Miscarriage Rate Is High With Frozen-Thawed Blastocysts Arising From Poor-Quality Cleavage Stage Embryos.
Miscarriage Rate Is High With Frozen-Thawed Blastocysts Arising From Poor-Quality Cleavage Stage Embryos.
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DOI：
10.3389/fendo.2020.561085
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发表时间：
2020
影响因子：
5.2
通讯作者：
Niu Z
中科院分区：
文献类型：
--
作者：
Xia L;Zhao S;Xu H;Wu X;Zhang A;Niu Z
具有低形态评分的胚胎仍然可以发育到胚泡阶段并产生良好的临床结果。然而，没有研究报告了从低质量的卵裂期胚胎发育的冷冻保存囊胚移植对妊娠和围产期结局的可能影响。在这项回顾性研究中，对体外受精和胚胎移植过程中移植来自第3天低质量卵裂期胚胎的囊胚的临床价值进行了评估。根据移植胚泡来源的第3天胚胎质量将患者分为3组：低质量（111个周期，A组）、高质量（235个周期，B组）和高质量（119个周期，C组）。A组流产率最高（30.2%），与C组（12.5%）相比有所增加（P = 0.03）。三组的临床妊娠率和活产率差异无统计学意义。然而，来自顶部第3天胚胎的良好囊胚导致更高的活产率。在218例活产婴儿中，三组之间的产科和围产期结局没有差异。结果表明，低质量卵裂期胚胎的延长培养可获得良好的临床妊娠率，但流产率较高。同时，不良围产期结局的风险并没有增加。
Embryos with low morphological scores can still develop to the blastocyst stage and result in good clinical outcomes. However, no studies have reported the possible effects of transferring cryopreserved blastocysts developed from poor-quality cleavage stage embryos on pregnancy and perinatal outcomes. In this retrospective study, the clinical value of transferring blastocysts derived from day 3 poor-quality cleavage stage embryos during in vitro fertilization and embryo transfer procedures was evaluated. According to the quality of embryos on day 3 from which the transferred blastocyst originated, patients were divided into three groups: poor-quality (111 cycles, group A), good-quality (235 cycles, group B), and top-quality (119 cycles, group C). Group A experienced the highest miscarriage rate (30.2%) which was increased when compared to group C (12.5%) (P = 0.03). The clinical pregnancy rates and live birth rates were not significantly different among the three groups. However, good blastocyst originating from top day 3 embryos resulted in higher live birth rate. Of the 218 live births, no differences in obstetric and perinatal outcomes were noted among the three groups. The results showed that extended culture of poor-quality cleavage stage embryos could resulted in favorable clinical pregnancy rates but at a higher incidence of miscarriages. Meanwhile, the risk of adverse perinatal outcomes was not increased.
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