Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Rd, Shanghai 200011, China.
Hum Reprod. 2020 Feb 29;35(2):308-316. doi: 10.1093/humrep/dez287.
Does the quality of a single transferred blastocyst affect singleton birthweight in frozen-embryo transfer (FET) cycles?
The transfer of a poor-quality blastocyst was associated with lower mean birthweight and gestation-adjusted birthweight (Z-scores) when compared with the transfer of an excellent-quality blastocyst during FET cycles.
Embryo quality is a strong predictor of IVF success rates. However, very few studies have examined the effect of embryo quality on singleton birthweight.
STUDY DESIGN, SIZE, DURATION: This retrospective study involved singleton live births born to women undergoing frozen-thawed single blastocyst transfers during the period from January 2010 to December 2017 at a tertiary care centre.
PARTICIPANTS/MATERIALS, SETTING, METHODS: A total of 1207 women who fulfilled the inclusion criteria were included and were grouped into four groups depending on the blastocyst quality: excellent, good, average and poor. The primary outcome measure was singleton birthweight. The Z-score was employed to calculate the birthweight adjusted for gestational age and newborn gender. Multiple linear regression analysis was performed to investigate the relationship between embryo quality and neonatal birthweight after adjustment for some potential confounders.
In the primary multivariable model, singletons from the poor-quality blastocyst group weighed 183.5 g less than those from the excellent-quality blastocyst group (95% CI: -295.1 to -71.9 g, P = 0.001) in terms of mean birthweight after accounting for patient characteristics, IVF treatment parameters, the year of treatment and newborn gender. Likewise, poor-quality blastocyst transfer was associated with lower gestation-adjusted Z-scores than the transfer of excellent-quality blastocysts (β = -0.35, 95% CI: -0.59 to -0.12, P = 0.003).
The current study was limited by its retrospective design and the fact that our analysis was restricted to women with singleton births from single blastocyst transfers. Future prospective studies are required to confirm our findings.
Our findings provide new insight into the relationship between embryo quality and neonatal outcomes by showing that poor-quality blastocyst transfer was associated with a decrease in singleton birthweight.
STUDY FUNDING/COMPETING INTEREST(S): This study was supported by the National Key Research and Development Program of China (grant no. 2018YFC1003000), the National Natural Science Foundation of China (grant nos. 81771533, 81571397 and 31770989), and the China Postdoctoral Science Foundation (Grant no. 2018M630456). The authors have no conflicts of interest to declare.
Not applicable.
在冷冻胚胎移植（FET）周期中，单个移植的囊胚质量是否会影响单胎出生体重？
与移植优质囊胚相比，在 FET 周期中移植质量差的囊胚与较低的平均出生体重和胎龄调整后的出生体重（Z 分数）相关。
胚胎质量是体外受精成功率的强有力预测指标。然而，很少有研究探讨胚胎质量对单胎出生体重的影响。
研究设计、大小、持续时间：这是一项回顾性研究，涉及 2010 年 1 月至 2017 年 12 月期间在一家三级保健中心接受冷冻解冻单个囊胚移植的单胎活产女性。
参与者/材料、地点、方法：共有 1207 名符合纳入标准的女性被纳入研究，并根据囊胚质量分为四组：优秀、良好、一般和差。主要结局指标为单胎出生体重。采用 Z 分数计算胎龄和新生儿性别调整后的出生体重。进行多元线性回归分析，以调查胚胎质量与新生儿出生体重之间的关系，同时调整一些潜在的混杂因素。
在主要的多变量模型中，在考虑患者特征、体外受精治疗参数、治疗年份和新生儿性别后，来自质量差的囊胚组的单胎出生体重比来自质量优秀的囊胚组少 183.5 克（95%CI：-295.1 至-71.9 克，P=0.001）。同样，与优质囊胚移植相比，质量差的囊胚移植与较低的胎龄调整 Z 分数相关（β=-0.35，95%CI：-0.59 至-0.12，P=0.003）。
目前的研究受到其回顾性设计的限制，并且我们的分析仅限于来自单个囊胚转移的单胎出生的女性。需要未来的前瞻性研究来证实我们的发现。
我们的研究结果通过表明质量差的囊胚移植与单胎出生体重下降有关，为胚胎质量与新生儿结局之间的关系提供了新的见解。
研究资金/利益冲突：本研究得到了中国国家重点研发计划（项目编号：2018YFC1003000）、国家自然科学基金（项目编号：81771533、81571397 和 31770989）和中国博士后科学基金（项目编号：2018M630456）的支持。作者没有利益冲突需要申报。
不适用。
