Increased pregnancy outcome after day 5 versus day 6 transfers of human vitrified-warmed blastocysts
Increased pregnancy outcome after day 5 versus day 6 transfers of human vitrified-warmed blastocysts
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DOI：
10.1017/s0967199419000273
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发表时间：
2019-10-01
期刊：
影响因子：
1.7
通讯作者：
Pickering, Susan J.
中科院分区：
文献类型：
--
作者：
Sciorio, Romualdo;Thong, K. J.;Pickering, Susan J.
玻璃化冷冻是一种高效的人类胚胎冷冻保存技术。延迟囊胚形成的影响可能是导致植入失败的原因，并对体外受精（IVF）结果产生负面影响。目前的文献显示了不一致的结果;一些研究宣布，与第6天（D 6）移植相比，第5天（D5）移植后的妊娠率更高，而其他研究则显示了相同的结果。在本研究中，对延迟囊胚形成（D5与D 6）的临床意义进行了研究。我们进行了一项回顾性研究，比较了温热单囊胚移植（WSBT）后的临床妊娠率和植入率。所有在爱丁堡辅助受孕计划，EFREC，爱丁堡皇家医院接受程序化温热移植的患者均纳入本研究，并根据囊胚玻璃化冷冻的日期分为两组：D5（n = 1563）和D 6（n = 517）。总生存率为95.0%（1976/2080），D5和D 6组之间无显著差异：分别为95.3%（1489/1563）和94.2%（487/517）。与D5胚胎相比，D 6囊胚的WSBT导致较低的植入和临床妊娠。D5胚胎的种植率和临床妊娠率分别为49.4%和42.6%，D 6胚胎的种植率和临床妊娠率分别为37.4%和32.2%，差异有统计学意义。多胎妊娠率为1.32%（D5为1.14%，D 6为1.84%）。虽然D 6玻璃化温热囊胚移植仍然是一个合理的选择，但优先移植D5胚胎将减少成功妊娠的时间。
Vitrification is a highly efficient technique for the cryopreservation of the human embryo. The effect of delayed blastulation may be responsible for implantation failures and negatively affects in vitro fertilization (IVF) outcomes. The current literature displays discordant results; some studies have announced higher pregnancy rates after day 5 (D5) transfer compared with day 6 (D6) transfer, while others have shown equivalent outcomes. In the present study an investigation into the clinical implications of delayed blastulation (D5 versus D6) was carried out. We performed a retrospective study comparing clinical pregnancies and implantation rates following warmed single blastocyst transfer (WSBT). All patients coming for a programmed warmed transfer at Edinburgh Assisted Conception Programme, EFREC, Royal Infirmary of Edinburgh, were included in this study and divided in two groups according to the day of blastocyst vitrification: D5 (n = 1563) and D6 (n = 517). The overall survival rate was 95.0% (1976/2080) with no significant difference between the D5 and D6 groups: 95.3% (1489/1563) and 94.2% (487/517) respectively. WSBT of D6 blastocysts resulted in a lower implantation and clinical pregnancy compared with D5 embryos. The implantation rate (IPR) and clinical pregnancy rate (CPR) were respectively 49.4% and 42.6% for the D5 and 37.4% and 32.2% for the D6 embryos, which was statistically significant. The multiple pregnancy rate was 1.32% (1.14% for D5 vs 1.84% for D6). Although the transfer of D6 vitrified-warmed blastocyst remains a reasonable option, priority to a D5 embryo would reduce the time to successful pregnancy.