What we learned from extended culture of 'rejected' day-3 cleavage stage embryos: a prospective cohort study
What we learned from extended culture of 'rejected' day-3 cleavage stage embryos: a prospective cohort study
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DOI：
10.1186/s13048-017-0332-5
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发表时间：
2017-05-16
影响因子：
4
通讯作者：
Shulman, Adrian
中科院分区：
文献类型：
--
作者：
Klement, Anat Hershko;Ovadia, Michal;Shulman, Adrian
背景：测试低质量的第 3 天胚胎是否能够成功发育和植入。方法：进行了一项前瞻性队列研究。无论是否在第 3 天移植了优质胚胎，都会进一步培养和跟踪质量较差（被拒绝）的胚胎。对每个胚胎的临床结果进行评估。结果：总共纳入了 694 个被拒绝的胚胎（来自 205 名患者），其胚芽率为 21.2%（147 个胚胎），而我们实验室报告的一般胚芽率为 64.2%（P < 0.01）。在多变量逻辑回归模型中，只有第 3 天的成绩显着影响爆胎（P = 0.01）。总共 97 个胚胎达到了新鲜移植或冷冻保存的资格，其中只有 6 个胚胎来自第 3 天得分 < 2 的胚胎。其中 52 个胚胎被移植，导致 21 例妊娠（16 例临床妊娠和 5 例化学妊娠）。总之，694 个培养胚胎产生了 16 例临床妊娠； 2.3% 的临床妊娠率。结论：低分第 3 天胚胎可导致成功的胚胎发育和临床妊娠。然而，正常的爆胎率很低。
Background: To test whether poor quality day-3 embryos can undergo successful blastulation and implantation.Methods: A prospective cohort study was conducted. Whether or not a good quality embryo was transferred on day-3, poor quality (rejected) embryos were further cultured and followed. The clinical outcome of each embryo was assessed.Results: A total of 694 rejected embryos (from 205 patients) were included, with a blastulation rate of 21.2% (147 embryos) compared to 64.2% general blastulation rate reported by our laboratory (P < 0.01). In a multivariate logistic regression model, only their grade on day-3 significantly affected blastulation (P = 0.01). A total of 97 embryos attained eligibility for fresh transfer or cryopreservation, only 6 of which resulted from a day-3 embryo scored < 2. Of these, 52 were transferred, resulting in 21 pregnancies (16 clinical and 5 chemical). In summary, 694 cultured embryos yielded 16 clinical pregnancies; a 2.3% clinical pregnancy rate.Conclusions: Low score day-3 embryos can result in successful blastulation and clinical pregnancies. However, the normal blastulation rate is poor.