scholarly journals Possibility of Live Birth For Patients With Low Serum β-hCG 14 Days After Blastocyst Transfer

2020 ◽  
Author(s):  
Yixuan Wu ◽  
Haiying Liu
Keyword(s):  
Live Birth ◽  
Roc Curve ◽  
Pregnancy Outcomes ◽  
Luteal Phase ◽  
Clinical Pregnancy ◽  
Blastocyst Transfer ◽  
Biochemical Pregnancy ◽  
Early Miscarriage ◽  
Β Hcg ◽  
Low Serum

Abstract Background: Although many previous study investigated the prediction of pregnancy outcomes by serumβ-hCG levels after blastocyst transfer, no study focused on the pregnancy outcomes of patients with initially low serum β-hCG levels. The purpose of the study was to investigate the pregnancy outcomes of patients with low serum β- level 14 days after blastocyst transfer. Methods: A retrospective study was performed in the Third Affiliated Hospital of Guangzhou Medical University. The purpose was to investigate the patients whose serum β-hCG levels were between 5-299 mIU/ml 14 days after frozen blastocyst transfer. Rates of live birth, early miscarriage, biochemical pregnancy loss and ectopic pregnancy were analyzed according to the female patients’ age by chi-squared test. Receiver operating characteristic (ROC) curves were plotted to explore the threshold for prediction of clinical pregnancy and live birth. Results: A total of 312 patients had serum β-hCG levels <300 mIU/ml 14 days after frozen blastocyst transfer, among which 18.6% were live birth, 47.4% were early miscarriage, 22.8% were biochemical pregnancy and 9.6% were ectopic pregnancy. Pregnancy outcomes were comparable between the patients aged <38 years and ≥38 years. ROC curve analysis showed that the predicted value ofβ-hCG for clinical pregnancy was 58.8 mIU/ml with the AUC of 0.752(95%CI :0.680-0.823), sensitivity of 95.0% and specificity of 53.5%.The threshold for live birth was 108.6mIU/ml with the area under the ROC curve (AUC) of 0.649(95%CI:0.0.583-0.715), sensitivity of 93.1% and specificity of 37.0%.For the β-hCG fold increase over 48 hours, the cut-off for clinical pregnancy was 1.4 with the AUC of 0.899(95%CI :0.801-0.996), sensitivity of 90.3% and specificity of 77.8%; the threshold for live birth was 1.9 with the AUC of 0.808(95%CI :0.724-0.891), sensitivity of 88.5% and specificity of 64.5%. Conclusions: Initially low serum β-hCG level 14 days after frozen blastocyst transfer indicated minimal likelihood of live birth. For patients having initial β-hCG >58.8 mIU/ml, luteal phase support is suggested to continue. Another serum β-hCG test and ultrasound should be performed one week later. If the initial serum β-hCG is < 58.8 mIU/ml, luteal phase support is suggested to discontinue and measurement of serum β-hCG and ultrasound can be arranged one week later.

scholarly journals Possibility of live birth in patients with low serum β-hCG 14 days after blastocyst transfer

2020 ◽  
Vol 13 (1) ◽  
Author(s):  
Yixuan Wu ◽  
Haiying Liu
Keyword(s):  
Live Birth ◽  
Roc Curve ◽  
Pregnancy Outcomes ◽  
Luteal Phase ◽  
Clinical Pregnancy ◽  
Blastocyst Transfer ◽  
Luteal Phase Support ◽  
Live Births ◽  
Β Hcg ◽  
Low Serum

