR between FET and fresh cycles, after correcting for various confounding factors. Sub-analysis was also performed in cycles using slow embryos. Results: Both LBR (19.13% vs 14.13%) and clinical pregnancy (22.48% vs 16.25%) rates (CPR) were higher in the fresh cycle group (p < 0.00). Multivariate analysis for confounding factors also confirmed that women receiving a frozen-thawed embryo had a significantly lower LBR rate compared to those receiving a fresh embryo (OR 0.76, 95% CI 0.68-0.86, p < 0.00). In the sub-analysis of 1,154 cycles using slow embryos, there was no statistical difference in LBR (6.40% vs 6.26%, p = 0.92) or CPR (8.10% vs 7.22%, p = 0.58) between the two groups. Conclusion: This study shows a lower LBR in FET cycles when compared to fresh cycles. Our results suggest that any potential gains in LBR due to improved embryo-endometrial synchrony following FET are lost, presumably due to freeze-thaw process-related embryo damage. Key words: Fresh, Frozen embryo transfer, Live birth, Embryo, Transfer.

scholarly journals Blastocyst stage transfer vs cleavage stage embryo transfer

2009 ◽  
Vol 2 (1) ◽  
pp. 23 ◽  
Author(s):  
Korula George ◽  
AnnM Mangalraj ◽  
K Muthukumar ◽  
TK Aleyamma ◽  
MohanS Kamath
Keyword(s):  
Embryo Transfer ◽  
Blastocyst Stage ◽  
Cleavage Stage ◽  
Cleavage Stage Embryo ◽  
Stage Embryo

scholarly journals Pregnancy Outcomes of Single/Double Blastocysts and Cleavage Embryo Transfers: a Retrospective Cohort Study of 24,422 Frozen-Thawed Cycles

2020 ◽  
Vol 27 (12) ◽  
pp. 2271-2278
Author(s):  
Xiaoyu Long ◽  
Yuanyuan Wang ◽  
Fangrong Wu ◽  
Rong Li ◽  
Lixue Chen ◽  
...  
Keyword(s):  
Embryo Transfer ◽  
Live Birth ◽  
Preterm Births ◽  
Live Birth Rate ◽  
Blastocyst Stage ◽  
Cleavage Stage ◽  
Cleavage Stage Embryo ◽  
Stage Embryo ◽  
Group B ◽  
Transfer Group

Abstract This study aims to evaluate the effect of blastocyst- and cleavage-stage embryo transfers with different numbers of transferred embryos on pregnancy outcomes in China. This was a retrospective cohort study that collected 24,422 frozen-thawed embryo transfer (FET) cycles in two affiliated hospitals of Peking University Health Science Center between January 2015 and May 2018. They were divided into four groups: the single cleavage-stage embryo transfer group (C-1) (763 cycles), double cleavage-stage embryo transfer group (C-2) (13,004 cycles), single blastocyst-stage embryo transfer group (B-1) (7913 cycles), and double blastocyst-stage embryo transfer group (B-2) (2046 cycles). Of the four groups, the live birth rate was the lowest in the C-1 group (11.8%) while it was the highest in the B-2 group (33.6%). However, the B-2 group was accompanied with higher risks of miscarriages, maternal complications, twin births, preterm births, and low birth weight. Compared with the C-2 group, the B-1 group had a lower live birth rate (23.0 vs 29.0%; aOR, 0.78; 95% CI, 0.72–0.85), but also had a lower risk for twin births (1.9 vs 23.4%; aOR, 0.06; 95% CI, 0.04–0.09) and preterm births (9.6 vs 16.1%; aOR, 0.51; 95% CI, 0.41–0.65). The probability of live birth in the B-1 group declined from 0.25 at 20–29 years old to 0.08 at > 40 years old, while the probabilities of adverse outcomes went up with maternal age. It can be concluded that single-blastocyst embryo transfer seems to be the best choice for all maternal ages. This group of embryo transfer has significantly reduced adverse neonatal outcomes. Especially, women with younger maternal age in this group appear to prominently benefit from single-blastocyst transfer.

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