Reproductive Medicine Center, Henan Provincial People's Hospital, ZhengZhou, China.
People's Hospital of ZhengZhou University, People's Hospital of Henan University, ZhengZhou, China.
Front Endocrinol (Lausanne). 2022 Oct 12;13:1010453. doi: 10.3389/fendo.2022.1010453. eCollection 2022.
To investigate the effects of blastocyst quality and morphological grade on the perinatal outcomes in patients undergoing frozen-thawed single blastocyst transfer cycles.
This single-center retrospective cohort study included 2648 singleton neonates resulting from frozen-thawed single blastocyst transfers performed between January 2017 and September 2021. Multivariate logistic regression was performed to evaluate perinatal outcomes for their association with blastocyst quality and morphological parameters.
Transfer of a good-quality blastocyst in a frozen-thawed cycle was associated with a lower rate of preterm delivery (PTD, adjusted OR =0.7, 95% CI 0.5-0.9; P=0.020) and a higher likelihood of a male neonate (adjusted OR =1.2, 95%CI 1.0-1.5; P=0.048). Compared with grade C inner cell mass (ICM) blastocyst transfer, grade B ICM (adjusted OR =0.5, 95%CI 0.2-0.9; P=0.027) and grade A ICM (adjusted OR =0.6, 95%CI 0.3-1.5; P=0.290) blastocyst transfers were associated with a lower rate of PTD, which was more evident for grade B ICM. After adjusting for confounders, the likelihood of a male neonate (grade B TE, OR =1.2, 95%CI 1.0-1.5, P=0.037; grade A TE OR =1.9, 95%CI 1.3-28, P=0.002) increased with increasing trophectoderm (TE) quality. Compared with expansion stage 4, the likelihood of a male neonate was 1.5 times greater with transfer of a stage 6 blastocyst (OR =1.5, 95%CI 1.0-2.3; P=0.06), and the risk of small for gestational age (SGA) was greater with transfer of a stage 5 blastocyst (adjusted OR =3.5, 95%CI 1.5-8.0; P=0.004). The overall grading of the blastocyst, expansion stage, ICM grade, and TE grade were not associated with length at birth, birthweight, large for gestational age (LGA), or birth defects (all P>0.05).
In frozen-thawed single blastocyst transfer cycles, transfer of a good-quality blastocyst was associated with a lower rate of PTD and a greater likelihood of a male neonate. Transfer of grade B ICM blastocysts decreased the rate of PTD, and TE quality was positively correlated with the likelihood of a male neonate.
研究囊胚质量和形态学分级对接受冻融单囊胚移植周期患者围产结局的影响。
本单中心回顾性队列研究纳入了 2017 年 1 月至 2021 年 9 月期间进行的冻融单囊胚移植后出生的 2648 例单胎新生儿。采用多变量逻辑回归评估囊胚质量和形态参数与围产结局的关系。
在冻融周期中移植优质囊胚与早产率降低相关（早产，调整后的 OR=0.7，95%CI 0.5-0.9；P=0.020），且男婴出生率增加（调整后的 OR=1.2，95%CI 1.0-1.5；P=0.048）。与 C 级内细胞团（ICM）囊胚移植相比，B 级 ICM（调整后的 OR=0.5，95%CI 0.2-0.9；P=0.027）和 A 级 ICM（调整后的 OR=0.6，95%CI 0.3-1.5；P=0.290）囊胚移植与早产率降低相关，B 级 ICM 更为明显。调整混杂因素后，优质囊胚（B 级滋养外胚层，OR=1.2，95%CI 1.0-1.5，P=0.037；A级滋养外胚层，OR=1.9，95%CI 1.3-28，P=0.002）的男婴出生率增加。与扩张期 4 相比，扩张期 6 囊胚移植的男婴出生率增加 1.5 倍（OR=1.5，95%CI 1.0-2.3；P=0.06），扩张期 5 囊胚移植的小于胎龄儿（SGA）风险更大（调整后的 OR=3.5，95%CI 1.5-8.0；P=0.004）。囊胚的整体分级、扩张阶段、ICM 分级和滋养外胚层分级与出生时的长度、出生体重、大于胎龄儿（LGA）或出生缺陷（均 P>0.05）均无关联。
在冻融单囊胚移植周期中，移植优质囊胚与早产率降低和男婴出生率增加相关。B 级 ICM 囊胚移植降低了早产率，滋养外胚层质量与男婴出生率呈正相关。