Abstract Background Although prior work has attempted to predict pregnancy outcomes by assaying serum β-hCG levels after blastocyst transfer, no study has focused on pregnancy outcomes in those with initially low serum β-hCG levels. This study sought to investigate pregnancy outcomes of patients with low serum β-hCG levels 14 days after blastocyst transfer. Methods A retrospective study was conducted at the Third Affiliated Hospital of Guangzhou Medical University to study patients whose serum β-hCG levels were at 5–299 mIU/ml 14 days after frozen blastocyst transfer. Rates of live birth, early miscarriage, biochemical pregnancy loss and ectopic pregnancy were analyzed according to the female patients’ age by Chi-squared analysis. Receiver operating characteristic (ROC) curves were plotted to explore the threshold of predicting clinical pregnancy and live births. Results 312 patients had serum β-hCG levels < 300 mIU/ml at 14 days after frozen blastocyst transfer, among which, 18.6% were live births, 47.4% were early miscarriages, 22.8% were biochemical pregnancies and 9.6% were ectopic pregnancies. ROC curve analysis showed that a predicted value of β-hCG for clinical pregnancy was 58.8 mIU/ml with an area under the ROC curve (AUC) of 0.752, a sensitivity of 95.0% and specificity of 53.5%. The threshold for live births was 108.6 mIU/ml with an AUC of 0.649, a sensitivity of 93.1% and a specificity of 37.0%. For the β-hCG fold increase over 48 h, the cut-off for clinical pregnancy was 1.4 with an AUC of 0.899, a sensitivity of 90.3% and a specificity of 77.8%. The threshold for live birth was 1.9 with an AUC of 0.808, a sensitivity of 88.5% and specificity of 64.5%. Conclusions Initially low serum β-hCG levels 14 days after frozen blastocyst transfer indicated minimal chances of live birth. For patients having an initial β-hCG > 58.8 mIU/ml, luteal phase support should continue. Another serum β-hCG test and ultrasound should be performed one week later. When an initial serum β-hCG is < 58.8 mIU/ml, luteal phase support should be discontinued and serum β-hCG measured with ultrasound one week later.

scholarly journals Possibility of Live Birth in Patients with Low Serum β-hCG 14 Days After Blastocyst Transfer

2020 ◽  
Author(s):  
Yixuan Wu ◽  
Haiying Liu
Keyword(s):  
Live Birth ◽  
Roc Curve ◽  
Pregnancy Outcomes ◽  
Luteal Phase ◽  
Clinical Pregnancy ◽  
Blastocyst Transfer ◽  
Luteal Phase Support ◽  
Live Births ◽  
Β Hcg ◽  
Low Serum

Abstract Background: Although prior work has attempted to predict pregnancy outcomes by assaying serum β-hCG levels after blastocyst transfer, no study has focused on pregnancy outcomes in those with initially low serum β-hCG levels. This study sought to investigate pregnancy outcomes of patients with low serum β-hCG levels 14 days after blastocyst transfer.Methods: A retrospective study was conducted at the Third Affiliated Hospital of Guangzhou Medical University to study patients whose serum β-hCG levels were at 5-299 mIU/ml 14 days after frozen blastocyst transfer. Rates of live birth, early miscarriage, biochemical pregnancy loss and ectopic pregnancy were analyzed according to the female patients’ age by Chi-squared analysis. Receiver operating characteristic (ROC) curves were plotted to explore the threshold of predicting clinical pregnancy and live births. Results: 312 patients had serum β-hCG levels <300 mIU/ml at 14 days after frozen blastocyst transfer, among which, 18.6% were live births, 47.4% were early miscarriages, 22.8% were biochemical pregnancies and 9.6% were ectopic pregnancies. Live birth rates were higher in the <38 years of age group as compared those > 38 years (19.0% vs.16.6%; P=0.045). ROC curve analysis showed that a predicted value of β-hCG for clinical pregnancy was 58.8 mIU/ml with an area under the ROC curve (AUC) of 0.752, a sensitivity of 95.0% and specificity of 53.5%. The threshold for live births was 108.6 mIU/ml with an AUC of 0.649, a sensitivity of 93.1% and a specificity of 37.0%. For the β-hCG fold increase over 48 hours, the cut-off for clinical pregnancy was 1.4 with an AUC of 0.899, a sensitivity of 90.3% and a specificity of 77.8%. The threshold for live birth was 1.9 with an AUC of 0.808, a sensitivity of 88.5% and specificity of 64.5%.Conclusions: Initially low serum β-hCG levels 14 days after frozen blastocyst transfer indicated minimal chances of live birth. For patients having an initial β-hCG >58.8 mIU/ml, luteal phase support should continue. Another serum β-hCG test and ultrasound should be performed one week later. When an initial serum β-hCG is < 58.8 mIU/ml, luteal phase support should be discontinued and serum β-hCG measured with ultrasound one week later.

scholarly journals Possibility of Live Birth in Patients with Low Serum β -hCG 14 Days After Blastocyst Transfer

