Wang Xiaojuan, Zhang Shuoping, Gu Yifan, Ma Shujuan, Peng Yangqin, Gong Fei, Tan Hongzhuan, Lin Ge
Department of Epidemiology and Health Statistics, School of Public Health, Central South University, Changsha, Hunan, People's Republic of China; Clinical Research Center for Reproduction and Genetics in Hunan Province, Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, Hunan, People's Republic of China.
Clinical Research Center for Reproduction and Genetics in Hunan Province, Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, Hunan, People's Republic of China.
Fertil Steril. 2023 Jan;119(1):56-66. doi: 10.1016/j.fertnstert.2022.09.030. Epub 2022 Nov 18.
To explore whether the associations of 3 blastocyst morphological parameters, namely, degree of blastocyst expansion (expansion), appearance of trophectoderm (TE) and inner cell mass, with live birth and singleton birth weight are influenced by blastocyst freezing and biopsy.
A retrospective study.
An assisted reproductive technology center.
PATIENT(S): 28,515 single blastocyst transfer cycles between January 2014 and August 2019.
INTERVENTION(S): Not applicable.
MAIN OUTCOME MEASURE(S): Live birth and singleton birth weight.
RESULT(S): Blastocyst transfer cycles were divided into 4 groups: biopsied blastocyst cycles (biopsied-blast), thawed blastocyst cycles (thawed-blast), blastocyst from thawed cleavage embryo cycles (blast-thawed-D3), and fresh blastocyst cycles (fresh-blast). Subgroup analyses by blastocyst stage (day 5 and day 6) were performed in thawed-blast and blast-thawed-D3. Because almost all blastocysts were biopsied on day 6 and fresh blastocysts were transferred on day 5, the biopsied-blast and fresh-blast were not divided into subgroups. First, the associations between blastocyst morphological parameters and live birth were analyzed. To explore the effect of freezing, we compared day-5 frozen cycles (thawed-blast) vs. day-5 fresh cycles (including fresh-blast and blast-thawed-D3) and day 6 frozen cycles (thawed-blast) vs. day-6 fresh cycles (blast-thawed-D3). Inner cell mass and TE were associated with live birth for day 5 embryos, and only TE affected live birth for day-6 embryos. The associations were the same in frozen cycles and fresh cycles. To explore the effect of biopsy, we compared day-6 biopsied cycles (biopsied-blast) vs. day-6 nonbiopsied cycles (including thawed-blast and blast-thawed-D3). All the 3 parameters were associated with live birth in biopsied-blast, whereas only TE was associated with live birth in nonbiopsied cycles. In addition, the associations between blastocyst morphological parameters and singleton birthweight were analyzed. In the 6 subgroups, expansion stage of day-6 embryos in biopsied-blast and TE grade of day-6 embryos in thawed-blast were associated with birth weight, and there are no associations in other subgroups.
CONCLUSION(S): The association of blastocyst morphological parameters with live birth may be affected by blastocyst biopsy and/or genetic testing, and its association with birth weight may be affected by blastocyst freezing and biopsy and/or genetic testing.
探讨囊胚的3个形态学参数，即囊胚扩张程度、滋养外胚层（TE）及内细胞团的外观，与活产及单胎出生体重之间的关联是否受囊胚冷冻及活检的影响。
一项回顾性研究。
一家辅助生殖技术中心。
2014年1月至2019年8月期间的28515个单囊胚移植周期。
不适用。
活产及单胎出生体重。
囊胚移植周期分为4组：活检囊胚周期（活检囊胚）、解冻囊胚周期（解冻囊胚）、解冻卵裂期胚胎来源的囊胚周期（囊胚-解冻-D3）及新鲜囊胚周期（新鲜囊胚）。对解冻囊胚组和囊胚-解冻-D3组按囊胚阶段（第5天和第6天）进行亚组分析。由于几乎所有囊胚在第6天进行活检，新鲜囊胚在第5天移植，因此活检囊胚组和新鲜囊胚组未再细分亚组。首先，分析囊胚形态学参数与活产之间的关联。为探讨冷冻的影响，我们比较了第5天冷冻周期（解冻囊胚）与第5天新鲜周期（包括新鲜囊胚和囊胚-解冻-D3），以及第6天冷冻周期（解冻囊胚）与第6天新鲜周期（囊胚-解冻-D3）。内细胞团和TE与第5天胚胎的活产相关，而对于第6天胚胎，只有TE影响活产。冷冻周期和新鲜周期中的关联相同。为探讨活检的影响，我们比较了第6天活检周期（活检囊胚）与第6天未活检周期（包括解冻囊胚和囊胚-解冻-D3）。在活检囊胚组中，所有3个参数均与活产相关，而在未活检周期中只有TE与活产相关。此外，分析了囊胚形态学参数与单胎出生体重之间的关联。在6个亚组中，活检囊胚组中第6天胚胎的扩张阶段和解冻囊胚组中第6天胚胎的TE等级与出生体重相关，其他亚组则无关联。
囊胚形态学参数与活产之间的关联可能受囊胚活检和/或基因检测的影响，其与出生体重之间的关联可能受囊胚冷冻、活检和/或基因检测的影响。
