Effect of Embryo Developmental Stage, Morphological Grading, and Ploidy Status on Live Birth Rate in Frozen Cycles of Single Blastocyst Transfer
Effect of Embryo Developmental Stage, Morphological Grading, and Ploidy Status on Live Birth Rate in Frozen Cycles of Single Blastocyst Transfer
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DOI：
10.1007/s43032-020-00381-6
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发表时间：
2020-11-10
影响因子：
2.9
通讯作者：
Shen, Rong
中科院分区：
文献类型：
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作者：
Ji, Hui;Zhou, Yuxi;Shen, Rong
探讨胚胎发育阶段或形态分级能否预测冷冻胚胎移植(FET)周期中单个囊胚的活产率(LBR)。这项回顾性研究包括1336个未经活检和360个整倍体FET周期。根据发育阶段(第5天[D5]和第6天[D6])和形态(优质和劣质)对囊胚进行分类。移植D5胚泡的非活组织周期LBR显著高于D6组(48.5vs.24.3%；p<；0.001)，高质量胚胎移植周期显著高于低质量胚胎移植周期(52.6vs.25.3%；p<；0.001)。在D5达到优质囊胚的胚胎，在D6获得的LBR显著高于相同质量的囊胚。同样的趋势也出现在低质量的胚胎中。仅在D5或D6胚泡移植方面，优质胚胎的LBR仍优于低质量胚胎。在整倍体胚胎移植的情况下，D5囊胚的LBR(48.9vs.44.9%，p=0.444)与D6囊胚的LBR(48.9vs.44.9%)没有显著差异。优质胚胎的LBR高于低质量胚胎(51.6vs.40.0%，p=0.030)；在控制混杂因素后，调整后的优势比仍然不显著(AOR1.56；95%CI0.99-2.45；p=0.056)。同一发育阶段或形态亚组的LBR差异无统计学意义。胚胎发育阶段和形态分级是预测非活检FET周期LBR的有用指标。然而，在整倍体转移周期中没有发现关联。
To determine whether embryo developmental stage or morphological grading can predict live birth rate (LBR) from a single blastocyst in nonbiopsied and biopsied frozen embryo transfer (FET) cycles. This retrospective study included 1336 nonbiopsied and 360 euploid FET cycles. Blastocysts were divided according to developmental stage (day 5 [D5] and day 6 [D6]) and morphology (good quality and low quality). Nonbiopsied cycles in which D5 blastocysts were transferred were associated with a significantly higher LBR than those in the D6 group (48.5 vs. 24.3%; p < 0.001), as well as in good-quality embryo transfer cycles than that in low-quality embryo cycles (52.6 vs. 25.3%; p < 0.001). Embryos reaching good-quality blastocysts on D5 yielded significantly higher LBR than those similar quality blastocysts on D6. The same trend was seen in low-quality embryos. Concerning only D5 or D6 blastocyst transfer, the LBRs of good-quality embryos were still superior to those of low-quality embryos. In the case of euploid embryo transfers, the LBR (48.9 vs. 44.9%, p = 0.444) of D5 blastocysts did not significantly differ from that of D6 blastocysts. Good-quality embryos showed a higher LBR than low-quality embryos (51.6 vs. 40.0%, p = 0.030); the adjusted odds ratio remained insignificant after controlling for confounders (aOR 1.56; 95% CI 0.99-2.45; p = 0.056). The LBRs in the same developmental stage or morphology subgroups were not statistically significant. Embryo developmental stage and morphological grade are useful predictors of LBR in nonbiopsied FET cycles. However, no association was found in euploid transfer cycles.