Liu Yan, Wang Taojun, Dai Shanjun, Shi Hao, Sun Yingpu
Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
Henan Key Laboratory of Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
Front Endocrinol (Lausanne). 2025 May 14;16:1473854. doi: 10.3389/fendo.2025.1473854. eCollection 2025.
To compare the clinical outcomes between frozen-thawed cleavage embryo transfer and frozen-thawed day 6 blastocyst transfer in patients younger than 35 using the freeze-all strategy without day 5 blastocyst formation.
This was a retrospective observational analysis performed between January 2018 and December 2022 at the Reproductive and Genetic Specialist Hospital of the First Affiliated Hospital of Zhengzhou University. A total of 576 patients younger than 35 who used the "freeze-all strategy" but produced no day 5 blastocysts were recruited. The patients were divided into 3 groups according to the number and stage of the transferred embryos: double cleavage-stage embryos (Group A), single good-quality day 6 blastocysts (Group B) and single inferior-quality day 6 blastocysts (Group C),and several pregnancy outcomes were measured.
Groups A and B exhibited significantly higher chemical (73.7%, 67.0% versus 51.9%) and clinical pregnancy rates (69.0%, 59.4% versus 44.2%) than Group C. The implantation rate was significantly higher in Group B than in Groups A and C (59.4% versus 45.7%, 43.5%). The live birth rate was significantly higher in Group A than in Group C (59.2% versus 48.1%). The multiple pregnancy rate was significantly higher in Group A than in Groups B and C (34.4% versus 1.6%, 1.5%). The early miscarriage rate was significantly higher in Group C than in Group A and Group B (23.5% versus 8.7%, 12.7%). Premature delivery rates, late miscarriage rates and ectopic pregnancy rates were comparable across groups.
A single good quality day 6 blastocyst transfer was the preferable strategy for the freeze-all strategy patients who younger than 35 and without day 5 blastocyst formation.
比较在35岁以下采用全胚冷冻策略且未形成第5天囊胚的患者中，冻融卵裂期胚胎移植与冻融第6天囊胚移植的临床结局。
这是一项回顾性观察分析，于2018年1月至2022年12月在郑州大学第一附属医院生殖与遗传专科医院进行。共招募了576名35岁以下采用“全胚冷冻策略”但未产生第5天囊胚的患者。根据移植胚胎的数量和阶段将患者分为3组：双卵裂期胚胎（A组）、单个优质第6天囊胚（B组）和单个劣质第6天囊胚（C组），并测量了多个妊娠结局。
A组和B组的生化妊娠率（73.7%，67.0%对51.9%）和临床妊娠率（69.0%，59.4%对44.2%）显著高于C组。B组的着床率显著高于A组和C组（59.4%对45.7%，43.5%）。A组的活产率显著高于C组（59.2%对48.1%）。A组的多胎妊娠率显著高于B组和C组（34.4%对1.6%，1.5%）。C组的早期流产率显著高于A组和B组（23.5%对8.7%，12.7%）。各组间早产率、晚期流产率和异位妊娠率相当。
对于35岁以下且未形成第5天囊胚的全胚冷冻策略患者，单个优质第6天囊胚移植是更优策略。