2020 ◽  
Author(s):  
Yixuan Wu ◽  
Haiying Liu
Keyword(s):  
Live Birth ◽  
Roc Curve ◽  
Pregnancy Outcomes ◽  
Luteal Phase ◽  
Clinical Pregnancy ◽  
Blastocyst Transfer ◽  
Luteal Phase Support ◽  
Live Births ◽  
Β Hcg ◽  
Low Serum

Abstract Background: Although prior work has attempted to predict pregnancy outcomes by assaying serum β-hCG levels after blastocyst transfer, no study has focused on pregnancy outcomes in those with initially low serum β-hCG levels. This study sought to investigate pregnancy outcomes of patients with low serum β-hCG levels 14 days after blastocyst transfer.Methods: A retrospective study was conducted at the Third Affiliated Hospital of Guangzhou Medical University to study patients whose serum β-hCG levels were at 5-299 mIU/ml 14 days after frozen blastocyst transfer. Rates of live birth, early miscarriage, biochemical pregnancy loss and ectopic pregnancy were analyzed according to the female patients’ age by Chi-squared analysis. Receiver operating characteristic (ROC) curves were plotted to explore the threshold of predicting clinical pregnancy and live births. Results: 312 patients had serum β-hCG levels <300 mIU/ml at 14 days after frozen blastocyst transfer, among which, 18.6% were live births, 47.4% were early miscarriages, 22.8% were biochemical pregnancies and 9.6% were ectopic pregnancies. ROC curve analysis showed that a predicted value of β-hCG for clinical pregnancy was 58.8 mIU/ml with an area under the ROC curve (AUC) of 0.752, a sensitivity of 95.0% and specificity of 53.5%. The threshold for live births was 108.6 mIU/ml with an AUC of 0.649, a sensitivity of 93.1% and a specificity of 37.0%. For the β-hCG fold increase over 48 hours, the cut-off for clinical pregnancy was 1.4 with an AUC of 0.899, a sensitivity of 90.3% and a specificity of 77.8%. The threshold for live birth was 1.9 with an AUC of 0.808, a sensitivity of 88.5% and specificity of 64.5%.Conclusions: Initially low serum β-hCG levels 14 days after frozen blastocyst transfer indicated minimal chances of live birth. For patients having an initial β-hCG >58.8 mIU/ml, luteal phase support should continue. Another serum β-hCG test and ultrasound should be performed one week later. When an initial serum β-hCG is < 58.8 mIU/ml, luteal phase support should be discontinued and serum β-hCG measured with ultrasound one week later.

scholarly journals Pregnancy Outcomes of Patients with Low Serum β-hCG Level 14 Days After Fresh Embryo Transfer

2020 ◽  
Author(s):  
Yixuan Wu ◽  
Haiying Liu
Keyword(s):  
Embryo Transfer ◽  
Pregnancy Outcomes ◽  
Roc Curves ◽  
Clinical Pregnancy ◽  
Ongoing Pregnancy ◽  
Fresh Embryo Transfer ◽  
Biochemical Pregnancy ◽  
Β Hcg ◽  
Low Serum ◽  
Day 3 Embryo

Abstract Background: Although previous studies had successfully illustrated different pregnancy outcomes by different serum β-hCG levels after embryo transfer, prognosis of pregnancy outcomes remains elusive when the serum β-hCG level is extremely low (e.g., < 100 mIU/ml 14 days after embryo transfer). Therefore, the purpose of our study is to investigate the pregnancy outcomes of patients with low serum β-hCG level 14 days after day 3 embryo transfer. Methods: A retrospective study was performed with 723 patients with a serum β-hCG level between 5 and 100 mIU/ml 14 days after day 3 fresh embryo transfer. Pregnancy outcomes (ongoing pregnancy, early miscarriage, biochemical pregnancy loss, and ectopic pregnancy) were analyzed according to the female patients’ age. Receiver operating characteristic (ROC) curves were plotted to indicate the threshold for prediction of clinical pregnancy and ongoing pregnancy. Sensitivity and specificity were calculated according the ROC curves as well. Results: Of the 723 patients with serum β-hCG level <100 mIU/mL 14 days after day 3 embryo transfer, 85.6% (619) had biochemical pregnancy, and only 14.4% (104) had clinical pregnancy (including 4.7% with ongoing pregnancy, 3.7% with ectopic pregnancy, and 5.9% with early miscarriage). The rate of ongoing pregnancy was significantly lower in ≥ 38-year group compared with < 38-year group (1.3% vs. 5.6%, P =0.029). The serum β-hCG level to predict clinical pregnancy was 44.7 mIU/ml (sensitivity, 91.3%; specificity, 82.1%; area under the ROC curve (AUROC), 0.908). For ongoing pregnancy, the serum β-hCG level was 53.7 mIU/ml (sensitivity, 94.1%; specificity, 81.4%; AUROC, 0.902). Conclusions: Initially low serum β-hCG level 14 days after day 3 embryo transfer indicated poor prognosis with minimal likelihood of ongoing pregnancy. Keywords: assisted reproductive technology; human chorionic gonadotropin; pregnancy; live birth; embryo transfer

