The Centre for Reproductive & Genetic Health (CRGH), Great Portland Street, London, W1W 5QS, UK.
Hammersmith Hospital, Imperial College NHS Trust, London, W12 0HS, UK.
J Assist Reprod Genet. 2022 Apr;39(4):987-993. doi: 10.1007/s10815-022-02440-0. Epub 2022 Feb 26.
To compare reproductive outcomes following a euploid embryo transfer, between those embryos vitrified-warmed twice to those vitrified-warmed once.
We retrospectively analysed 694 single euploid frozen embryo transfer cycles following preimplantation genetic testing for aneuploidy (PGT-A). For cycles in group 1 (N = 451), embryos were biopsied for PGT-A at blastocyst stage and vitrified. For cycles in group 2 (N = 146), embryos were vitrified at blastocyst stage, before being warmed and biopsied for PGT-A and vitrified again. For cycles in group 3 (N = 97), embryos were vitrified on day-3, before being warmed, cultured to day-5 and biopsied for PGT-A and re-vitrified.
The pregnancy, clinical pregnancy and livebirth rate in group 2 were not statistically different to group 1 (pregnancy rate, adjusted OR 1.09, 95% CI 0.62-1.91; clinical pregnancy, aOR 0.89, 95% CI 0.58-1.37; live birth rate, aOR 0.85, 95% CI 0.56-1.28). There was also no significant difference between group 3 and group 1, with similar pregnancy rate (aOR 1.22, 95% CI 0.74-1.99), clinical pregnancy rate (aOR 1.21, 95% CI 0.75-1.96) and live birth rate (aOR 1.15, 95% CI, 0.73-1.80). There was no significant difference in miscarriage rates between all three groups. The age at the oocyte collection, embryo quality and day of biopsy were associated with pregnancy, clinical pregnancy and live birth rate.
This study suggests that vitrifying and warming embryos twice at blastocyst or at cleavage and then blastocyst stage, can lead to similar reproductive outcomes to embryos vitrified-warmed once, after a single euploid embryo transfer.
比较两次玻璃化冷冻-解冻胚胎与一次玻璃化冷冻-解冻胚胎的移植后妊娠结局。
我们回顾性分析了 694 例经植入前遗传学检测（PGT-A）的单倍体冷冻胚胎移植周期。第 1 组（N=451）的胚胎在囊胚期活检进行 PGT-A 后进行玻璃化冷冻。第 2 组（N=146）的胚胎在囊胚期先进行玻璃化冷冻，然后解冻活检进行 PGT-A 并再次玻璃化冷冻。第 3 组（N=97）的胚胎在第 3 天进行玻璃化冷冻，然后解冻、培养至第 5 天进行活检进行 PGT-A 并再次玻璃化冷冻。
第 2 组的妊娠率、临床妊娠率和活产率与第 1 组相比无统计学差异（妊娠率，调整 OR 1.09，95%CI 0.62-1.91；临床妊娠率，aOR 0.89，95%CI 0.58-1.37；活产率，aOR 0.85，95%CI 0.56-1.28）。第 3 组与第 1 组也无显著差异，其妊娠率相似（aOR 1.22，95%CI 0.74-1.99），临床妊娠率（aOR 1.21，95%CI 0.75-1.96）和活产率（aOR 1.15，95%CI，0.73-1.80）。三组间流产率无显著差异。卵母细胞采集时的年龄、胚胎质量和活检日与妊娠、临床妊娠和活产率有关。
本研究表明，两次玻璃化冷冻-解冻胚胎（在囊胚期或卵裂期及囊胚期）与一次玻璃化冷冻-解冻胚胎相比，可在单次单倍体胚胎移植后获得相似的妊娠结局。
