Center for Reproductive Medicine, Department of Reproductive Endocrinology, Zhejiang Provincial People's Hospital, Hangzhou Medical College, Hangzhou, China.
J Obstet Gynaecol Res. 2022 Oct;48(10):2563-2570. doi: 10.1111/jog.15369. Epub 2022 Jul 22.
To explore whether sequential embryo transfer benefits patients with repeated implantation failure (RIF) undergoing frozen-thawed embryo transfer (FET) cycles.
We included 311 patients with a history of RIF in this retrospective study. We did sequential transfers with a cleavage embryo on day 3 and a blastocyst on day 5 in 77 patients; blastocyst transfers with two blastocysts on day 5 in 80 patients; and cleavage embryo transfers with two cleavage embryos on day 3 in 154 patients. We compared clinical outcomes between the three groups.
The clinical pregnancy rate was comparable between the blastocyst transfer group (48.8%), the sequential transfer group(48.1%) and the cleavage embryo transfer group (48.1%). There was no statistically significant difference found (p > 0.05). The ongoing pregnancy and multipregnancy rates were also comparable between the three groups (p > 0.05). The early miscarriage rate was significantly higher in the sequential transfer group (32.4%) compared with the blastocyst group (12.8%) and the cleavage embryo group (12.2%) (p < 0.05). However, after adjusting for confounders, there was no significant difference in early miscarriage rates in the sequential transfer group compared with the blastocyst group (odds ratio [OR], 2.97; 95% confidence interval [CI], 0.85-9.24; p = 0.07) and the cleavage embryo group (OR, 3.03; 95% CI, 0.94-8.06; p = 0.08).
Sequential embryo transfer failed to improve clinical outcomes for patients with RIF.
探讨反复着床失败（RIF）患者行冻融胚胎移植（FET）周期时，序贯胚胎移植是否获益。
本回顾性研究纳入了 311 例 RIF 病史患者。77 例患者行第 3 天卵裂期胚胎序贯移植，第 5 天移植囊胚；80 例患者行第 5 天两个囊胚移植；154 例患者行第 3 天两个卵裂期胚胎移植。比较三组患者的临床结局。
囊胚移植组（48.8%）、序贯移植组（48.1%）和卵裂期胚胎移植组（48.1%）的临床妊娠率相当，差异无统计学意义（p>0.05）。三组的活产率和多胎妊娠率也相当（p>0.05）。序贯移植组的早期流产率（32.4%）显著高于囊胚组（12.8%）和卵裂期胚胎组（12.2%）（p<0.05）。然而，在校正混杂因素后，序贯移植组与囊胚组（优势比[OR]，2.97；95%置信区间[CI]，0.85-9.24；p=0.07）和卵裂期胚胎组（OR，3.03；95% CI，0.94-8.06；p=0.08）的早期流产率差异均无统计学意义。
序贯胚胎移植未能改善 RIF 患者的临床结局。
