Clinical strategy of the first frozen-thawed embryo transfer after cryopreservation in patients of different ages
10.3760/cma.j.cn101441-20200310-00116
- VernacularTitle:不同年龄患者全胚冷冻后首次冻融胚胎移植的临床策略
- Author:
Juan ZHENG
1
;
Liming ZHOU
1
;
Yiting SUN
1
;
Aili XIA
1
;
Jie LI
1
Author Information
1. 浙江省宁波市妇女儿童医院生殖中心 315000
- Publication Type:Journal Article
- Keywords:
Age;
Freezing;
Embryo transfer;
Pregnancy rate;
Multiple
- From:
Chinese Journal of Reproduction and Contraception
2021;41(3):212-219
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore how to make transplantation strategy for patients of different ages in frozen-thawed embryo (FET) cycle.Methods:A retrospective cohort analysis of the first FET cycles during the period from January 2018 to April 2020 in Reproductive Center of Ningbo Women & Children Hospital was performed. Based on the age of the patients, they were divided into three groups: ≤30 years old group (1150 cycles), 30-35 years old group (932 cycles) and >35 years old group (405 cycles). In each age group, according to the grade and number of transferred embryos, they were divided into the single cleavage stage embryo transplant (SET3) subgroup, the single 5th day blastocyst transplant (SET5) subgroup, the single 6th day blastocyst transplant (SET6) subgroup, the double cleavage stage embryos transplant (DET3) subgroup, the double 5th day blastocyst transplant (DET5) subgroup and the double 6th day blastocyst transplant (DET6) subgroup. All patients were followed up until June 30, 2020. The clinical outcomes of each subgroups within the same age group were compared.Results:1) In ≤30 years old group: the clinical pregnancy rate, the persistent pregnancy rate and the live birth rate in SET5 subgroup were 66.17% (221/334), 60.48% (202/334), 35.93% (120/334), respectively, which were higher than those in SET3 subgroup [41.18% (28/68), 36.76% (25/68), 25.00% (17/68); P<0.001, P=0.001, P=0.045] and that in SET6 subgroup [54.42% (80/147), 43.54% (64/147), 27.21% (40/147); P<0.001, P=0.001, P<0.001]. The multiple rate in DET5 subgroup was 47.80% (76/159), which was higher than that in DET6 subgroup [29.49% (23/78), P=0.007]. 2) In 30-35 years old group: the clinical pregnancy rate, the persistent pregnancy rate and the live birth rate in SET5 subgroup were 63.59% (138/217), 55.30% (120/217) and 29.95% (65/217), which were higher than those in SET3 subgroup [30.65% (19/62), 27.42% (17/62),14.52% (9/62); P<0.001, P<0.001, P=0.015]. The multiple rate in DET5 subgroup was 56.86% (58/102), which was higher than that in DET3 subgroup [32.54% (41/126)] and DET6 subgroup [28.57% (16/56)], and the differences were statistically significant ( P<0.001, P=0.001). 3) In >35 years old group: the clinical pregnancy rate, the sustained pregnancy rate and the live birth rate in DET5 subgroup were 53.45% (31/58), 39.66% (23/58), 20.69% (12/58), compared with those in SET6 subgroup [43.75% (21/48), 35.42% (17/48), 16.76% (8/48)], the differences were not statistically significant ( P=0.320, P=0.655, P=0.583), while compared with SET3 subgroup [16.98% (9/53), 15.09% (8/53), 7.55% (4/53)], the differences were statistically significant ( P<0.010, P=0.004, P=0.049). The clinical pregnancy rate and the sustained pregnancy rate in DET5 subgroup were 66.67% (26/39), 53.85% (21/39), which were higher than those in DET3 subgroup [33.89% (61/180), 27.22% (49/180)], and the differences were statistically significant ( P<0.001 , P=0.001). The clinical pregnancy rate in DET5 subgroup was higher than that in DET6 subgroup [51.85% (14/27)], and the difference was statistically significant ( P=0.001) .Conclusion:For patients of all ages, single embryo transfer should be selected, and avoid the transfer of two 5th day blastocysts as far as possible. The 5th day single blastocyst is preferred for embryo transfer.
