Comparison of pregnancy and perinatal outcomes between cleavage-stage embryo transfer and blastocyst-stage embryo transfer
10.3760/cma.j.cn101441-20230227-00071
- VernacularTitle:卵裂期胚胎与囊胚移植的妊娠结局和围产期结局的比较
- Author:
Jiajing KANG
1
;
Zengrong TU
;
Hong XIA
;
Xiaofang HAN
;
Fang GUO
;
Min YANG
;
Mengyao LIANG
;
Jin ZHANG
;
Ruonan GUO
;
Hong LI
Author Information
1. 山西医科大学第五临床医学院生殖医学科，太原 030000
- Publication Type:Journal Article
- Keywords:
Preterm birth;
Cleavage-stage embryo transfer;
Blastocyst-stage embryo transfer;
Large for gestational age;
Clinical outcomes
- From:
Chinese Journal of Reproduction and Contraception
2023;43(12):1229-1236
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the pregnancy and perinatal outcomes following cleavage-stage embryo transfer and blastocyst-stage embryo transfer, and to explore the best strategy of embryo transfer for infertile patients.Methods:In this retrospective cohort study, data of patients who underwent in vitro fertilization/intracytoplasmic sperm injection from January 2021 to December 2022 in Reproductive Medicine Department of the Fifth Hospital and the First Hospital of Shanxi Medical University and Jinzhong Yingtai Women's and Children's Hospital were collected. Patients were divided into cleavage-stage embryo transfer group (named D3 group, n=2 827) and blastocyst-stage embryo transfer group (named D5 group, n=1 253). The main observation indicators were large for gestational age (LGA) and preterm birth (PTB). The secondary observation indicators were multiple pregnancy, gestational age, birth weight and newborn gender. Univariate and multivariate logistic regression were applied to analyze the correlation between embryo transfer type and adverse outcomes. Results:Clinical pregnancy rate [64.5% (808/1 253)], live birth rate [55.5% (696/1 253)], implantation rate [46.0% (1 026/2 230)], multiple pregnancy rate [22.6% (183/808)], male newborn rate [58.6% (515/879)], single LGA rate [19.8% (103/520)] and single PTB rate [21.7% (113/520)] in D5 group were significantly higher than those in D3 group [54.3% (1 535/2 827), P<0.001; 48.2% (1 362/2 827), P<0.001; 36.7% (1 962/5 346), P<0.001; 19.0% (291/1 535), P=0.026; 49.7% (822/1 653), P=0.001; 7.5% (80/1 071), P<0.001; 17.2% (184/1 071), P=0.029]. LGA rate [24.8% (72/290)] in the single frozen-embryo transfer and LGA rate [13.5% (31/230)] in the single fresh-embryo transfer of D5 group were significantly higher than those of D3 group [8.8% (36/409), P<0.001; 6.6% (44/662), P=0.002]. LGA in male newborns [24.8% (82/330)] and female newborns [11.1% (21/190)] of D5 group were significantly higher than those of D3 group [9.1% (54/592), a OR=2.95, 95% CI: 2.01-4.33, P<0.001; 5.4% (26/479), a OR=2.04, 95% CI: 1.10-3.77, P=0.024]. Conclusion:The risk of LGA and premature birth in blastocyst-stage embryo transfer is higher than that in cleavage-stage embryo transfer. In clinical practice, embryo transfer methods should be selected based on the condition of patient and embryo.
