GeneraLife IVF, Clinica Valle Giulia, Rome, Italy.
GeneraLife IVF, Clinica Valle Giulia, Rome, Italy.
Reprod Biomed Online. 2022 Feb;44(2):221-227. doi: 10.1016/j.rbmo.2021.09.027. Epub 2021 Oct 8.
The study aimed to retrospectively evaluate the impact of cryo-storage duration on clinical, obstetric and perinatal outcomes after vitrified-warmed euploid blastocyst transfer.
This was an observational study including 2688 vitrified-warmed euploid single blastocyst transfers that was conducted at a private IVF centre between May 2013 and March 2020. It included a total of 1884 women (age 38 ± 3 years) undergoing at least one transfer after preimplantation genetic testing for aneuploidies. The euploid blastocysts transferred were clustered into seven groups according to the cryo-storage duration between vitrification and warming: ≤60 days (n = 646; control group), 61-90 days (n = 599), 91-180 days (n = 679), 181-360 days (n = 405), 361-720 days (n = 144), 721-1080 days (n = 118) and >1080 days (n = 97). The primary outcome was the live birth rate (LBR) per transfer. The secondary outcomes were miscarriage rate, obstetric and perinatal issues. The data were adjusted for confounders through logistic or linear regressions.
A significantly lower LBR was reported for transfers performed within 91-180 days (n = 291/679, 42.9%; P = 0.017), 181-360 days (n = 169/405, 41.7%; P = 0.016) and 361-720 days (n = 57/144, 39.6%; P = 0.034) versus ≤60 days (n = 319/646, 49.4%). However, this was mainly due to top-quality embryos being transferred first when more euploid blastocysts were available, thereby leaving lower quality ones for subsequent procedures. Indeed, the multivariate odds ratios adjusted for confounders showed similar results across all cryo-storage duration clusters. No difference was reported also for all secondary outcomes.
Cryo-storage duration even beyond 3 years from blastocyst vitrification does not affect clinical, obstetric and perinatal outcomes.
本研究旨在回顾性评估玻璃化冷冻和解冻后囊胚移植中冷冻保存时间对临床、产科和围产结局的影响。
这是一项观察性研究,纳入了 2013 年 5 月至 2020 年 3 月在一家私立试管婴儿中心进行的 2688 例玻璃化冷冻解冻后单囊胚移植。共纳入 1884 名女性(年龄 38 ± 3 岁),她们均接受了植入前胚胎非整倍体检测,至少进行过一次移植。根据玻璃化和解冻之间的冷冻保存时间,将转移的整倍体囊胚分为七组:≤60 天(n=646;对照组)、61-90 天(n=599)、91-180 天(n=679)、181-360 天(n=405)、361-720 天(n=144)、721-1080 天(n=118)和>1080 天(n=97)。主要结局是每移植的活产率(LBR)。次要结局是流产率、产科和围产问题。通过逻辑或线性回归调整了混杂因素。
91-180 天(n=291/679,42.9%;P=0.017)、181-360 天(n=169/405,41.7%;P=0.016)和 361-720 天(n=57/144,39.6%;P=0.034)组的 LBR 显著低于≤60 天(n=319/646,49.4%)组。然而,这主要是由于当有更多的整倍体囊胚时,首先转移高质量的胚胎,从而为后续程序留下质量较低的胚胎。事实上,调整混杂因素的多变量优势比在所有冷冻保存时间组中均显示出相似的结果。所有次要结局也没有差异。
即使囊胚玻璃化冷冻后超过 3 年,冷冻保存时间也不会影响临床、产科和围产结局。