Department of Obstetrics and Gynecology, Center of Reproductive Medicine, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, The Third Affiliated Hospital of Guangzhou Medical University, 63 Duobao Road, Guangzhou, Guangdong, China.
Key Laboratory for Reproductive Medicine of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
BMC Pregnancy Childbirth. 2023 Jan 30;23(1):79. doi: 10.1186/s12884-023-05387-x.
Blastocyst developmental speed, morphological grading and patient age are associated with pregnancy outcomes of frozen-thawed cycles. This study aimed to compare the clinical and neonatal outcomes between poor-quality D5 blastocysts and good-quality D6 blastocysts stratified by patient age.
A total of 1,623 cycles were divided into two groups: group A (n = 723) received one D5 poor-quality blastocyst; group B (n = 900) received one D6 good-quality blastocyst. Pregnancy and neonatal outcomes were compared among the four groups stratified by 35 years of age.
When patients were in the same age group, there was no significant difference in terms of age, body mass index, infertility duration, infertility type, fertilization method, proportion of endometrial preparation protocols, and endometrial thickness between D5 poor-quality and D6 high-quality blastocysts groups. Live birth rate of D5 poor-quality blastocysts was higher than that of D6 high-quality blastocysts for patients aged < 35 years (35.48% vs. 31.13%, p > 0.05), but there was no statistical difference. The same trend was showed for patients aged ≥ 35 years (29.09% vs. 21.28%, p > 0.05). Moreover, when patients were in the same age category, there was no significant difference in terms of gestational age, birth weight, birth height, and rates of preterm birth, low birth weight, and very low birth weight between groups A and B.
The preferential selection of poor-quality D5 blastocysts for transfer compared to high-quality D6 blastocysts is recommended, especially for advanced age patients. Single good-quality D6 blastocyst transfer can be considered for the acceptable live birth rate.
囊胚的发育速度、形态分级和患者年龄与冷冻解冻周期的妊娠结局有关。本研究旨在比较按患者年龄分层的劣质 D5 囊胚和优质 D6 囊胚之间的临床和新生儿结局。
共有 1623 个周期分为两组：A 组（n=723）移植一枚 D5 劣质囊胚；B 组（n=900）移植一枚 D6 优质囊胚。比较四组患者的妊娠和新生儿结局，按年龄分层。
当患者处于同一年龄组时，D5 劣质囊胚和 D6 优质囊胚组之间的年龄、体重指数、不孕持续时间、不孕类型、受精方式、内膜准备方案比例和内膜厚度均无显著差异。年龄<35 岁的患者中，D5 劣质囊胚的活产率高于 D6 优质囊胚（35.48% vs. 31.13%，p>0.05），但无统计学差异。年龄≥35 岁的患者也表现出同样的趋势（29.09% vs. 21.28%，p>0.05）。此外，当患者处于同一年龄组时，A 组和 B 组之间的胎龄、出生体重、出生身高以及早产、低出生体重和极低出生体重的发生率均无显著差异。
建议优先选择劣质 D5 囊胚进行移植，而不是优质 D6 囊胚，尤其是对于高龄患者。对于可接受的活产率，可以考虑单枚优质 D6 囊胚移植。
