Jin Qi, Jiang Xiaohua, Zong Lu, Wu Tong, Zheng Shengxia, Wu Limin, Xu Bo
Center for Reproduction and Genetics, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, The First Affiliated Hospital of USTC, University of Science and Technology of China, No. 17 Lujiang Road, Luyang District, Hefei City, Anhui Province, China.
Institute of International Finance, University of Science and Technology of China, Hefei, China.
Reprod Sci. 2025 May;32(5):1580-1588. doi: 10.1007/s43032-024-01734-1. Epub 2024 Nov 25.
The aim of this study was to evaluate which frozen embryo transfer (FET) strategy benefits the recurrent implantation failure (RIF) population. A retrospective study of 336 women with RIF was performed from July 2020 to October 2023. The patients were divided into three groups according to the FET protocol. The three FET protocols included transferring a blastocyst on both days 5 and 6 (Group 1, n = 138); transferring a cleavage-stage embryo on day 3 and a blastocyst on day 5 (Group 2, n = 55); and transferring double blastocysts on day 5 (Group 3, n = 143).The sequential day 5 and day 6 blastocyst ET strategy significantly improved in vitro fertilization success rates compared with those of both the traditional double-blastocyst day 5 transfer strategy and the strategy involving one cleavage-stage embryo transfer on day 3 and one blastocyst transfer on day 5 in RIF patients. Compared with those observed in Day 5 double-blastocyst transfer, the rates of clinical pregnancy and implantation increased (51.75% vs. 64.49%, P < 0.001 and 37.06% vs. 41.3%, P = 0.005, respectively), while the rates of biochemical pregnancy and multiple gestation decreased (18.18% vs. 12.32%, P = 0.006 and 43.24% vs. 28.09%, P = 0.044, respectively) with the new protocol.Blastocysts from sequential embryo transfer on day 5 and day 6 were more effective than those from the traditional FET protocol at improving pregnancy outcomes and lowering the multiple pregnancy rate in RIF patients. When only one or zero good-quality blastocysts are available, sequential blastocyst ET on days 5 and 6 should be considered.
本研究的目的是评估哪种冷冻胚胎移植（FET）策略对反复种植失败（RIF）人群有益。对2020年7月至2023年10月期间的336例RIF女性进行了一项回顾性研究。根据FET方案将患者分为三组。三种FET方案包括在第5天和第6天均移植囊胚（第1组，n = 138）；在第3天移植卵裂期胚胎并在第5天移植囊胚（第2组，n = 55）；以及在第5天移植双囊胚（第3组，n = 143）。与传统的第5天双囊胚移植策略以及第3天移植一个卵裂期胚胎和第5天移植一个囊胚的策略相比，第5天和第6天序贯囊胚移植策略显著提高了RIF患者的体外受精成功率。与第5天双囊胚移植相比，新方案使临床妊娠率和着床率升高（分别为51.75%对64.49%，P < 0.001和37.06%对41.3%，P = 0.005），而生化妊娠率和多胎妊娠率降低（分别为18.18%对12.32%，P = 0.006和43.24%对28.09%，P = 0.044）。在改善RIF患者的妊娠结局和降低多胎妊娠率方面，第5天和第6天序贯胚胎移植的囊胚比传统FET方案的囊胚更有效。当只有一个或零个优质囊胚可用时，应考虑第5天和第6天的序贯囊胚移植。
