Live birth rate and neonatal outcome following cleavage-stage embryo transfer versus blastocyst transfer using the freeze-all strategy
Live birth rate and neonatal outcome following cleavage-stage embryo transfer versus blastocyst transfer using the freeze-all strategy
复制标题
卵裂期胚胎移植与使用全冷冻策略囊胚移植后的活产率和新生儿结局
DOI：
10.1016/j.rbmo.2018.12.034
复制
发表时间：
2019-06-01
影响因子：
4
通讯作者：
Kuang, Yanping
中科院分区：
文献类型：
--
作者：
Zhu, Qianqian;Zhu, Jing;Kuang, Yanping
研究问题：在冷冻治疗方案中，卵裂期胚胎移植和囊胚移植后的活产率和新生儿结局如何？设计：这是一项回顾性队列研究。所有优质胚胎在第三天冷冻;剩余的胚胎继续生长，直到它们达到囊胚期，然后冷冻。在2007年至2016年期间，11，801名患者接受了卵裂期胚胎移植，1009名患者在第一个治疗周期使用冷冻策略进行了囊胚移植。对活产率和新生儿结局进行评价。囊胚期移植后第一个冷冻胚胎移植周期的活产率高于卵裂期移植（69.1%对55.5%，P < 0.01），但囊胚期移植与卵裂期移植在第2个冷冻胚胎移植周期的活产率无差异（45.2%对52.7%，P > 0.05）。同样，第一个完整IVF周期的累积活产率也无差异（71.1%对69.2%，P > 0.05）。囊胚移植比卵裂期移植早产单胎分娩的风险更高。然而，早期早产，低出生体重，极低出生体重，高出生体重和极高出生体重的风险没有差异between the two group.Conclusions：没有证据支持囊胚移植的优越性相比，卵裂阶段转移在冷冻治疗方案。囊胚移植后早产单胎分娩的风险可能高于卵裂期移植，但需要进一步的研究来验证这一点。
Research question: What are the live birth rates and neonatal outcomes following cleavage-stage embryo transfer and blastocyst transfer in a freeze-all treatment scenario?Design: This was a retrospective cohort study. All good-quality embryos were frozen on the third day; the remaining embryos were grown on until they reached blastocyst stage and then frozen. Between 2007 and 2016, 11,801 patients underwent cleavage-stage embryo transfer and 1009 patients underwent blastocyst transfer in the first treatment cycle using the freeze-all strategy. The live birth rate and neonatal outcomes were evaluated.Results: The live birth rate in the first frozen embryo transfer cycle was higher following blastocyst transfer than following cleavage-stage transfer (69.1% versus 55.5%, P < 0.01), but there was no difference in live birth rate in the second frozen embryo transfer cycle between blastocyst transfer and cleavage-stage transfer (45.2% versus 52.7%, P > 0.05). Similarly, no difference was found in the cumulative live birth rate for the first complete IVF cycle (71.1% versus 69.2%, P > 0.05). Blastocyst transfer gave a higher risk of preterm singleton delivery than did cleavage-stage transfer. However, there was no difference in the risk of early preterm delivery, low birth weight, very low birth weight, high birth weight and very high birth weight between the two groups.Conclusions: There is no evidence to support the superiority of blastocyst transfer compared with cleavage-stage transfer in a freeze-all treatment scenario. There may be a higher risk of preterm singleton delivery following blastocyst transfer than following cleavage-stage transfer but further studies are needed to verify this.