Selection of embryo transfer strategies in frozen embryo transfer cycle
10.3760/cma.j.cn101441-20190508-00185
- VernacularTitle:冷冻胚胎复苏周期胚胎移植策略的选择
- Author:
Jing LIU
1
;
Hongjiao KONG
1
;
Yichun GUAN
1
;
Junliang ZHAO
1
;
Jiaheng LI
1
;
Yuchao ZHANG
1
;
Xiaoyang LIU
1
;
Yimeng LI
1
;
Xingling WANG
1
Author Information
1. 郑州大学第三附属医院生殖医学中心 450052
- Publication Type:Journal Article
- Keywords:
Frozen-thawed embryo transfer;
Transfer strategy;
Live birth;
Clinical pregnancy
- From:
Chinese Journal of Reproduction and Contraception
2020;40(6):454-460
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To preliminarily explore the priority order of transfer of frozen low-quality blastocyst and high-quality cleavage embryos in the recovery frozen-thawed embryo transfer (FET) cycle of frozen embryos.Methods:In this retrospective study, 3677 in vitro fertilization-embryo transfer (IVF-ET) cycles were reviewed in Reproductive Medicine Center of the Third Affiliated Hospital of Zhengzhou University from November 2015 to May 2018. According to the stage of embryo development, quality and number of embryos transferred, the embryos were divided into five groups: single-non-high-quality blastocyst group (group A), single-high-quality blastocyst group (group B), day 3 (D3) double-high-quality embryo group (group C), D3 high-quality plus non-high-quality embryo group (group D) and D3 double-non-high-quality embryo group (group E). According to the age of the patients, they were divided into three subgroups, <35 years old, 35-37 years old and >37 years old. The main observation indicator was live birth rate, and the secondary observation indicators were clinical pregnancy rate, implantation rate, and multiple birth rate. Results:The implantation rates of double D3 embryos transfer groups (groups C-E) were significantly lower than those of single blastocyst groups (groups A and B)(all P<0.05), while the multiple pregnancy rates were significantly higher than those of single blastocyst groups (all P<0.01). There was no significant difference in clinical pregnancy rate between group C and group A ( P>0.05). Live birth rate increased significantly when patients were younger than 35 years old ( P=0.003), but there was no significant difference when patients were older than 35 years old. There was no significant difference in clinical pregnancy rate and live birth rate between group D and group A when patients were younger than 38 years old. When the patient was over 37 years old, the clinical pregnancy rate of group D was lower significantly ( P=0.018), but there was no significant difference in the live birth rate ( P>0.05). The clinical pregnancy rate and the live birth rate of group E were lower than those of group A. The difference was significant when the age of the patients was less than 35 years and more than 37 years (all P<0.01). There was no significant difference when the age of the patients was 35-37 years ( P>0.05). Age and the type of embryos transferred were independent factors affecting live birth. After adjusting the effect of age on live birth, compared with group A, the effects of group B ( OR=1.311, 95% CI=1.083-1.586, P=0.005), group C ( OR=1.322, 95% CI=1.092-1.601, P=0.004), group E ( OR=0.616, 95% CI=0.468-0.809, P=0.001) on the live birth rate were significantly different, while the effects of group D ( OR=1.139, 95% CI=0.914-1.420, P=0.247) on the live birth rate was not significantly different from those of group A. Conclusion:Considering multiple pregnancies and live births, the optimal transplantation sequence of frozen embryo transfer cycle may be single-high-quality blastocyst, single-non-high-quality blastocyst, D3 double-high-quality embryo, D3 high-quality plus non-high-quality embryo and D3 double-non-high-quality embryo.
