Comparison of clinical outcome between day 5 and day 6 single blastocyst transfers in cycles undergoing preimplantation genetic testing for aneuploidy

Association Between Pregnancy Outcomes and the Time of Progesterone Exposure of D6 Single-Blastocyst Transfer in Frozen-Thawed Cycles: A Retrospective Cohort Study

Purpose

The objective of this study was to assess reproductive outcomes of D6 blastocysts transferred on day 6 in comparison to those transferred on day 7 of progesterone exposure in frozen-thawed embryo transfer cycles.

Patients and Methods

This retrospective cohort study included 2029 D6 single blastocysts from the first frozen-thawed embryo transfer cycles of patients at the Hospital for Reproductive Medicine Affiliated to Shandong University from February 2017 to January 2020. Participants were divided into Group A (blastocyst transferred on the 6th day of progesterone exposure, n=1634) and Group B (blastocyst transferred on the 7th day of progesterone exposure, n=395).

Results

The live birth rate was comparable between Group A and Group B (38.7% versus 38.7%, P=0.999). Subgroup analysis revealed a significantly higher preterm birth rate in D6 single blastocysts transferred on the 7th day than in those transferred on the 6th day of progesterone exposure for natural cycle frozen-thawed embryo transfer (5.2% versus 11.3%, P=0.020). After adjustment for potential confounders, the differences in the preterm birth rate in natural cycles persisted (adjusted odds ratio 2.347, 95% confidence interval 1.129-4.877, P=0.022).

Conclusion

In frozen-thawed embryo transfer cycles, transferring on the 6th or 7th day of progesterone exposure of D6 blastocysts did not affect the live birth rate; however, when a natural cycle protocol is adopted, the possible preterm risk of transferring D6 blastocysts on the 7th day of progesterone exposure should be noted.

Which factors affect the live birth outcome of the first single euploid frozen-thawed blastocyst transfer in couples with balanced chromosomal translocations?

Objective

The objective of this study is to investigate the factors that influence the live birth rate (LBR) of the first single euploid frozen-thawed blastocyst transfer (FBT) cycles after preimplantation genetic testing for structural rearrangements (PGT-SR) in couples with balanced chromosomal translocations (BCT).

Design

Single center, retrospective and observational study.

Methods

A total of 336 PGT-SR and the first single euploid FBT cycles between July 2016 and December 2022 were included in this study. The patients were divided into two groups according to the live birth outcomes. The parameters of the study population, controlled ovarian stimulation cycles, and FBT cycles were analyzed. Multivariable binary logistic regression was performed to find the factors that affected the LBR.

Results

The percentage of blastocysts at developmental stage Day 5 compared to Day 6 (51.8% vs. 30.8%; P<0.001) and with morphology ≥BB compared to

Conclusion

The developmental stage and morphology of blastocyst affect the live birth outcome of the first single euploid FBT in BCT carriers undergoing PGT-SR.

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Key Words

• balanced chromosomal translocations
• euploid
• frozen-thawed blastocyst transfer
• live birth
• preimplantation genetic testing for structural rearrangements (PGT-SR)

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MESH Headings

• Humans
• Female
• Pregnancy
• Retrospective Studies
• Live Birth
• Translocation, Genetic
• Adult
• Embryo Transfer/methods
• Male
• Cryopreservation
• Pregnancy Rate
• Preimplantation Diagnosis/methods
• Birth Rate
• Fertilization in Vitro/methods
• Pregnancy Outcome
• Blastocyst
• Ovulation Induction/methods

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Affiliation(s)

Ruixiao Zhang Reproductive Medicine Center, Henan Provincial People’s Hospital, Zhengzhou, China Reproductive Medicine Center, Zhengzhou University People’s Hospital, Zhengzhou, China Reproductive Medicine Center, Henan University People’s Hospital, Zhengzhou, China
Yahui Hu Reproductive Medicine Center, Henan Provincial People’s Hospital, Zhengzhou, China Reproductive Medicine Center, Zhengzhou University People’s Hospital, Zhengzhou, China Reproductive Medicine Center, Henan University People’s Hospital, Zhengzhou, China
Chenchen Cui Reproductive Medicine Center, Henan Provincial People’s Hospital, Zhengzhou, China Reproductive Medicine Center, Zhengzhou University People’s Hospital, Zhengzhou, China Reproductive Medicine Center, Henan University People’s Hospital, Zhengzhou, China
Cuilian Zhang Reproductive Medicine Center, Henan Provincial People’s Hospital, Zhengzhou, China Reproductive Medicine Center, Zhengzhou University People’s Hospital, Zhengzhou, China Reproductive Medicine Center, Henan University People’s Hospital, Zhengzhou, China

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