Blastocyst-stage embryos provide better frozen-thawed embryo transfer outcomes for young patients with previous fresh embryo transfer failure
Blastocyst-stage embryos provide better frozen-thawed embryo transfer outcomes for young patients with previous fresh embryo transfer failure
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DOI：
10.18632/aging.103055
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发表时间：
2020-04-30
期刊：
影响因子：
5.2
通讯作者：
Sun, Ying-Pu
中科院分区：
文献类型：
--
作者：
Fang, Lanlan;He, Jingyan;Sun, Ying-Pu
年龄较大的患者或卵巢反应降低的患者胚胎数量较少，这限制了胚胎选择的机会。然而，对于接受冻融胚胎移植(ET)的年轻患者来说，胚胎阶段是否会影响妊娠结局尚不清楚。本研究将2952例首次冻融胚胎移植患者分为两组：新鲜胚胎移植失败组(A组)和卵巢过度刺激综合征(OHSS)高危未接受新鲜胚胎移植组(B组)。结果显示，B组患者的临床妊娠率(CPR)和活产率(LBR)显著高于A组患者。囊胚期冻融胚胎移植组的CPR、LBR显著高于卵裂期冻融胚胎移植组，异位妊娠率明显低于卵裂期冻融胚胎移植组。B组的CPR、EPR、LBR和自然流产率(SAR)与囊胚期和卵裂期冻融ET相似。这些结果表明，胚胎期冻融ET更适合于有一次失败的新鲜ET周期的年轻患者。
Older patients or patients with a reduced ovarian response have a low number of embryos, which limits the opportunity for embryo selection. However, for young patients undergoing frozen-thawed embryo transfer (ET), it remains unclear whether embryo stage affects pregnancy outcomes. In the present study, a total of 2952 patients undergoing their first frozen-thawed ET were divided into two groups: patients who had experienced one failed fresh ET (Group A) and patients who had not received fresh ET because of the high risk of ovarian hyperstimulation syndrome (OHSS) (Group B). Our results show that Group B patients had a significantly higher clinical pregnancy rate (CPR) and live birth rate (LBR) than Group A patients. However, Group A patients who underwent blastocyst-stage frozen-thawed ET had a significantly higher CPR and LBR and a lower ectopic pregnancy rate (ePR) than did those who underwent cleavage-stage frozen-thawed ET. In Group B, CPR, ePR, LBR and spontaneous abortion rate (sAR) were similar with blastocyst-stage and cleavage-stage frozen-thawed ET. These results suggest that blastocyst-stage frozen-thawed ET is more appropriate for young patients who had previously undergone one failed fresh ET cycle.