Department of Obstetrics and Gynecology, Başkent University School of Medicine, Şehit Temel Kuğuoğlu Cd. No: 34 Bahçelievler, Ankara, Turkey.
Arch Gynecol Obstet. 2023 Jun;307(6):1969-1974. doi: 10.1007/s00404-023-07031-7. Epub 2023 Apr 6.
We aimed to evaluate the effect of extending the culture of cleavage-stage embryos to the blastocyst stage in vitrified-warmed cycles on pregnancy outcomes.
This is a retrospectively designed pilot study of a single center. All patients who applied for freeze-all cycle procedures during in vitro fertilization treatment were included in the study. Patients were classified into three subgroups. The embryos obtained were frozen at the cleavage or blastocyst stage. After a warming process, the cleavage-stage embryos were divided into two subgroups: the first group of embryos was transferred (vitrification day 3-embryo transfer (ET) day 3 (D3T3)) on the warming day; for the second group, the embryo culture was extended to the blastocyst stage (vitrification day 3-ET day 5 (after the extension of the embryo culture to the blastocyst stage), (D3T5)). Frozen blastocyst-stage embryos were transferred after warming (vitrification day 5-ET day 5 (D5T5)). Hormone replacement treatment was the only endometrial preparation regimen given during the embryo transfer cycle. The main outcome of the study was live birth rates. The clinical pregnancy rate and positive pregnancy test rate were determined as the secondary outcomes of the study.
The study included a total of 194 patients. The positive pregnancy test rates (PPR) and clinical pregnancy rates (CPR) of the D3T3, D3T5, and D5T5 groups were 14.0% and 59.2%; 43.8% and 9.3%; and 56.3% and 39.6%, respectively (p < 0.001 and p < 0.001). The live birth rates (LBR) of patients in the D3T3, D3T5, and D5T5 groups were 7.0%, 44.7%, and 27.1%, respectively (p < 0.001). In subgroup analysis of patients with a poor number of 2PN embryos (defined as having < = 4 2PN embryos), the D3T5 group had significantly higher PPR (10.7%, 60.6%, 42.4%; p < 0.001), CPR (7.1%, 57.6%, 39.4%; p < 0.001), and LBR (3.6%, 39.4%, 21.2%; p: 0.001).
Extending the culture after warming to the blastocyst stage may be a better alternative than a cleavage-stage embryo transfer.
我们旨在评估在玻璃化冷冻-解冻周期中将卵裂期胚胎培养至囊胚期对妊娠结局的影响。
这是一项单中心回顾性设计的初步研究。所有在体外受精治疗中申请全冷冻周期的患者均纳入本研究。患者分为三组。获得的胚胎在卵裂期或囊胚期冷冻。解冻后，将卵裂期胚胎分为两组：第一组胚胎在解冻当天进行转移（玻璃化日 3-胚胎移植日 3（D3T3））；对于第二组，胚胎培养延长至囊胚期（玻璃化日 3-胚胎移植日 5（胚胎培养延长至囊胚期后）（D3T5））。解冻后的囊胚期胚胎在第 5 天转移（玻璃化日 5-胚胎移植日 5（D5T5））。激素替代治疗是胚胎移植周期中唯一的子宫内膜准备方案。本研究的主要结局是活产率。临床妊娠率和阳性妊娠试验率被确定为研究的次要结局。
该研究共纳入 194 例患者。D3T3、D3T5 和 D5T5 组的阳性妊娠试验率（PPR）和临床妊娠率（CPR）分别为 14.0%和 59.2%；43.8%和 9.3%；和 56.3%和 39.6%（p<0.001 和 p<0.001）。D3T3、D3T5 和 D5T5 组患者的活产率（LBR）分别为 7.0%、44.7%和 27.1%（p<0.001）。在 2PN 胚胎数量较少（定义为<=4 个 2PN 胚胎）的患者亚组分析中，D3T5 组的 PPR（10.7%、60.6%、42.4%；p<0.001）、CPR（7.1%、57.6%、39.4%；p<0.001）和 LBR（3.6%、39.4%、21.2%；p：0.001）均显著更高。
与卵裂期胚胎移植相比，将解冻后的培养延长至囊胚期可能是更好的选择。
Zotero 插件