Pereira Nigel, Brauer Anate A, Melnick Alexis P, Lekovich Jovana P, Spandorfer Steven D
The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medical Center, 1305 York Ave, New York, NY, 10021, USA.
J Assist Reprod Genet. 2015 Jun;32(6):939-43. doi: 10.1007/s10815-015-0478-2. Epub 2015 May 1.
To investigate the prognostic value of growth of 4-cell embryos on the day of transfer in determining clinical pregnancy and live birth rates after fresh in vitro fertilization (IVF)-embryo transfer (ET) cycles.
Retrospective cohort study of all patients between January 2008 and January 2013 initiating fresh IVF-ET cycles resulting in embryos that were not more than 4 cells 72 h after oocyte retrieval in the morning of their transfer. Patients were stratified into 2 groups based on whether embryos did or did not grow more than the 4-cell stage on the afternoon of ET. The odds of clinical pregnancy and live birth were considered as primary outcomes. Student's t-tests and Chi-square (χ2) tests were used as indicated, with logistic regression controlling for maternal age and number of embryos transferred.
Three hundred forty three patients were identified for inclusion: 165 and 178 patients had 4-cell embryos with and without growth on the afternoon of ET, respectively. The demographic and baseline IVF cycle characteristics of the study cohort were comparable. Patients with embryo growth had higher clinical pregnancy (13.9 % vs. 4.49 %) and live birth (10.9 % vs. 3.37 %) rates compared to patients without embryo growth. This represented an overall increased odds of clinical pregnancy [Odds ratio (OR) = 3.44; 95 % Confidence Intervals (CI) 1.49-7.93; P = 0.004)] and live birth (OR = 3.51; 95 % CI 1.36-9.07; P = 0.01). The increased odds remained unchanged after adjusting for maternal age and number of embryos transferred.
Transfer of 4-cell embryos 3 days after oocyte retrieval can result in clinical pregnancies and live births, albeit at a low rate. Growth of an embryo more than the 4-cell stage on the afternoon of ET may serve as a positive prognostic factor for IVF-ET cycle outcome.
探讨在新鲜体外受精（IVF）-胚胎移植（ET）周期中，移植当天4细胞胚胎的生长情况对确定临床妊娠率和活产率的预后价值。
对2008年1月至2013年1月期间所有开始新鲜IVF-ET周期的患者进行回顾性队列研究，这些患者在移植当天上午卵母细胞取出后72小时内胚胎不超过4细胞。根据移植当天下午胚胎是否生长超过4细胞阶段，将患者分为两组。将临床妊娠和活产的几率视为主要结局。根据需要使用学生t检验和卡方（χ2）检验，并采用逻辑回归控制产妇年龄和移植胚胎数量。
确定纳入343例患者：165例和178例患者在移植当天下午分别有生长和未生长的4细胞胚胎。研究队列的人口统计学和基线IVF周期特征具有可比性。与胚胎未生长的患者相比，胚胎生长的患者临床妊娠率（13.9%对4.49%）和活产率（10.9%对3.37%）更高。这表明临床妊娠的总体几率增加[优势比（OR）=3.44；95%置信区间（CI）1.49-7.93；P=0.004]，活产几率增加（OR=3.51；95%CI 1.36-9.07；P=0.01）。在调整产妇年龄和移植胚胎数量后，增加的几率保持不变。
卵母细胞取出后3天移植4细胞胚胎可导致临床妊娠和活产，尽管发生率较低。移植当天下午胚胎生长超过4细胞阶段可能是IVF-ET周期结局的一个积极预后因素。
