Developmentally delayed cleavage-stage embryos maintain comparable implantation rates in frozen embryo transfers
Developmentally delayed cleavage-stage embryos maintain comparable implantation rates in frozen embryo transfers
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DOI：
10.1007/s10815-015-0561-8
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发表时间：
2015-10-01
影响因子：
3.1
通讯作者：
Paulson, Richard
中科院分区：
文献类型：
--
作者：
Burks, Heather;Buckbinder, Jennifer;Paulson, Richard
在新鲜的IVF周期中，在发育的第3天达到八细胞阶段的胚胎被认为比在第4天达到这个阶段的胚胎有更高的植入机会。为了确定这种差异在冷冻保存后是否仍然存在，我们比较了使用延迟卵裂期胚胎的冷冻胚胎移植（FET）周期之间的妊娠率和种植率（冷冻保存第4天）和正常卵裂期胚胎参与者在2008年至2012年期间使用冷冻保存在第3天（n = 76）或第4天（n = 48）的胚胎进行FET，这取决于实现八单元阶段所需的时间长度。所有胚胎，无论冷冻保存的日期，在口服雌二醇准备子宫内膜后阴道孕酮的第4天解冻并移植。采用卡方和Mann-Whitney U检验比较患者的人口统计学资料和周期结局，第4天组中更多的妇女卵巢储备功能下降（44 vs 16%，p = 0.003）。两组在前一个新周期的妊娠结局没有差异。FET后第3天和第4天组的妊娠率、着床率和活产率没有差异，这是第一个研究使用第3天和第4天冷冻胚胎的结局。尽管在第4天组中卵巢储备减少（DOR）的患病率较高，但FET周期中使用的卵裂期延迟胚胎的发育以及胚胎以正常速度生长，这表明只要维持子宫内膜同步，胚胎发育延迟不会影响胚胎着床。
In fresh IVF cycles, embryos reaching the eight-cell stage on day 3 of development are thought to have a higher chance of implantation than those reaching this stage on day 4. To determine whether this difference persists after cryopreservation, we compared pregnancy and implantation rates between frozen embryo transfer (FET) cycles using delayed cleavage-stage embryos (cryopreserved day 4) and normal cleavage-stage embryos (cryopreserved day 3).Participants underwent FET between 2008 and 2012 using embryos cryopreserved on either day 3 (n = 76) or day 4 (n = 48), depending on the length of time needed to achieve the eight-cell stage. All embryos, regardless of day of cryopreservation, were thawed and transferred on the 4th day of vaginal progesterone following endometrial preparation with oral estradiol. Chi-square and Mann-Whitney U tests were used to compare patient demographics and cycle outcomes.More women in the day 4 group had diminished ovarian reserve (44 vs 16 %, p = 0.003). Pregnancy outcomes in preceding fresh cycles were not different between the two groups. Pregnancy, implantation, and live birth rates following FET did not differ between the day 3 and day 4 groups.This is the first study to address outcomes using day 3 versus day 4 cryopreserved embryos. Despite a higher prevalence of diminished ovarian reserve (DOR) in the day 4 group, delayed cleavage-stage embryos utilized in FET cycles performed as well as embryos growing at the normal rate, suggesting delayed embryo development does not affect embryo implantation as long as endometrial synchrony is maintained.