İnal Hasan Ali, Öztürk İnal Zeynep
Clinic of Reproductive Endocrinology, Konya Training and Research Hospital, Konya, Turkey
J Turk Ger Gynecol Assoc. 2021 Dec 6;22(4):279-285. doi: 10.4274/jtgga.galenos.2021.2020.0171. Epub 2021 Mar 5.
To evaluate whether or not embryo transfer (ET) day has an effect on the rates of clinical pregnancy (CPR) and live birth (LBR) in in vitro fertilization-intracytoplasmic sperm injection (IVF-ICSI) treatment.
A total of 757 patients who underwent IVF-ICSI treatment between 2012 and 2017 were included. The participants were stratified into three groups according to ET day: group 1 (day 2 transfer, n=43); group 2 (day 3 transfer, n=633); and group 3 [day 5 (blastocyst) transfer, n=81]. Basal parameters and IVF-ICSI outcomes were compared between the groups.
Group 1 and 2 patients were older, had a higher body mass index, worse response rate, lower antral follicle count, lower peak estradiol levels, and less endometrial thickness, and required higher total gonadotropin dose than group 3. In addition, the number of oocytes and metaphase II oocytes, fertilization rate, and 2 pronucleus number were statistically different between the groups. The CPR (19.5% vs 36.9% vs 39.0%, respectively) and LBR (14.6% vs 30.4% vs 35.1%, respectively) were significantly lower in group 1 than in groups 2 and 3 (p<0.05). Grade 1 embryos were significantly more prevalent in groups 1 and 2 with clinical pregnancy positive [odds ratio (OR): 4.444; 95% confidence interval (CI): 0.876-22.536; p=0.001 and OR: 1.756; 95% CI: 1.234-2.500; p<0.001) and live birth (OR: 5.021; 95% CI: 0.787-31.768; p=0.001 and OR: 1.676; 95% CI: 1.154-2.433; p=0.007).
These data suggest that an earlier ET day has a negative effect on the CPR. Older primary infertile women should not postpone their desire to have a baby because they appear to be poorer responders.
评估体外受精-卵胞浆内单精子注射（IVF-ICSI）治疗中胚胎移植（ET）日是否对临床妊娠率（CPR）和活产率（LBR）有影响。
纳入2012年至2017年间接受IVF-ICSI治疗的757例患者。根据ET日将参与者分为三组：第1组（第2天移植，n = 43）；第2组（第3天移植，n = 633）；第3组[第5天（囊胚）移植，n = 81]。比较各组间的基础参数和IVF-ICSI结局。
第1组和第2组患者年龄更大，体重指数更高，反应率更差，窦卵泡计数更低，雌二醇峰值水平更低，子宫内膜厚度更薄，且比第3组需要更高的促性腺激素总剂量。此外，各组间卵母细胞和MII期卵母细胞数量、受精率及双原核数量存在统计学差异。第1组的CPR（分别为19.5% vs 36.9% vs 39.0%）和LBR（分别为14.6% vs 30.4% vs 35.1%）显著低于第2组和第3组（p<0.05）。在临床妊娠阳性的第1组和第2组中，1级胚胎明显更常见[优势比（OR）：4.444；95%置信区间（CI）：0.876 - 22.536；p = 0.001，以及OR：1.756；95% CI：1.234 - 2.500；p<0.001]，活产情况亦是如此（OR：5.021；95% CI：0.787 - 31.768；p = 0.001，以及OR：1.676；95% CI：1.154 - 2.433；p = 0.007）。
这些数据表明，较早的ET日对CPR有负面影响。年龄较大的原发性不孕女性不应因看起来反应较差而推迟生育意愿。
