Effect of frozen-thawed blastocyst transfer of different pronuclear zygotes origins on clinical pregnancy outcome and neonatal outcome
10.3760/cma.j.cn101441-20220608-00252
- VernacularTitle:不同原核来源囊胚冻融移植对临床妊娠结局及新生儿的影响
- Author:
Ya ZHANG
1
;
Jijun HU
1
;
Caihua ZHANG
1
;
Yang LIU
1
;
Lu YANG
1
;
Ying XU
1
;
Danyang LI
1
;
Bingnan REN
1
;
Yichun GUAN
1
;
Lijun SUN
1
Author Information
1. 郑州大学第三附属医院生殖医学中心，郑州 450052
- Publication Type:Journal Article
- Keywords:
Pregnancy rate;
Nonpronuclear zygotes;
Monopronuclear zygotes;
Single blastocyst transfer;
Live birth rate;
Neonate
- From:
Chinese Journal of Reproduction and Contraception
2023;43(9):904-912
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the clinical application value of frozen-thawed single blastocyst derived from nonpronuclear (0PN) zygotes, monopronuclear (1PN) zygotes and two-pronuclei (2PN) discarded embryos.Methods:A retrospective cohort analysis of the data of patients who underwent frozen-thawed single blastocyst transfer at the Reproduction Center of the Third Affiliated Hospital of Zhengzhou University from March 2014 to November 2020. According to the different sources of transplanted blastocysts, they were divided into 4 groups including group A derived from 2PN available embryos (2PN embryos with morphological rating Ⅰ-Ⅲ), group B derived from 0PN embryos, group C derived from 1PN embryos, group D derived from 2PN discarded embryos (2PN embryos with morphological rating Ⅳ). The basic data of the four groups were analyzed,and group A was used as the reference group to compare the clinical pregnancy outcomes of groups B, C and D, respectively. The neonatal situation was compared at the cycle of singleton live birth. Logistic regression was used to correct for confounding factors and calculate the adjusted odds ratio (a OR) and 95% confidence interval ( CI). Results:After correcting for confounding factors by logistic regression, the live birth rate in group B was significantly lower than that in group A (a OR=0.701, 95% CI: 0.534-0.920, P=0.011). The clinical pregnancy rate and the live birth rate in group D were significantly lower than those in group A (a OR=0.595, 95% CI: 0.456-0.777, P<0.001; a OR=0.600, 95% CI: 0.449-0.800, P=0.001). The differences in miscarriage rate, pregnancy complications and multiple pregnancy rate were not statistically significant compared with group A (all P>0.05). The differences in all the above indicators in group C were not statistically significant compared with group A ( P>0.05). The risk of occurrence of macrosomia (group B: a OR=2.367, 95% CI: 1.299-4.315, P=0.005; group D: a OR=2.711, 95% CI: 1.463-5.026, P=0.002), large for gestational age (group B: a OR=1.930, 95% CI: 1.158-3.217, P=0.012; group D: a OR=2.039, 95% CI: 1.174-3.543, P=0.011) were significantly higher in groups B and D than in group A. The differences in the risk of occurrence of low birth weight, small for gestational age and preterm birth were not statistically significant in groups B and D compared with group A ( P>0.05), and the difference in the risk of occurrence of the above indicators was not statistically significant in group C compared with group A ( P>0.05). Conclusion:When 2PN embryos are not available, abandoned 0PN, 1PN, and 2PN embryos can be transferred after blastocyst culture, but attention should be paid to the increased risk of macrosomia and large for gestational age in offspring.
