Lan Liuping, Li Xiang, Luo Bowen, Liu Weiwu, Zhu Lingling, Zhang Juguang, Wen Jian, Feng Keng, Li Derong, Lei Feifei, Deng Guosheng, Luo Yudi, Yang Zengyu
Reproductive Medicine Center, Maternal and Child Health Care Hospital of Yulin, Yulin, Guangxi, China.
Front Endocrinol (Lausanne). 2025 May 1;16:1530112. doi: 10.3389/fendo.2025.1530112. eCollection 2025.
This study aims to investigate the impact of day-3 (D3) cleavage-stage embryo thawing with immediate transfer versus thawing and overnight culture before transfer on clinical outcomes. It also examines the relationship between cleavage-stage embryo developmental speed after overnight culture and clinical pregnancy outcomes, as well as factors influencing clinical pregnancy in frozen embryo transfer (FET).
A retrospective analysis was conducted on 1,040 patients who underwent D3 cleavage-stage frozen embryo transfer at Yulin City Maternal and Child Health Hospital between July 2022 and December 2023. Patients were divided into two groups based on embryo culture time after thawing: control (same-day transfer, 2-3 hours) and experimental (overnight culture, 18-20 hours). Clinical pregnancy rates, embryo implantation rates, early miscarriage rates, and multiple pregnancy rates were compared between groups. The experimental group was further subdivided based on the number of cleavage blastomeres increased after culture: A1 (≥4 blastomeres), A2 (1-3 blastomeres), and A3 (no increase). A binary logistic regression analysis identified independent factors affecting clinical pregnancy outcomes in FET.
No significant differences were found between the control and experimental groups in clinical pregnancy rate (37.2% vs. 40.2%), embryo implantation rate (24.9% vs. 26.4%), early miscarriage rate (13.1% vs. 18.8%), or multiple pregnancy rate (9.2% vs. 10.2%) ( > 0.05). In the experimental group, clinical pregnancy rates for A1, A2, and A3 subgroups were 44.2%, 29.8%, and 25.5%, respectively. Early miscarriage rates were 18.6%, 10.7%, and 38.5%, showing statistically significant differences ( < 0.05). Female age, endometrial thickness, embryo morphology, and the number of cleavage blastomeres were identified as independent factors influencing clinical pregnancy rate.
This study indicates that D3 embryos with an increase in the number of blastomeres to more than four or entering the compaction stage after overnight culture have better pregnancy outcomes. Female age and endometrial thickness are important factors influencing clinical pregnancy rates. Optimizing culture conditions and ensuring optimal endometrial thickness may help improve the success rate of frozen-thawed embryo transfer.
本研究旨在探讨第三天（D3）卵裂期胚胎解冻后立即移植与解冻后过夜培养再移植对临床结局的影响。同时研究过夜培养后卵裂期胚胎发育速度与临床妊娠结局之间的关系，以及影响冻融胚胎移植（FET）临床妊娠的因素。
对2022年7月至2023年12月在榆林市妇幼保健院接受D3卵裂期冻融胚胎移植的1040例患者进行回顾性分析。根据解冻后胚胎培养时间将患者分为两组：对照组（当日移植，2 - 3小时）和试验组（过夜培养，18 - 20小时）。比较两组的临床妊娠率、胚胎着床率、早期流产率和多胎妊娠率。试验组根据培养后卵裂球增加数量进一步细分：A1（≥4个卵裂球）、A2（1 - 3个卵裂球）和A3（未增加）。采用二元逻辑回归分析确定影响FET临床妊娠结局的独立因素。
对照组和试验组在临床妊娠率（37.2%对40.2%）、胚胎着床率（24.9%对26.4%）、早期流产率（13.1%对18.8%）或多胎妊娠率（9.2%对10.2%）方面均无显著差异（>0.05）。在试验组中，A1、A2和A3亚组的临床妊娠率分别为44.2%、29.8%和25.5%。早期流产率分别为18.6%、10.7%和38.5%，差异有统计学意义（<0.05）。女性年龄、子宫内膜厚度、胚胎形态和卵裂球数量被确定为影响临床妊娠率的独立因素。
本研究表明，过夜培养后卵裂球数量增加至4个以上或进入致密化阶段的D3胚胎具有更好的妊娠结局。女性年龄和子宫内膜厚度是影响临床妊娠率的重要因素。优化培养条件并确保最佳子宫内膜厚度可能有助于提高冻融胚胎移植的成功率。
