Assisted Reproduction Center, Northwest Women's and Children's Hospital, Xi'an, People's Republic of China.
Medicine Department, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia.
Hum Fertil (Camb). 2023 Dec;26(5):1185-1194. doi: 10.1080/14647273.2022.2153348. Epub 2023 Jan 31.
We evaluated if elective single-blastocyst transfer (eSBT) could be adopted in women aged 36 or older. In this retrospective cohort, women aged ≥36 years received IVF ovarian stimulation cycles and had ≥ two blastocysts. A total of 240 women underwent eSBT and 189 double-blastocyst transfer (DBT) in the first transfer cycle. The subsequent frozen-thawed embryo transfer cycles were a combination of single- and double- blastocyst transfers. Analysis was stratified for patients in age groups 36-37, 38-39 and ≥40, considering the quality of the blastocyst transferred. The cumulative live birth rates (cLBR) were 74.2% (178/240) versus 63.0% (119/189) after eSBT versus DBT, respectively (aOR: 1.09 (0.68, 1.75)). Time to live birth did not vary significantly between the two groups (HR: 0.85 (0.68, 1.08)). The total number of children born was 194 after eSBT (162 singletons and 16 pairs of twins) versus 154 (84 singletons and 35 twins) after DBT. The odds ratios for preterm birth (0.37 (0.21-0.64)), and low birth weight (0.31 (0.16, 0.60)) were all lower in eSBT. In women aged ≥36 years, cLBR following single- versus double- blastocyst transfer was comparable while the odds of multiple live births and adverse perinatal outcomes were reduced.
我们评估了选择性单囊胚移植（eSBT）是否可用于年龄在 36 岁或以上的女性。在这项回顾性队列研究中，年龄≥36 岁的女性接受了体外受精卵巢刺激周期，并且有≥2 个囊胚。共有 240 名女性在第一次移植周期中接受了 eSBT，189 名女性接受了双囊胚移植（DBT）。随后的冷冻胚胎移植周期是单囊胚和双囊胚的组合移植。根据转移的囊胚质量，对年龄在 36-37 岁、38-39 岁和≥40 岁的患者进行了分层分析。eSBT 组的累积活产率（cLBR）为 74.2%（178/240），DBT 组为 63.0%（119/189）（aOR：1.09（0.68，1.75））。两组之间的活产时间没有显著差异（HR：0.85（0.68，1.08））。eSBT 组出生的儿童总数为 194 名（162 名单胎和 16 对双胞胎），DBT 组为 154 名（84 名单胎和 35 对双胞胎）。eSBT 组早产（0.37（0.21-0.64））和低出生体重（0.31（0.16，0.60））的比值均较低。在年龄≥36 岁的女性中，单囊胚与双囊胚移植后的累积活产率相当，而多胎活产和不良围产结局的几率降低。
