Factors influencing clinical pregnancy outcomes after single embryo transfer
10.3760/cma.j.cn101441-20200909-00490
- VernacularTitle:单胚胎移植周期临床结局的影响因素分析
- Author:
Yingxue CHEN
1
;
Jun ZHANG
1
;
Xiaomin WU
1
;
Xingyu ZHOU
1
;
Zhe WANG
1
;
Shiling CHEN
1
Author Information
1. 南方医科大学南方医院妇产科生殖医学中心，广州 510515
- Publication Type:Journal Article
- Keywords:
Fertilization in vitro;
Single embryo transfer;
Embryo quality;
Cleavage embryo;
Morula;
Blastocyst
- From:
Chinese Journal of Reproduction and Contraception
2021;41(6):503-511
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the factors influencing clinical pregnancy outcomes after single embryo transfer (SET) undergoing in vitro fertilization-embryo transfer (IVF-ET) treatment cycles. Methods:A retrospective cohort analysis was carried out on SET cycles of Center for Reproductive Medicine in Nanfang Hospital from September 1st, 2013 to December 31st, 2019. Totally 2734 SET cycles were assigned to day 3 (D3) group, day 4 (D4) group, day 5 (D5) group, day 6 (D6) group according to the different stages of embryo development and analyzed for the relation of clinical pregnancy outcomes to ages, different embryo stages and quality.Results:The total clinical pregnancy rate (CPR) was 39.8% (1098/2734) and the live birth rate (LBR) was 30.5% (842/2734) in the 2761 SET cycles. The significant differences were observed among four groups in CPR [D3 group, D4 group, D5 group and D6 group: 33.3% (264/793), 36.4% (142/390), 52.5% (492/937) and 32.6% (200/614), respectively, P<0.001] and LBR [24.8% (203/793), 30.5% (119/390), 40.9% (383/937) and 22.3% (137/614), respectively, P<0.001]. In D3 group, significantly higher CPR and LBR were observed after transfer of top-quality cleavage embryos (8-cell I, 7-cell I, 8-cell II) than those in other cleavage embryos [CPR: 41.7% (207/496) vs. 19.2% (57/297), P<0.001; LBP: 32.1% (159/496) vs. 14.8% (441/297), P<0.001]. In D4 group, significantly higher CPR and LBR were observed after transfer of embryo with entirely compaction than partial compaction [CPR: 40.4% (134/332) vs. 13.8% (8/58), P<0.001; LBR: 34.0% (113/332) vs. 10.3% (113/332), P=0.001]. In slow-growing blastocysts group, fresh transfer of embryos which began blastulation but did not reach Gardner stage III by D5 resulted in similar outcomes to the transfer of fully expanded blastocysts by D6 [CPR: 30.6% (22/72) vs. 32.6% (200/614), P>0.05; LBR: 27.8% (20/72) vs. 22.3% (137/614), P>0.05]. Conclusion:SET of a top-quality D5 blastocyst or D4 morula can reduce the incidence of multiple pregnancies and obtain the best pregnancy outcome. For slow-growing D5 blastocysts, it may be a strategy to improve pregnancy outcome to continue culture until D6 fully expanded blastocysts and then perform subsequent frozen-thawed embryo transfer. For cleavage embryo, SET of top-quality cleavage embryos (8-cell I, 7-cell I, 8-cell II) also achieved satisfactory pregnancy outcome.
