Huang Jiaan, Tao Yu, Zhang Jie, Yang Xiaoyan, Wu Jiayi, Kuang Yanping, Wang Yun
Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Front Physiol. 2020 May 15;11:415. doi: 10.3389/fphys.2020.00415. eCollection 2020.
Previous studies have reported the association between embryo quality and perinatal outcomes in fresh cycles, after cleavage-stage or blastocyst embryo transfer, and found no significant difference. However, in terms of vitrified-warmed embryo transfer cycles, the impact of embryo quality on neonatal and maternal outcomes has not been evaluated.
To explore the association between the quality of a single vitrified-warmed embryo and perinatal outcomes.
This retrospective study included 2403 live-born singletons derived from single vitrified-warmed embryo transfer cycles during January 2006 and July 2018. Neonatal and maternal outcomes were compared between singletons resulting from the use of single good quality embryo (GQE) ( = 1854) and single poor quality embryo (PQE) ( = 549) and analyzed in the group of cleavage-stage embryo transfer and the group of blastocyst transfer, respectively.
A significantly higher risk of low birthweight (LBW, birthweight <2500 g) was observed in the singletons derived from the transfer of single PQE compared with those derived from the transfer of single GQE both in cleavage and blastocyst stages (cleavage-stage, AOR 2.62, 95% CI 1.27-5.37; blastocyst stage, AOR 1.98, 95% CI 1.06-3.70). An increased risk of preterm birth (PTB, gestational age <37 weeks) was also observed in singletons born after transfer of a PQE of cleavage-stage compared with those after a GQE of cleavage-stage (AOR 2.40, 95% CI 1.28-4.49). The transfer of single poor quality blastocyst was associated with a higher risk of placenta previa compared with the transfer of single good quality blastocyst (AOR 2.65, 95% CI 1.26-5.57). Other maternal complications, neonatal malformations, and neonatal complications were similar between compared groups.
In vitrified-warmed cycles with single embryo transfer, poor embryo quality would result in a significantly higher risk of LBW, regardless of cleavage-stage or blastocyst embryo transfer. Meanwhile, the transfer of poor cleavage-stage embryo was also associated with an increased incidence of PTB.
既往研究报道了新鲜周期中卵裂期或囊胚期胚胎移植后胚胎质量与围产期结局之间的关联，且未发现显著差异。然而，对于玻璃化冷冻复苏胚胎移植周期，胚胎质量对新生儿和母亲结局的影响尚未得到评估。
探讨单个玻璃化冷冻复苏胚胎的质量与围产期结局之间的关联。
这项回顾性研究纳入了2006年1月至2018年7月期间2403例单胎活产儿，这些单胎活产儿来自单个玻璃化冷冻复苏胚胎移植周期。比较了使用单个优质胚胎（GQE）（n = 1854）和单个劣质胚胎（PQE）（n = 549）所分娩单胎的新生儿和母亲结局，并分别在卵裂期胚胎移植组和囊胚移植组进行分析。
在卵裂期和囊胚期，与单个GQE移植所分娩的单胎相比，单个PQE移植所分娩的单胎出生体重低（LBW，出生体重<2500 g）的风险显著更高（卵裂期，调整后比值比[AOR] 2.62，95%置信区间[CI] 1.27 - 5.37；囊胚期，AOR 1.98，95% CI 1.06 - 3.70）。与卵裂期GQE移植后出生的单胎相比，卵裂期PQE移植后出生的单胎早产（PTB，孕周<37周）风险也增加（AOR 2.40，95% CI 1.28 - 4.49）。与单个优质囊胚移植相比，单个劣质囊胚移植与前置胎盘风险更高相关（AOR 2.65，95% CI 1.26 - 5.57）。比较组之间的其他母亲并发症、新生儿畸形和新生儿并发症相似。
在单个胚胎移植的玻璃化冷冻复苏周期中，无论卵裂期或囊胚期胚胎移植，胚胎质量差都会导致LBW风险显著更高。同时，劣质卵裂期胚胎移植也与PTB发生率增加相关。
