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Zhu H, Xu W, Jin X, Xue Y, Tong X, Zhang S. Association of the duration of post-thaw culture with clinical outcome after vitrified-warmed day 3 embryo transfer in 10,464 cycles: A retrospective cohort study. Medicine (Baltimore) 2020; 99:e21660. [PMID: 32872029 PMCID: PMC7437799 DOI: 10.1097/md.0000000000021660] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
This study aimed to investigate the effect of the duration of embryo culture on clinical outcome in vitrified-warmed cycles.This retrospective cohort study enrolled 10,464 infertile patients, with a total of 18,843 vitrified-warmed day 3 embryos from 2012 to 2017 at a single center. The patients were divided into 2 groups: 9470 cycles in the short-term culture group (0.5-8 hours of post-thaw culture) and 994 cycles in the 48 to 72 hours culture group. The independent effect of the following variables on clinical outcomes was determined: duration of post-thaw culture, maternal age, transferred embryos, embryo quality, and endometrial thickness.We found that the pregnancy rate was positively associated with the post-thaw culture time. Ordinary least square regression analyses showed that the duration of post-thaw culture was positively associated with implantation and live birth rates overall. However, the implantation and live birth rates were not significantly associated with the post-thaw culture time in the short-term culture group. Additionally, maternal age and the number of transferred embryos were independent predictors of the implantation and live birth rates. Moreover, the duration of post-thaw culture did not affect live birth weight.These results indicated that the pregnancy rate is positively associated with the duration of post-thaw culture. Therefore, under the condition of not affecting work shifts, properly prolonging the duration of post-thaw culture to improve the outcome of frozen-thawed embryo transfer should be considered.
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Huang J, Yang X, Wu J, Kuang Y, Wang Y. Impact of Day 7 Blastocyst Transfer on Obstetric and Perinatal Outcome of Singletons Born After Vitrified-Warmed Embryo Transfer. Front Physiol 2020; 11:74. [PMID: 32116782 PMCID: PMC7028682 DOI: 10.3389/fphys.2020.00074] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Accepted: 01/23/2020] [Indexed: 11/17/2022] Open
Abstract
Background Extended embryo culture has been reported to affect perinatal outcome regarding higher risks of large for gestational age (LGA) and preterm birth (PTB) yet decreased risk of small for gestational age (SGA). However, existing data about the obstetric outcome and the safety for offspring resulting from the transfer of day 7 blastocysts is rare. Objectives To compare obstetric and perinatal outcome using embryos vitrified on day 7 with those vitrified on day 3, day 5, and day 6. Methods Data were collected from 4489 infertile women who gave birth to live-born singletons after vitrified-warmed embryo transfer cycles from January 1, 2006 to December 31, 2017. Singletons were compared depending on the age of embryos. Main perinatal outcome parameters included PTB (gestational age < 37 weeks), very PTB (VPTB, gestational age < 32 weeks), LGA (birthweights > 90th percentiles), and SGA (birthweights < 10th percentiles). Obstetric outcomes included gestational diabetes (GDM), pregnancy-induced hypertension (PIH), preterm premature rupture of membranes (PPROM), pre-eclampsia, placenta previa, placental abruption, and postpartum hemorrhage. Propensity score matching (PSM) was used to adjust the confounding factors across groups and then analyze the association between in vitro culture period and the outcome measures. Results After PSM, the transfer of day 7 blastocysts was associated with higher birth weight Z-scores and increased incidence of very large for gestational age (VLGA) compared with the transfer of day 3 cleavage-stage embryos while the incidence of PTB, low birth weight (LBW), SGA did not reach statistical significance. Moreover, comparable perinatal outcome was found in the comparison of day 7 vs. day 5 and day 7 vs. day 6. Day 7 blastocysts did not result in adverse obstetric outcome compared with day 3, day 5, and day 6 embryos, respectively. Conclusion In vitrified-warmed transfer cycles, day 7 blastocysts were associated with adverse perinatal outcome regarding higher risk of VLGA compared with day 3 cleavage-stage embryo, while blastocysts with diverse growth rates embrace similar developmental viability regardless of blastocysts vitrified on day 5, day 6, or day 7.
