Department of Obstetrics, Gynecology, and Reproductive Endocrinology and Infertility, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
Massachusetts General Hospital Fertility Center, YAW-10-A, 55 Fruit Street, Boston, MA, 02114, USA.
J Assist Reprod Genet. 2018 May;35(5):879-884. doi: 10.1007/s10815-018-1157-x. Epub 2018 Mar 27.
To evaluate the differences in implantation and pregnancy rates when embryo transfer occurs on D2 versus D3 in women with a low yield of fertilized oocytes.
A total of 156 IVF/ICSI cycles from 141 women at an academic fertility center were analyzed in a retrospective fashion. Women with a low number of fertilized oocytes (≤ 2 two pronuclei (2PN) stage zygotes) who had their fresh embryo transfer on D2 or D3 were included in the study. Positive pregnancy test per IVF cycle (PPT), clinical pregnancy rate (CPR), spontaneous abortion rate (SABR), and implantation rate (IMPR) were the main outcome measures assessed. Mann-Whitney U test and χ test were used as appropriate. A generalized linear mixed effect model adjusted for relevant covariates was conducted. P < 0.05 was considered significant.
Patients having their embryo transfer on D2, when compared to those who had a D3 embryo transfer, experienced similar PPT [30.8 vs. 28.2%, respectively; adjusted OR (95%CI): 0.49 (0.16, 1.52)], CPR [26.9 vs. 25.6%, respectively; adjusted OR (95%CI): 0.44 (0.12, 1.67)], and IMPR [17.3 vs. 16.7%, respectively; adjusted β (95%CI) - 5.6% (- 15.0, 3.9)].
Our findings suggest that transferring embryos on D2 versus D3 in women with a limited number of 2PN stage zygotes does not affect early pregnancy outcomes. These results indicate that there can be some flexibility in scheduling the day of transfer at the convenience of both the patient and the center.
评估在卵母细胞受精率低的患者中，胚胎移植在第 2 天（D2）和第 3 天（D3）时着床率和妊娠率的差异。
回顾性分析了一家学术生育中心的 141 名患者的 156 个 IVF/ICSI 周期。本研究纳入了新鲜胚胎移植在 D2 或 D3 的卵母细胞受精数低（≤2 个原核期（2PN）胚胎）的患者。主要观察指标为每个 IVF 周期的阳性妊娠试验（PPT）、临床妊娠率（CPR）、自然流产率（SABR）和着床率（IMPR）。采用 Mann-Whitney U 检验和卡方检验，采用广义线性混合效应模型进行校正。P<0.05 为差异有统计学意义。
与 D3 胚胎移植相比，D2 胚胎移植患者的 PPT 相似[分别为 30.8%和 28.2%；校正后比值比（95%CI）：0.49（0.16，1.52）]，CPR 相似[分别为 26.9%和 25.6%；校正后比值比（95%CI）：0.44（0.12，1.67）]，IMPR 相似[分别为 17.3%和 16.7%；校正后β（95%CI）：-5.6%（-15.0，3.9）]。
我们的研究结果表明，在卵母细胞受精数低的患者中，胚胎移植在第 2 天和第 3 天进行不会影响早期妊娠结局。这些结果表明，在方便患者和中心的前提下，移植日的安排可以具有一定的灵活性。
