Faculté de Médecine, Assistance Publique - Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre, Centre Hospitalier Universitaire (CHU) Cochin, Service d'Histologie-Embryologie-Biologie de la Reproduction, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.
Département "Génomique, Epigénétique et Physiopathologie de la Reproduction," Institut Cochin, INSERM U1016, CNRS UMR8104, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.
J Assist Reprod Genet. 2018 Feb;35(2):311-319. doi: 10.1007/s10815-017-1063-7. Epub 2017 Oct 18.
The aims of this study were to investigate the possible benefits of extending the culture of poor-quality day-2 embryos (PQE) versus good-quality embryos (GQE) and to identify factors associated with pregnancy and live birth when transferring frozen-thawed blastocysts originating from GQE and PQE.
This is a retrospective cohort follow-up study performed between November 2012 and February 2015 at the IVF Laboratory Unit of Cochin University Hospital (Paris, France) including 3108 day-2 supernumerary embryos resulting from 1237 IVF/ICSI cycles.
Total blastulation rate was 67.2% from GQE and 48.7% from PQE. Percentage of good-quality blastocysts was 60.7 and 47.9% respectively including 14.7 and 7.3% top-quality blastocysts. A total of 150 blastocysts originating from GQE and 729 from PQE were frozen, and then, 37 and 164 were thawed and transferred respectively resulting in 19 (51.4%) and 61 (37.9%) clinical pregnancies with 13 (35.1%) deliveries from GQE and 32 (19.9%) from PQE (p = 0.046) without any difference in neonatal outcomes. Quality of blastocysts that resulted in live birth was similar in the two groups. Women < 35 years old and day-5 blastocyst expansion were predictive of pregnancy and live birth.
(i) PQE are able to reach the blastocyst stage, to implant, and to give healthy babies and (ii) women age and day of blastocyst expansion are predictive of pregnancy and live birth.
本研究旨在探讨延长培养质量差的第 2 天胚胎（PQE）与优质胚胎（GQE）的可能益处，并确定在转移来自 GQE 和 PQE 的冷冻解冻囊胚时与妊娠和活产相关的因素。
这是一项回顾性队列随访研究，于 2012 年 11 月至 2015 年 2 月在法国巴黎 Cochin 大学医院的体外受精实验室进行，纳入了 1237 个 IVF/ICSI 周期中产生的 3108 个第 2 天多余胚胎。
GQE 的总囊胚形成率为 67.2%，PQE 为 48.7%。优质囊胚的比例分别为 60.7%和 47.9%，包括 14.7%和 7.3%的顶级优质囊胚。共冷冻了 150 个来自 GQE 的囊胚和 729 个来自 PQE 的囊胚，然后解冻并转移了 37 个和 164 个，分别导致 19 个（51.4%）和 61 个（37.9%）临床妊娠，13 个（35.1%）分娩来自 GQE，32 个（19.9%）来自 PQE（p=0.046），新生儿结局无差异。两组中导致活产的囊胚质量相似。年龄<35 岁和第 5 天囊胚扩张是妊娠和活产的预测因素。
（i）PQE 能够达到囊胚阶段、着床并生育健康婴儿；（ii）女性年龄和囊胚扩张日是妊娠和活产的预测因素。