scholarly journals Effect of blastocyst morphology and developmental speed on transfer strategy for grade “C” blastocyst in vitrified‐warmed cycles

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Yuxia He ◽  
Shiping Chen ◽  
Jianqiao Liu ◽  
Xiangjin Kang ◽  
Haiying Liu
Keyword(s):  
Pregnancy Rate ◽  
Live Birth ◽  
Pregnancy Outcomes ◽  
Multiple Pregnancy ◽  
Poor Quality ◽  
Clinical Pregnancy ◽  
Neonatal Outcomes ◽  
Blastocyst Transfer ◽  
Blastocyst Development ◽  
Multiple Pregnancy Rate

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.

Gonadotropin-releasing hormone agonist combined with hormone replacement therapy improves pregnancy outcome in intrauterine adhesion

2021 ◽  
Author(s):  
Meilan Mo ◽  
Qizhen Zheng ◽  
Hongzhan Zhang ◽  
Shiru Xu ◽  
Fen Xu ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Live Birth ◽  
Subgroup Analysis ◽  
Pregnancy Outcomes ◽  
Preparation Method ◽  
Clinical Pregnancy ◽  
Ongoing Pregnancy ◽  
Endometrial Preparation ◽  
Significant Difference ◽  
Early Miscarriage

Abstract Objective: This retrospective study aimed to explore the optimal endometrial preparation method in women with intrauterine adhesions (IUAs).Method: A total of 882 frozen-thawed embryo transfer (FET) cycles were categorized into three groups based on endometrial preparation methods: hormone replacing therapy cycle (HRT, n=636), natural cycle (NC n=174), and HRT with GnRH-a pretreatment (HRT+GnRH-a, n=72. Logistic regression was performed to investigate the association between cycle regimens and pregnancy outcomes. Subgroup analysis of IUAs combined with thin endometrium (≤7mm) was also performed.Results: HRT with GnRH-a pretreatment was associated with higher incidences of clinical pregnancy, ongoing pregnancy, and live birth, but lower early miscarriage compared with either HRT or NC. Logistic regression indicated that after controlling for potential confounders, the incidences of live birth (HRT+GnRH-a as reference; NC: aOR=0.577, 95%CI 0.304-1.093; HRT: aOR=0.434, 95%CI 0.247-0.765) and ongoing pregnancy (NC: aOR=0.614, 95%CI 0.324-1.165; HRT: aOR=0.470, 95%CI 0.267-0.829) remained significantly higher in HRT+GnRH-a compared to those in HRT, but comparable to those in NC. While there was no significant difference with respect to the clinical pregnancy rate (NC: aOR=0.695, 95%CI 0.374-1.291; HRT: aOR=0.650, 95%CI 0.374-1.127) and early miscarriage rate (NC: aOR=1.734, 95%CI 0.417-7.175; HRT: aOR=2.594, 95%CI 0.718-9.378) between groups. Subgroup analysis suggested there was no priority of endometrial preparation method in IUAs combined with thin endometrium.Conclusion: HRT with GnRH-a pretreatment improves pregnancy outcomes in women with history of IUAs. GnRH-a may restore the endometrial receptivity in the FET cycles in IUAs.

scholarly journals Using Deep Learning in a Monocentric Study to Characterize Maternal Immune Environment for Predicting Pregnancy Outcomes in the Recurrent Reproductive Failure Patients

