Department of Reproductive Medicine, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China.
Department of Reproductive Medicine, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China.
Eur J Obstet Gynecol Reprod Biol. 2022 Apr;271:265-270. doi: 10.1016/j.ejogrb.2022.03.001. Epub 2022 Mar 4.
To compare perinatal outcomes of singletons after blastocyst versus cleavage-stage embryo transfer in frozen-thawed embryo transfer (FET) cycles.
This was a retrospective cohort study of 4835 women who conceived after frozen-thawed embryo transfer and delivered a singleton baby from January 2015 to March 2020. The perinatal outcomes of the singletons born after blastocyst transfer (N = 3364) were compared to the singletons born after cleavage-stage transfer (N = 1471), including gestational week, birth weight, newborn gender and Apgar score.
Univariate and multivariate analysis found that infants born after blastocyst transfer had a higher risk of preterm birth (PTB) [adjusted odds ratio (aOR) 1.480; 95% confidence interval (CI) 1.213-1.807], large for gestational age (LGA) (aOR 1.329, 95%CI 1.149-1.536) and very large for gestational age (VLGA) (aOR 1.317, 95%CI 1.092-1.590) compared to infants born after cleavage-stage embryo transfer. When categorized by gestational weeks, the proportion of LGA was significantly higher for boys born after BT between GW 37 to 41 (aOR 1.301, 95%CI 1.051-1.609) and for girls born after BT between GW 32 to 41 (aOR 2.690, 95%CI 1.154-6.271, aOR 1.377, 95%CI 1.094-1.733), compared to boys and girls born after CT.
Our data suggested that the risk of PTB and LGA increased after blastocyst transfer versus cleavage-stage embryo transfer in FET cycles, and the risk of LGA is more apparent in the last trimester of pregnancy. Further studies are needed to confirm our findings and explored the association between the extended embryo culture and long-term outcomes of offspring.
比较冻融胚胎移植（FET）周期中囊胚期与卵裂期胚胎移植后单胎的围产结局。
这是一项回顾性队列研究，纳入了 2015 年 1 月至 2020 年 3 月间接受 FET 并分娩单胎活婴的 4835 名妇女。比较了囊胚期移植（N=3364）和卵裂期移植（N=1471）后出生的单胎的围产结局，包括孕周、出生体重、新生儿性别和阿普加评分。
单因素和多因素分析发现，囊胚期移植的婴儿早产（PTB）[校正优势比（aOR）1.480；95%置信区间（CI）1.213-1.807]、巨大儿（LGA）（aOR 1.329，95%CI 1.149-1.536）和特大儿（VLGA）（aOR 1.317，95%CI 1.092-1.590）的风险均高于卵裂期胚胎移植的婴儿。当按孕周分类时，GW37 至 41 周时 BT 出生的男孩 LGA 比例明显更高（aOR 1.301，95%CI 1.051-1.609），GW32 至 41 周时 BT 出生的女孩 LGA 比例更高（aOR 2.690，95%CI 1.154-6.271，aOR 1.377，95%CI 1.094-1.733），而 CT 出生的男孩和女孩则无此现象。
我们的数据表明，FET 周期中囊胚期移植后 PTB 和 LGA 的风险高于卵裂期胚胎移植，LGA 的风险在妊娠晚期更为明显。需要进一步的研究来证实我们的发现，并探讨延长胚胎培养与后代长期结局之间的关系。
