Clinical research of sequential embryo transfer in frozen thawed cycles of patients with recurrent implantation failure
10.3760/cma.j.cn101441-20191010-00447
- VernacularTitle:解冻周期序贯移植治疗反复种植失败的临床研究
- Author:
Yinfeng ZHANG
1
;
Haining LUO
;
Rui SHI
;
Yaojia ZHANG
;
Junfang MA
;
Yunshan ZHANG
Author Information
1. 天津市中心妇产科医院生殖医学中心 天津市人类发育与生殖调控重点实验室 300052
- Publication Type:Journal Article
- Keywords:
Reproductive technology, assisted;
Embryo transfer;
Frozen thawed cycle;
Repeated implantation failure;
Sequential embryo transfer
- From:
Chinese Journal of Reproduction and Contraception
2020;40(11):893-898
- CountryChina
- Language:Chinese
-
Abstract:
Objectives:To investigate the effect of sequential embryo transfer, cleavage stage and blastocyst stage embryo transfer on the clinical outcome of patients with recurrent implantation failure (RIF) and the relationship between the number of sequential transfered embryos and multiple pregnancy.Methods:A retrospective case-control study was conducted and the outcome of 317 patients with a history of RIF were analyzed, of which 50 women underwent sequential embryo transfer of two embryos on Day 3 and Day 5/6 (group A), 61 women underwent sequential embryo transfer of three embryos on Day 3 and Day 5/6 (group B), 124 women underwent Day 3 embryo transfer only (group C) and 82 women underwent Day 5/6 embryo transfer only (group D) at the Reproductive Medical Center of Tianjin Central Hospital of Gynecology and Obstetrics from January 2015 to January 2019. General information, controlled ovarian hyperstimulation outcome and pregnancy outcome were analyzed among four groups.Results:There were no significant differences in age, duration of infertility, body mass index (BMI), and basal hormone levels between the groups. The embryo implantation rate of groups A, B and D (36.0%, 31.1% and 31.3%) was significantly higher than that of group C (17.0%, P<0.001, P<0.001, P=0.026). The clinical pregnancy rate, the ongoing pregnancy rate and the live birth rate of group A (62.0%, 56.0%, 52.0%) and group B (60.7%, 49.2%, 47.5%) were significantly higher than those in group C (28.2%, 20.2%, 17.7%, all P<0.001) and group D (40.2%, 31.7%, 30.5%; group A vs. group D, P=0.015, P=0.006, P=0.014; group B vs. group D, P=0.016, P=0.034 , P=0.037). The early abortion rate of group A (3.2%) was significantly lower than that of group C (25.7%, P=0.028). The multiple pregnancy rate in group B (32.4%) was higher than that in group A (16.1%), group C (14.3%), and group D (21.2%), but the difference was not statistically significant ( P>0.05). The preterm birth rate in group B (34.5%) was higher than that in group A (25.9%), group C (13.0%), and group D (8.0%). The difference in preterm birth rate between group B and group D was statistically significant ( P=0.020). Conclusion:Sequential embryo transfer of frozen-thawed embryo transfer cycle can effectively improve the clinical pregnancy rate of patients with RIF. Especially, the sequential embryo transfer of 2 embryos can significantly improve the clinical pregnancy rate and the live birth rate without increasing the multiple pregnancy rate. Sequential transplantation can be used as an effective treatment for RIF patients.