2021 ◽  
Vol 12 ◽  
Author(s):  
Chunyu Huang ◽  
Zheng Xiang ◽  
Yongnu Zhang ◽  
Dao Shen Tan ◽  
Chun Kit Yip ◽  
...  
Keyword(s):  
Pregnancy Outcome ◽  
Live Birth ◽  
Pregnancy Outcomes ◽  
Prediction Models ◽  
Reproductive Failure ◽  
Clinical Pregnancy ◽  
Clinical Samples ◽  
Ongoing Pregnancy ◽  
Biochemical Pregnancy ◽  
Immune Factors

Recurrent reproductive failure (RRF), such as recurrent pregnancy loss and repeated implantation failure, is characterized by complex etiologies and particularly associated with diverse maternal factors. It is currently believed that RRF is closely associated with the maternal environment, which is, in turn, affected by complex immune factors. Without the use of automated tools, it is often difficult to assess the interaction and synergistic effects of the various immune factors on the pregnancy outcome. As a result, the application of Artificial Intelligence (A.I.) has been explored in the field of assisted reproductive technology (ART). In this study, we reviewed studies on the use of A.I. to develop prediction models for pregnancy outcomes of patients who underwent ART treatment. A limited amount of models based on genetic markers or common indices have been established for prediction of pregnancy outcome of patients with RRF. In this study, we applied A.I. to analyze the medical information of patients with RRF, including immune indicators. The entire clinical samples set (561 samples) was divided into two sets: 90% of the set was used for training and 10% for testing. Different data panels were established to predict pregnancy outcomes at four different gestational nodes, including biochemical pregnancy, clinical pregnancy, ongoing pregnancy, and live birth, respectively. The prediction models of pregnancy outcomes were established using sparse coding, based on six data panels: basic patient characteristics, hormone levels, autoantibodies, peripheral immunology, endometrial immunology, and embryo parameters. The six data panels covered 64 variables. In terms of biochemical pregnancy prediction, the area under curve (AUC) using the endometrial immunology panel was the largest (AUC = 0.766, accuracy: 73.0%). The AUC using the autoantibodies panel was the largest in predicting clinical pregnancy (AUC = 0.688, accuracy: 78.4%), ongoing pregnancy (AUC = 0.802, accuracy: 75.0%), and live birth (AUC = 0.909, accuracy: 89.7%). Combining the data panels did not significantly enhance the effect on prediction of all the four pregnancy outcomes. These results give us a new insight on reproductive immunology and establish the basis for assisting clinicians to plan more precise and personalized diagnosis and treatment for patients with RRF.

scholarly journals Ultra-Long GnRH Agonist Protocol During IVF/ICSI Improves Pregnancy Outcomes in Women With Adenomyosis: A Retrospective Cohort Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Jie Lan ◽  
Yaoqiu Wu ◽  
Zexuan Wu ◽  
Yingchen Wu ◽  
Rong Yang ◽  
...  
Keyword(s):  
Cohort Study ◽  
Live Birth ◽  
Retrospective Cohort Study ◽  
Pregnancy Outcomes ◽  
Retrospective Cohort ◽  
Statistical Significance ◽  
Clinical Pregnancy ◽  
Miscarriage Rate ◽  
Early Miscarriage

ObjectiveThis study aimed to compare the ultra-long gonadotropin-releasing hormone agonist (GnRH-a) protocol and the long GnRH-a protocol during in vitro fertilization (IVF) or intracytoplasmic sperm (ICSI) treatment on fertility outcomes in women with adenomyosis.Materials and MethodsThis study was a retrospective cohort study. From January 2011 to May 2018, a total of 371 fresh IVF/ICSI cycles were included. Among the cycles included, 237 cycles of 212 women underwent the ultra-long GnRH-a protocol, while 134 cycles of 116 women underwent the long GnRH-a protocol. The rates of implantation, clinical pregnancy per embryo transfer, live birth, and early miscarriage were estimated between the compared protocols.ResultsIn the study, the early miscarriage rate in women undergoing the ultra-long GnRH-a protocol was significantly lower than those undergoing the long GnRH-a protocol (12.0% versus 26.5%, p = 0.045), whereas the differences in the rates of biochemical pregnancy, implantation, clinical pregnancy, and live birth in women between the two groups showed no statistical significance. The pregnancy outcomes were also sub-analyzed according to the adenomyotic region (diffuse and focal). As for diffuse adenomyosis, the rates of clinical pregnancy and live birth in women undergoing the ultra-long GnRH-a protocol were significantly higher than those undergoing the long GnRH-a protocol (55.3% versus 37.9%, p = 0.025; 43.4% versus 25.9%, p = 0.019, respectively). However, pregnancy outcomes showed no difference between the two protocols in women with focal adenomyosis.ConclusionsThe ultra-long GnRH-a protocol during IVF/ICSI improves pregnancy outcomes in women with adenomyosis, especially in women with diffuse adenomyosis when compared with the long GnRH-a protocol.

