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POSEIDON患者第3天移植策略分析。

Analysis of the day 3 transfer strategy for POSEIDON patients.

作者信息

Wyroba Jakub, Kochan Joanna

机构信息

Malopolski Institute of Fertility Diagnostics and Treatment - krakOvi, Krakow, Poland.

Fertility Disorders Clinic, Andrzej Frycz Modrzewski Krakow University, Krakow, Poland.

出版信息

JBRA Assist Reprod. 2025 Feb 21;29(2):298-305. doi: 10.5935/1518-0557.20240111.

DOI:10.5935/1518-0557.20240111
PMID:39983034
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12225133/
Abstract

OBJECTIVE

The aim of the study was to analyze the effectiveness of the day 3 ET strategy, and the morphology of the transferred embryos, in patients from POSEIDON and non-POSEIDON groups.

METHODS

600 cycles of patients meeting the POSEIDON criteria and 600 non-POSEIDON cycles were analyzed to determine the proportion of cycles with an ET on days 3 or 5, or FET. Then we reviewed 330 day 3 ETs to compared the developmental stage, morphology, zona pellucida thickness and implantation potential of embryos transferred on day 3 from POSEIDON and non-POSEIDON patients.

RESULTS

Most cycles of POSEIDON patients end with ET on day 3 (42%) or without transfer (37%). In contrast, most cycle of non-POSEIDON patients end with FET (44%) and just 9% is canceled. The lowest percentage of embryos at the morula stage was recorded in POSEIDON groups III (10%) and IV (9%). The average number of cells in embryos was comparable in all groups. The largest percentage of top-quality embryos (grade A) were in POSEIDON group I (47%) .The highest implantation potential were observed in the non-POSEIDON group <35Y (28%), and in POSEIDON groups I (28%) and III (26%). The highest incidence of miscarriage was recorded in all POSEIDON and non-POSEIDON groups that included patients who were ≥35 years of age.

CONCLUSIONS

The day 3 ET strategy still seems optimal for POSEIDON patients. The prognosis depends on which Poseidon group the patient is in. The best prognosis is for group I and the worst for group IV.

摘要

目的

本研究旨在分析在波塞冬组和非波塞冬组患者中，第3天胚胎移植（ET）策略的有效性以及移植胚胎的形态。

方法

分析600个符合波塞冬标准患者的周期以及600个非波塞冬周期，以确定在第3天或第5天进行ET或冻融胚胎移植（FET）的周期比例。然后，我们回顾了330例第3天ET，比较了波塞冬组和非波塞冬组患者在第3天移植胚胎的发育阶段、形态、透明带厚度和着床潜力。

结果

波塞冬组患者的大多数周期在第3天进行ET结束（42%）或未进行移植（37%）。相比之下，非波塞冬组患者的大多数周期以FET结束（44%），仅有9%被取消。在波塞冬组III（10%）和IV（9%）中，桑椹胚阶段的胚胎百分比最低。所有组中胚胎的平均细胞数相当。优质胚胎（A级）比例最高的是波塞冬组I（47%）。在非波塞冬组<35岁患者中（28%）以及波塞冬组I（28%）和III（26%）中观察到最高的着床潜力。在所有包括≥35岁患者的波塞冬组和非波塞冬组中，流产发生率最高。

结论

对于波塞冬组患者，第3天ET策略似乎仍然是最佳选择。预后取决于患者所属的波塞冬组。I组预后最佳，IV组最差。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba76/12225133/1737aab23010/jbra-29-02-0298-g04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba76/12225133/b04984139597/jbra-29-02-0298-g01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba76/12225133/fb48e3a23ad9/jbra-29-02-0298-g02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba76/12225133/c6d16769e36e/jbra-29-02-0298-g03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba76/12225133/1737aab23010/jbra-29-02-0298-g04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba76/12225133/b04984139597/jbra-29-02-0298-g01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba76/12225133/fb48e3a23ad9/jbra-29-02-0298-g02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba76/12225133/c6d16769e36e/jbra-29-02-0298-g03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba76/12225133/1737aab23010/jbra-29-02-0298-g04.jpg

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本文引用的文献

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Effects of sequential cleavage and blastocyst embryo transfer on pregnancy outcomes in patients with poor ovarian response.序贯卵裂期与囊胚期胚胎移植对卵巢反应不良患者妊娠结局的影响
J Reprod Immunol. 2023 Feb;155:103780. doi: 10.1016/j.jri.2022.103780. Epub 2022 Nov 28.
2
Predicting IVF outcome in poor ovarian responders.预测卵巢反应不良患者的 IVF 结局。
BMC Womens Health. 2022 Sep 30;22(1):395. doi: 10.1186/s12905-022-01964-y.
3
Day-3 vs. Day-5 fresh embryo transfer.第三天胚胎与第五天胚胎移植的比较。
JBRA Assist Reprod. 2023 Jun 22;27(2):163-168. doi: 10.5935/1518-0557.20220027.
4
Cumulative delivery rate per aspiration IVF/ICSI cycle in POSEIDON patients: a real-world evidence study of 9073 patients.POSEIDON 患者每周期抽吸 IVF/ICSI 的累积妊娠率：9073 例真实世界证据研究。
Hum Reprod. 2021 Jul 19;36(8):2157-2169. doi: 10.1093/humrep/deab152.
5
POSEIDON classification and the proposed treatment options for groups 1 and 2: time to revisit? A retrospective analysis of 1425 ART cycles.波塞冬分类法以及针对第1组和第2组的拟议治疗方案：是否需要重新审视？对1425个辅助生殖周期的回顾性分析
Hum Reprod Open. 2021 Feb 14;2021(1):hoaa070. doi: 10.1093/hropen/hoaa070. eCollection 2021.
6
Effect of Age and Embryo Morphology on Live Birth Rate After Transfer of Unbiopsied Blastocysts.未活检囊胚移植后年龄和胚胎形态对活产率的影响。
JBRA Assist Reprod. 2021 Jul 21;25(3):373-382. doi: 10.5935/1518-0557.20200101.
7
The Conundrum of Poor Ovarian Response: From Diagnosis to Treatment.卵巢低反应难题：从诊断到治疗
Diagnostics (Basel). 2020 Sep 11;10(9):687. doi: 10.3390/diagnostics10090687.
8
Management Strategies for POSEIDON Group 2.POSEIDON 2 组的管理策略。
Front Endocrinol (Lausanne). 2020 Feb 27;11:105. doi: 10.3389/fendo.2020.00105. eCollection 2020.
9
Management Strategies for POSEIDON Groups 3 and 4.波塞冬3组和4组的管理策略
Front Endocrinol (Lausanne). 2019 Sep 11;10:614. doi: 10.3389/fendo.2019.00614. eCollection 2019.
10
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J Assist Reprod Genet. 2017 Jan;34(1):79-87. doi: 10.1007/s10815-016-0825-y. Epub 2016 Nov 10.