Demirel Cem, Goksever Celik Hale, Tulek Firat, Tuysuz Gulsum, Donmez Ersan, Ergin Tolga, Buyru Faruk, Bastu Ercan
Ataşehir Memorial IVF Center, Department of Obstetrics and Gynecology, Istanbul, Turkey; Bilgi University, Faculty of Health Sciences, Istanbul, Turkey.
Saglik Bilimleri University Istanbul Kanuni Sultan Suleyman Training and Research Hospital, Department of Obstetrics and Gynecology, Istanbul, Turkey.
J Gynecol Obstet Hum Reprod. 2021 Jun;50(6):101967. doi: 10.1016/j.jogoh.2020.101967. Epub 2020 Nov 5.
Embryo quality assessment with morphological evaluation remains the first-line method of assessment to select the best embryo for transfer. We aimed to determine if an effect of poor quality embryos on good quality ones exists, whether by a paracrine effect or an adverse endometrial influence, when they are transferred together.
We included 412 couples, who underwent intracytoplasmic sperm injection (ICSI) cycles in a tertiary IVF center. Single embryo transfer with a good quality embryo and double embryo transfers with a good + poor quality embryo were evaluated. Overall pregnancy (PR) and live birth rates (LBR) were our main outcome measures.
When PR and LBR are compared, there was no statistical significance between single embryo transfer (SET) and double embryo transfer (DET) groups (51.7 % vs 53.7 %, p = 0.620 and 47 % vs 43.1 %, p = 0.117). When the PR and LBRs were compared between SET from poor cohort and DET group, the outcomes were better in DET group (22.1 % vs 53.7 %, p < 0.001 and 22.1 % vs 43.1 %, p < 0.001). The PR and LBRs of SET from good cohort were significantly better than those of DET (64.4 % vs 53.7 %, p < 0.001 and 57.7 % vs 43.1, p < 0.001). When the PR and LBRs of SET from good cohort and SET from poor cohort were compared, better results were obtained in SET from good cohort.
The addition of poor quality embryo even is of benefit to the LBR, in the setting of when there is only one good quality blastocyst available for the transfer.
通过形态学评估进行胚胎质量评估仍然是选择最佳胚胎进行移植的一线评估方法。我们旨在确定质量差的胚胎与质量好的胚胎一起移植时,是否会通过旁分泌效应或不良的子宫内膜影响对质量好的胚胎产生影响。
我们纳入了412对夫妇,他们在一家三级体外受精中心接受了卵胞浆内单精子注射(ICSI)周期治疗。评估了优质胚胎的单胚胎移植以及优质+劣质胚胎的双胚胎移植情况。总体妊娠率(PR)和活产率(LBR)是我们的主要观察指标。
比较PR和LBR时,单胚胎移植(SET)组和双胚胎移植(DET)组之间无统计学意义(51.7%对53.7%,p = 0.620;47%对43.1%,p = 0.117)。比较劣质队列的SET组和DET组的PR和LBR时,DET组的结果更好(22.1%对53.7%,p < 0.001;22.1%对43.1%,p < 0.001)。优质队列的SET组的PR和LBR显著优于DET组(64.4%对53.7%,p < 0.001;57.7%对43.1%,p < 0.001)。比较优质队列的SET组和劣质队列的SET组的PR和LBR时,优质队列的SET组结果更好。
在只有一个优质囊胚可用于移植的情况下,添加劣质胚胎甚至对活产率有益。