Clinical outcomes of single embryo transfer in gonadotropin-releasing hormone antagonist protocol
10.3760/cma.j.cn101441-20210426-00192
- VernacularTitle:拮抗剂方案单胚胎移植临床结局分析
- Author:
Kang LUAN
1
;
Hong JIANG
1
;
Huiqun YIN
1
;
Cunli WANG
1
;
Jie ZHU
1
;
Zhenyi CAO
1
;
Yan WU
1
Author Information
1. 中国人民解放军联勤保障部队第901医院生殖医学中心，合肥 230031
- Publication Type:Journal Article
- Keywords:
Antagonist protocol;
Single blastocyst transfer;
Single cleavage-stage embryo transfer;
Clinical outcomes
- From:
Chinese Journal of Reproduction and Contraception
2022;42(2):125-131
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical value of single embryo transfer for the patients with gonadotropin-releasing hormone (GnRH) antagonist protocol.Methods:The clinical data of the patients underwent in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) in Reproductive Medicine Center, the 901th Hospital of the Joint Logistics Support Force of PLA from January 2017 to March 2021 were retrospectively analyzed in this cohort study. According to the days of embryo development and No. of embryos, patients were divided into day 3 (D3) single top-quality cleavage-stage embryo transfer group (single top-quality embryo group), D3 double top-quality cleavage-stage embryo transfer group (double top-quality embryos group), and single blastocyst transfer group. In fresh cycles, there were 301 patients in single top-quality embryo group, 253 patients in double top-quality embryos group and 127 patients in single blastocyst group in frozen-thawed embryo transfer (FET) cycles,there were 84 patients in single top-quality embryo group, 136 patients in double top-quality embryos group and 396 patients in single blastocyst group in first FET cycles after all embryos frozen,there were 69 patients in single top-quality group and 161 patients in single blastocyst group. The rates of clinical pregnancy, implantation, multiple pregnancy, early abortion and ongoing pregnancy in the fresh and FET cycles were compared among single top-quality embryo group, double top-quality embryos group and single blastocyst group. Also, the rates of clinical pregnancy, implantation, multiple pregnancy, early abortion and ongoing pregnancy of single top-quality embryo transfer and single blastocyst transfer were compared between the fresh cycle and the first FET cycle. One-way ANOVA and chi-square test were used in this study. Results:There were no significant difference in duration of infertility, body mass index (BMI), the levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol, anti-Müllerian hormone (AMH), gonadotropin (Gn) and the numbers of oocytes retrieved among all the groups (all P>0.05). There were no significant differences in the rates of clinical pregnancy, implantation, multiple pregnancy, early abortion and ongoing pregnancy between single top-quality embryo group and single blastocyst group (all P>0.05) in fresh cycle, while the clinical pregnancy rate [46.18% (139/301)], the ongoing pregnancy rate [40.86% (123/301)] and the multiple pregnancy rate [0% (0/139)] in single top-quality embryo group were significantly lower than those in double top-quality embryos group [58.89% (149/253), P<0.001; 52.17% (132/253), P<0.001; 30.20% (45/149), P<0.001], with the similar implantation rate between the two groups ( P>0.016 7). The rates of clinical pregnancy, implantation and ongoing pregnancy were comparable between single top-quality embryo group and double top-quality embryos group in FET cycle ( P>0.016 7), while which were all significantly lower than those in single blastocyst group [62.88% (249/396), P<0.001; 63.89% (253/396), P<0.001; 55.30% (219/396), P<0.001]. The multiple pregnancy rate of double top-quality embryos group [20.37% (11/54)] was significantly higher than that of single top-quality embryo group [0% (0/27), P=0.013] in FET cycle. The ongoing pregnancy rate of the single top-quality embryo transfer in first FET cycle [27.54% (19/69)] was significantly lower than that in fresh cycle [40.86% (123/301), P=0.040], while the clinical pregnancy rate [63.35% (102/161)] and the implantation rate [63.98% (103/161)] of single blastocyst transfer in first FET cycle were significantly higher than those in fresh cycle [50.39% (64/127), P=0.027; 51.97% (66/127), P=0.040]. Conclusion:The clinical outcomes of D3 single top-quality cleavage-stage embryo transfer were similar to D5 single blastocyst transfer in fresh cycle, while the clinical outcomes of single blastocyst transfer in FET cycle were better compared with fresh cycle for the patients with GnRH antagonist protocol. Single embryo transfer can significantly reduce the multiple pregnancy rate of IVF/ICSI .
