Reproductive Medicine Center, Maternal and Child Health Care Hospital of Yulin, Yulin, China.
Reproductive Center, No.940 Hospital of Joint Logistic Support Force of the Chinese People's Liberation Army, Lanzhou, China.
Front Endocrinol (Lausanne). 2024 Oct 18;15:1464313. doi: 10.3389/fendo.2024.1464313. eCollection 2024.
To investigate the number of cells in D3-stage embryos of high-quality blastocysts as a contributing factor, to evaluate the clinical pregnancy outcomes in frozen-thawed embryo transfer cycles, and to determine the impact of D3-stage cell count on pregnancy outcomes.
Patients under 38 years old who underwent frozen-thawed single high-quality blastocyst transfer at our center were selected. Based on the cell count of D3 cleavage-stage embryos forming blastocysts, patients were divided into three groups: ≤6 cells, 7-9 cells, and ≥10 cells. A multivariate regression analysis was used to establish the prediction model, analyzing the impact of different D3 cleavage-stage cell counts on clinical pregnancy outcomes to guide clinical laboratories in selecting blastocysts with the best pregnancy outcomes for transfer.
This study identified a significant association between D3 cell count, blastocyst development stage, and embryo age. Embryos with a higher D3 cell count (≥10) were more likely to reach advanced blastocyst stages and form blastocysts by D5, whereas embryos with fewer D3 cells (≤6) were more likely to form blastocysts on D6. While D3 cell count significantly influenced blastocyst stage and timing of embryo development, no significant differences were observed between groups regarding clinical pregnancy, implantation, or live birth rates. Notably, embryos with fewer D3 cells exhibited a significantly lower miscarriage rate than other groups. Multivariate regression analysis showed a significant correlation between blastocyst stage, embryo age, and D3 cell count, particularly in D5 embryos and more advanced blastocysts. The increased miscarriage rate may be related to lower D3 cell count, and inadequate endometrial preparation was associated with poorer pregnancy outcomes. The type of infertility was also linked to D3 cell count, with secondary infertility patients showing more significant influencing factors.
D3 cell count and related factors play a critical role in pregnancy outcomes during frozen-thawed high-quality blastocyst transfer cycles. Optimizing embryo age, selecting blastocysts at different stages, and refining endometrial preparation protocols are likely to enhance clinical pregnancy and live birth rates.
研究高质量囊胚 D3 期胚胎细胞数作为影响因素，评估冻融胚胎移植周期的临床妊娠结局，并探讨 D3 期细胞计数对妊娠结局的影响。
选择本中心进行冻融单枚优质囊胚移植且年龄小于 38 岁的患者。根据 D3 期卵裂期胚胎形成囊胚的细胞计数，将患者分为 3 组：≤6 细胞、7-9 细胞和≥10 细胞。采用多变量回归分析建立预测模型，分析不同 D3 期卵裂期细胞计数对临床妊娠结局的影响，指导临床实验室选择最有利于移植的妊娠结局的囊胚。
本研究发现 D3 细胞计数、囊胚发育阶段和胚胎年龄之间存在显著关联。D3 细胞计数较高（≥10）的胚胎更有可能到达高级囊胚阶段，并在 D5 形成囊胚，而 D3 细胞计数较少（≤6）的胚胎更有可能在 D6 形成囊胚。虽然 D3 细胞计数显著影响囊胚阶段和胚胎发育的时间，但各组之间的临床妊娠、着床和活产率无显著差异。值得注意的是，D3 细胞计数较少的胚胎流产率明显低于其他组。多变量回归分析显示囊胚阶段、胚胎年龄和 D3 细胞计数之间存在显著相关性，尤其是在 D5 胚胎和更高级的囊胚中。较高的流产率可能与较低的 D3 细胞计数有关，而子宫内膜准备不足与较差的妊娠结局相关。不孕类型也与 D3 细胞计数有关，继发不孕患者的影响因素更为显著。
D3 细胞计数及相关因素在冻融高质量囊胚移植周期中对妊娠结局起着关键作用。优化胚胎年龄、选择不同阶段的囊胚以及细化子宫内膜准备方案，可能会提高临床妊娠率和活产率。