scholarly journals Effect of Blastocyst Morphology and Developmental Speed on Transfer Strategy for Grade “C” Blastocyst in Vitrified-warmed Cycles

2021 ◽  
Author(s):  
yuxia He ◽  
shiping Chen ◽  
jianqiao Liu ◽  
xiangjin Kang ◽  
haiying Liu
Keyword(s):  
Pregnancy Rate ◽  
Live Birth ◽  
Pregnancy Outcomes ◽  
Multiple Pregnancy ◽  
Poor Quality ◽  
Clinical Pregnancy ◽  
Neonatal Outcomes ◽  
Blastocyst Transfer ◽  
Blastocyst Development ◽  
Multiple Pregnancy Rate

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 were analyzed 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. Conclusion: 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.

scholarly journals Laser-assisted Hatching Improves Live Birth Rate of Vitrified-warmed Blastocyst Transfer Cycles: a Case Control Study

2021 ◽  
Author(s):  
Shui-Ying Ma ◽  
Lian-Jie Li ◽  
Hui Zhao ◽  
Cheng Li ◽  
Haibin Zhao ◽  
...  
Keyword(s):  
Live Birth ◽  
Birth Rate ◽  
Live Birth Rate ◽  
Monozygotic Twin ◽  
Clinical Pregnancy ◽  
Blastocyst Transfer ◽  
Assisted Hatching ◽  
Vitro Fertilization ◽  
Biochemical Pregnancy

Abstract Background Assisted hatching is a widely accepted technique in assisted reproductive technology, however, it’s efficiency remains controversial and lack of data on safety. The aim of this study was to assess whether laser-assisted hatching improves clinical pregnancy results of vitrified-warmed blastocyst transfer cycles.Methods This was a retrospective cohort study of 4143 vitrified-warmed blastocyst transfer cycles from October 2014 to December 2015 at a single, university-based hospital. Cases involving blastocysts that survived after warming were divided into the assisted hatching (AH) group (n=1975) and non-AH group (n=2168). In the AH group, laser AH was performed for the warmed blastocysts before transfer. In the non-AH group, the warmed blastocysts were transferred without AH. The primary outcome was live birth rate after survived vitrified-warmed blastocyst transfers.Results No significant differences in age, endometrial preparation regimen, number of embryos transferred, or blastocyst developmental stage were found between the two groups (P>0.05). The biochemical pregnancy (67.0% vs. 63.6%; P=0.023; odds ratio [OR], 1.177; 95% confidence interval [CI], 1.032–1.344), clinical pregnancy (59.2% vs. 56.0%; P=0.041; OR, 1.163; 95% CI, 1.024–1.321), live birth (48.6% vs. 45.4%; P=0.041; OR, 1.160; 95% CI, 1.022–1.316), and implantation (52.1% vs. 49.3%; P=0.039) rates of the AH group were significantly higher than those of the non-AH group. The early miscarriage (17.1% vs. 17.8%; P=0.674), monozygotic twin (1.5% vs. 0.90%; P=0.214), and birth defect (3.1% vs. 3.6%; P=0.571) rates were similar in both groups. Conclusions In vitrified-warmed blastocyst transfer cycles, laser AH is associated with high clinical pregnancy and live birth rates. The benefits of AH outweigh its drawbacks, which include prolonged in vitro procedure, thermal damage, and higher workload in the in vitro fertilization laboratory.Trial registration: retrospectively registered

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