Department of Obstetrics and Gynecology, Tangdu Hospital, The Air Force Military Medical University, Xi'an, 710038, China.
Arch Gynecol Obstet. 2021 Feb;303(2):573-580. doi: 10.1007/s00404-020-05774-1. Epub 2020 Oct 8.
This study aimed to investigate whether the extended culture of day 3 (D3) embryos with low blastomere number to blastocyst following frozen-thawed embryo transfer improved the clinical outcomes.
This was a retrospective study of clinical data of women undergoing in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) cycles in the Tangdu Hospital. The patients were divided into groups with 4-5, 6, 7-9 and > 9 cells based on the blastomere number of D3 embryos. The clinical outcomes were compared.
In fresh transfer cycles, the implantation and clinical pregnancy rates significantly decreased, while the abortion rate significantly increased in the groups with 4-5 and 6 cells compared with those with 7-9 and > 9 cells. In frozen-thawed transfer cycles, the clinical pregnancy and implantation rates for a single blastocyst transfer cycle showed no significant differences in the groups with 4-5 and 6 cells compared with those with 7-9 and > 9 cells. However, the abortion rate was significantly higher in the group with 4-5 cells than in that with 7-9 and > 9 cells. In the double blastocyst transfer cycle, the clinical pregnancy rate showed no significant differences among the groups with 4-5, 6, and 7-9 cells.
The implantation and clinical pregnancy rates of D3 embryos with 6 cells significantly decreased; these embryos were not considered as high-quality embryos. Extended culture of D3 embryos with ≤ 6 blastomeres to blastocysts, particularly 6-cell embryos, resulted in a similar clinical pregnancy rate as that of blastocysts derived from D3 embryos with ≥ 7 blastomeres.
本研究旨在探讨在冻融胚胎移植中,将低卵裂球数的第 3 天(D3)胚胎延长培养至囊胚,是否能改善临床结局。
这是一项对唐都医院接受体外受精/胞浆内单精子注射(IVF/ICSI)周期的妇女进行的回顾性临床数据分析。根据 D3 胚胎的卵裂球数,患者被分为 4-5、6、7-9 和>9 细胞组。比较各组的临床结局。
在新鲜移植周期中,4-5 细胞和 6 细胞组的着床率和临床妊娠率显著降低,而流产率显著升高;与 7-9 和>9 细胞组相比。在冻融移植周期中,对于单个囊胚移植周期,4-5 和 6 细胞组的临床妊娠率和着床率与 7-9 和>9 细胞组无显著差异。然而,4-5 细胞组的流产率显著高于 7-9 和>9 细胞组。在双囊胚移植周期中,4-5、6 和 7-9 细胞组的临床妊娠率无显著差异。
6 细胞的 D3 胚胎着床率和临床妊娠率显著下降;这些胚胎不能被认为是高质量胚胎。将≤6 个卵裂球的 D3 胚胎延长培养至囊胚,特别是 6 细胞胚胎,可获得与≥7 个卵裂球的 D3 胚胎衍生的囊胚相似的临床妊娠率。