Department of Obstetrics, Gynecology, and Reproductive Sciences, Rutgers Robert Wood Johnson Medical School, 125 Paterson Street, Suite 2100, New Brunswick, NJ, 08901, USA.
IVI-Reproductive Medicine Associates of New Jersey, Basking Ridge, NJ, USA.
J Assist Reprod Genet. 2021 Aug;38(8):2157-2164. doi: 10.1007/s10815-021-02252-8. Epub 2021 Jun 4.
To evaluate embryology and pregnancy outcomes following individual and group embryo culture in the setting of contemporary laboratory practices and freeze-all cycles.
Patients underwent ovarian stimulation followed by intracytoplasmic sperm injection (ICSI). Embryos proceeded through individual culture and then underwent preimplantation genetic testing for aneuploidy (PGT-A) via trophectoderm biopsy. In a subsequent cycle, participants underwent single embryo transfer of a vitrified-warmed, euploid embryo. Outcomes were compared to controls undergoing group culture during the same time frame. The Mann-Whitney U test and logistic regression models were utilized.
Outcomes were assessed for 144 patients whose embryos underwent individual culture and 449 controls whose embryos underwent group culture. There were no significant differences in fertilization rates between groups (81.7% for individual culture vs. 84.1% for group culture, p = 0.22). However, individual culture was associated with a decreased rate of blastocyst formation compared to group culture (43.5% vs. 48.5%, p < 0.01). Following single, vitrified-warmed euploid blastocyst transfer, there were no significant differences between individual culture and group culture, respectively, in rates of positive βhCG (81.9% vs. 81.5%, p = 0.91), sustained implantation (63.9% vs. 65.0%, p = 0.80), biochemical miscarriage (16.7% vs. 12.3%, p = 0.18), or clinical miscarriage (1.4% vs. 4.2%, p = 0.13).
While individual culture appears to negatively impact the rate of usable blastocyst formation compared to group culture, there were no significant differences in pregnancy outcomes following transfer of a single, vitrified-warmed euploid blastocyst.
评估在当代实验室实践和全冷冻周期中,个体胚胎培养和群体胚胎培养对胚胎学和妊娠结局的影响。
患者接受卵巢刺激和胞浆内单精子注射(ICSI)。胚胎进行个体培养,然后通过滋养外胚层活检进行胚胎植入前遗传学检测(PGT-A)。在下一个周期,患者接受单个冷冻解冻、整倍体胚胎的移植。将结果与同一时期进行群体培养的对照组进行比较。使用 Mann-Whitney U 检验和逻辑回归模型。
对 144 名胚胎进行个体培养的患者和 449 名胚胎进行群体培养的对照组进行了结果评估。两组的受精率无显著差异(个体培养组为 81.7%,群体培养组为 84.1%,p = 0.22)。然而,与群体培养相比,个体培养形成囊胚的比例较低(43.5%比 48.5%,p < 0.01)。在进行单个冷冻解冻、整倍体囊胚移植后,个体培养组和群体培养组的阳性βhCG 率(81.9%比 81.5%,p = 0.91)、持续着床率(63.9%比 65.0%,p = 0.80)、生化流产率(16.7%比 12.3%,p = 0.18)和临床流产率(1.4%比 4.2%,p = 0.13)均无显著差异。
虽然与群体培养相比,个体培养似乎会降低可用囊胚形成的比例,但在移植单个冷冻解冻、整倍体囊胚后,妊娠结局并无显著差异。