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Affiliation(s)
- Jiaan Huang
- Department of Assisted Reproduction, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaoyan Yang
- Department of Assisted Reproduction, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiayi Wu
- Department of Assisted Reproduction, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yanping Kuang
- Department of Assisted Reproduction, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yun Wang
- Department of Assisted Reproduction, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Luo L, Gu F, Jie H, Ding C, Zhao Q, Wang Q, Zhou C. Early miscarriage rate in lean polycystic ovary syndrome women after euploid embryo transfer - a matched-pair study. Reprod Biomed Online 2017; 35:576-582. [PMID: 28802704 DOI: 10.1016/j.rbmo.2017.07.010] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Revised: 06/28/2017] [Accepted: 07/04/2017] [Indexed: 12/31/2022]
Abstract
The early miscarriage rate is reported to be higher in patients with polycystic ovary syndrome (PCOS) compared with non-PCOS patients. However, whether PCOS is an independent risk factor for early miscarriage is still controversial; to what extent embryonic aneuploidy accounts for miscarriages of PCOS is still unknown. In this 1:3 matched-pair study, 67 lean PCOS patients and 201 controls matched for age, body mass index (BMI) and embryo scores undergoing a single euploid blastocyst transfer in vitrified-warmed cycles were analysed. Clinical pregnancy, early miscarriage and live birth rates were compared. Logistic regression analysis was performed to further evaluate the factors associated with early miscarriage and live birth. Clinical pregnancy rates were 50.7% in PCOS and 55.2% in control groups. Early miscarriage rate was significantly (P = 0.029) increased in the PCOS group compared with controls; non-PCOS patients had a significantly higher live birth rate than PCOS patients, P < 0.001. Further regression analyses showed that PCOS was significantly associated with a higher risk of early miscarriage and decreased chance of live birth. In conclusion, PCOS in women undergoing pre-implantation genetic diagnosis may, independently from BMI and karyotype, increase the risk of miscarriage.
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Affiliation(s)
- Lu Luo
- The Centre of Reproductive Medicine, Department of Obstetrics and Gynecology, First Affiliated Hospital of Sun Yat-sen University, and Guangdong Provincial Key Laboratory of Reproductive Medicine, Guangdong, China
| | - Fang Gu
- The Centre of Reproductive Medicine, Department of Obstetrics and Gynecology, First Affiliated Hospital of Sun Yat-sen University, and Guangdong Provincial Key Laboratory of Reproductive Medicine, Guangdong, China
| | - Huying Jie
- The Centre of Reproductive Medicine, Department of Obstetrics and Gynecology, First Affiliated Hospital of Sun Yat-sen University, and Guangdong Provincial Key Laboratory of Reproductive Medicine, Guangdong, China
| | - Chenhui Ding
- The Centre of Reproductive Medicine, Department of Obstetrics and Gynecology, First Affiliated Hospital of Sun Yat-sen University, and Guangdong Provincial Key Laboratory of Reproductive Medicine, Guangdong, China
| | - Qiang Zhao
- Department of Obstetrics and Gynecology, Jiangmen Central Hospital of Sun Yat-sen University, Guangdong, China
| | - Qiong Wang
- The Centre of Reproductive Medicine, Department of Obstetrics and Gynecology, First Affiliated Hospital of Sun Yat-sen University, and Guangdong Provincial Key Laboratory of Reproductive Medicine, Guangdong, China
| | - Canquan Zhou
- The Centre of Reproductive Medicine, Department of Obstetrics and Gynecology, First Affiliated Hospital of Sun Yat-sen University, and Guangdong Provincial Key Laboratory of Reproductive Medicine, Guangdong, China.
