Clinical application value of blastocysts derived from poor-quality embryos after day 3 transplantation and frozen
10.3760/cma.j.cn101441-20200330-00172
- VernacularTitle:第3日移植冷冻后剩余非优质胚胎囊胚培养的临床应用价值
- Author:
Li LIU
1
;
Xiaomin CAO
1
;
Xuanlin ZHANG
1
;
Jianyong DI
1
;
Yuanyuan WANG
1
;
Fengqin XU
1
Author Information
1. 天津市第一中心医院生殖医学科 300192
- Publication Type:Journal Article
- Keywords:
Blastocyst culture;
Blastocyst transfer;
Pregnancy rate;
Frozen-thawed cycle
- From:
Chinese Journal of Reproduction and Contraception
2021;41(4):313-319
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the clinical value of blastocysts derived from poor-quality embryos after day 3 (D3) transplantation and frozen, to investigate the best embryo strategies of frozen-thawed blastocysts.Methods:A retrospective cohort study was conducted on 362 frozen-thawed blastocyst transfer cycles were retrospectively analyzed in the Department of Reproductive Medicine, Tianjin First Central Hospital from July 2015 to March 2020. According to the days of culture, they were divided into day 5 (D5) and day 6 (D6) blastocyst transplantation group; according to the number of embryos transferred, they were divided into single blastocyst transplantation group and double blastocyst transplantation group; according to the embryo quality, single blastocyst transplantation group was divided into single high-quality embryo group and single poor-quality embryo group. The double blastocyst transplantation group was divided into double high-quality blastocyst group, a high-quality embryo matching a poor-quality blastocyst transplantation group and the double poor-quality blastocyst group. Clinical pregnancy rate, implantation rate and multiple pregnancy rate were compared in each group.Results:The clinical pregnancy rate and the implantation rate of D5 blastocyst transplantation group in thawing cycles were higher than those of D6 blastocyst transplantation group [62.96% (102/162) vs. 42.50%(85/200), 53.98% (122/226) vs. 35.86% (104/290)](all P<0.001), and there was no statistically significant difference of early abortion rate and multiple pregnancy rate between the D5 and D6 groups ( P>0.05). There was no statistically significant difference in the clinical pregnancy rate and the early abortion rate of D5 single blastocyst groups and double blastocyst pregnancy ( P>0.05), the implantation rate of single blastocyst group was higher than that of the double blastocyst group [62.24% (61/98) vs. 47.66% (61/128)] while the multiple pregnancy rate of single blastocyst group was lower than that of the double blastocyst group [3.28% (2/61) vs. 46.34% (19/41)] ( P=0.029, P<0.001). The clinical pregnancy rate and the multiple pregnancy rate of D6 single blastocyst group were lower than those of D6 double blastocyst pregnancy group [35.45% (39/110) vs. 51.11% (46/90), 5.13% (2/39) vs. 26.09% (12/46)] ( P=0.026, P=0.009), there were no statistically significant differences in implantation rate and early abortion rate (all P>0.05). There were no statistically significant differences in clinical pregnancy rate, implantation rate, early abortion rate and multiple pregnancy rate between single high-quality embryo and poor-quality embryo group in D5 and D6 single blastocyst transplantation group (all P>0.05). There were no statistically significant differences in clinical pregnancy rate, implantation rate, early abortion rate, and multiple pregnancy rate of the double high-quality blastocyst transplantation group, a high-quality embryo matching a poor-quality blastocyst transplantation group and the double poor-quality blastocyst group in D5 ( P>0.05). The implantation rate of D6 double poor-quality embryo group [26.67% (24/90)] was lower than that of the double high-quality embryo group [47.62% (20/42)] and a high-quality embryo matching a poor-quality embryo group [43.75% (7/16)]( P=0.029), while there were no statistically significant differences in clinical pregnancy rate, early abortion rate, and multiple pregnancy rate (all P>0.05). Conclusion:After the high-quality D3 embryo transfer and freezing, the remaining poor-quality embryos can be cultured to form blastocyst, better clinical pregnancy rate was obtained for transfer the frozen-thawed blastocysts, it increases the value of embryos and reduces the cost of treatment. The quality of D5 blastocyst is better than that of D6 blastocyst. The single blastocyst transplantation of D5 is preferred to reduce the rate of multiple pregnancy without affecting the clinical pregnancy rate.