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Bourdon M, Santulli P, Gayet V, Maignien C, Marcellin L, Pocate-Cheriet K, Chapron C. Assisted reproduction technique outcomes for fresh versus deferred cryopreserved day-2 embryo transfer: a retrospective matched cohort study. Reprod Biomed Online 2016; 34:248-257. [PMID: 28065417 DOI: 10.1016/j.rbmo.2016.11.015] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Revised: 11/19/2016] [Accepted: 11/30/2016] [Indexed: 12/17/2022]
Abstract
Ovarian stimulation could adversely affect endometrial receptivity and consequently embryo implantation. One emerging strategy is the 'freeze-all' approach. Most studies have focused on blastocyst transfers, with limited research on day-2 deferred cryopreserved embryo transfers. In this large retrospective cohort study, outcomes were compared between day-2 fresh versus deferred cryopreserved embryo transfers. After matching by age and number of previous cycles, 325 cycles were included in the fresh group and 325 in the deferred cryopreserved embryo transfers group: no significant differences were found between groups in implantation (0.20 ± 0.33 versus 0.17 ± 0.31, respectively) and ongoing pregnancy rates (21.85% versus 18.46%). Independent predictors for ongoing pregnancy after a multiple logistic regression analysis were the women's age (OR = 0.92; 95% CI 0.88 to 0.97), body mass index (OR = 0.94; 95% CI 0.89 to 0.99), the number of two pronuclei embryos (OR = 1.19; 95% CI 1.04 to 1.40) and at least one grade 1 embryo transferred (OR = 1.97; 95% CI 1.26 to 3.05). In the case of a day-2 embryo transfer, outcomes after treatment with assisted reproduction techniques are similar for fresh versus deferred cryopreserved embryo transfers when pre-transfer progesterone exposures are similar in the two groups.
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Affiliation(s)
- Mathilde Bourdon
- Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre, Department of Gynaecology Obstetrics II and Reproductive Medicine Paris, Centre Hospitalier Universitaire (CHU) Cochin, Batiment Port Royal 53, avenue de l'Observatoire, 75679 Paris, France
| | - Pietro Santulli
- Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre, Department of Gynaecology Obstetrics II and Reproductive Medicine Paris, Centre Hospitalier Universitaire (CHU) Cochin, Batiment Port Royal 53, avenue de l'Observatoire, 75679 Paris, France; Institut Cochin, INSERM U1016, Laboratoire d'immunologie, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.
| | - Vanessa Gayet
- Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre, Department of Gynaecology Obstetrics II and Reproductive Medicine Paris, Centre Hospitalier Universitaire (CHU) Cochin, Batiment Port Royal 53, avenue de l'Observatoire, 75679 Paris, France
| | - Chloé Maignien
- Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre, Department of Gynaecology Obstetrics II and Reproductive Medicine Paris, Centre Hospitalier Universitaire (CHU) Cochin, Batiment Port Royal 53, avenue de l'Observatoire, 75679 Paris, France
| | - Louis Marcellin
- Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre, Department of Gynaecology Obstetrics II and Reproductive Medicine Paris, Centre Hospitalier Universitaire (CHU) Cochin, Batiment Port Royal 53, avenue de l'Observatoire, 75679 Paris, France; Institut Cochin, INSERM U1016, Laboratoire d'immunologie, Université Paris Descartes, Sorbonne Paris Cité, Paris, France; Institut Cochin, INSERM U1016, Département de 'Génetique, Développement et Cancer', Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Khaled Pocate-Cheriet
- Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Assistance Publique - Hôpitaux de Paris (AP- HP), Hôpital Universitaire Paris Centre, Service d'Histologie-Embryologie-Biologie de la Reproduction, Centre Hospitalier Universitaire (CHU) Cochin, Batiment Port Royal 53, avenue de l'Observatoire, 75679 Paris, France
| | - Charles Chapron
- Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre, Department of Gynaecology Obstetrics II and Reproductive Medicine Paris, Centre Hospitalier Universitaire (CHU) Cochin, Batiment Port Royal 53, avenue de l'Observatoire, 75679 Paris, France; Institut Cochin, INSERM U1016, Département de 'Génetique, Développement et Cancer', Université Paris Descartes, Sorbonne Paris Cité, Paris, France
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