The impact of embryo quality on singleton birthweight in vitrified-thawed single blastocyst transfer cycles (original) (raw)
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Fertility and sterility, 2016
To explore obstetric and perinatal outcomes in singleton pregnancies occurring as a result of fresh and thawed frozen embryo transfer using anonymized Human Fertilisation and Embryology Authority data. Retrospective cohort study. Not applicable. Singleton births after IVF/intracytoplasmic sperm injection cycles in the United Kingdom (1991-2011). A total of 112,432 cycles (95,911 fresh and 16,521 frozen) were analyzed using multivariate logistic regression to explore associations between type of embryo transferred (frozen vs. fresh) and obstetric and perinatal outcomes. Relative risks (RRs) and their 99.5% confidence intervals (CIs) were calculated using Stata 14 MP, adjusting for potential confounders. Birth weight. The adjusted RR (99.5% CI) of low birth weight [0.73 (0.66-0.80)] and very low birth weight [0.78 (0.63-0.96)] were all lower after frozen embryo transfer; however, RR of having a high birth weight baby was higher [1.64 (1.53-1.76)]. There was no difference in RR of pret...
The European Research Journal, 2023
Objectives: Our study examined the effects of the trophectoderm biopsy (TB) day and the presence of necrotic foci (NF) or separate blastomeres (SB) within euploid embryos on in vitro fertilization (IVF) pregnancy outcomes. Methods: This retrospective cohort study was conducted from January 2017 to September 2021 at Memorial Sisli Hospital, Istanbul, Turkey. The study comprised a total of 2758 frozen-thawed euploid embryo transfer cycles. After thawing, blastocysts were graded using Gardner's classification Top-Quality (TQ), Good-Quality (GQ), Moderate-Quality (MQ), Poor-Quality (PQ) and further divided into groups according to the presence of NF and/or SB and evaluated for pregnancy outcomes. Results: There were significant correlations between pregnancy outcomes and the degree of blastocoele expansion, as well as the presence of NF or SB in the euploid embryo. Ongoing pregnancy rates were lower in the group with NF in the inner cell mass (ICM) or trophectoderm (TE) than in the group without NF. The presence of SB decreased the rates of ongoing pregnancy and increased the rates of miscarriage. Embryos with expansion grades ≤ 3 had lower rates of ongoing pregnancy and higher rates of miscarriage compared to embryos with expansion grades > 3. TQ and GQ embryos had a higher rate of ongoing pregnancy and a lower rate of miscarriage than MQ and PQ embryos. Conclusions: When selecting the embryo to be transferred to a patient, careful consideration should be given to the morphological grade of the embryo as well as whether or not it contains NF and SB.
Fertility and Sterility
Objective: To evaluate the impact of a poor quality embryo (PQE) during double ET (DET) with a top quality embryo (TQE) on IVF outcome. Design: A review of prospectively collected data. Setting: Tertiary level fertility clinic. Patient(s): All patients undergoing blastocyst transfers as part of fresh IVF (n ¼ 939) and frozen ET (n ¼ 1,009) cycles performed between 2010 and 2016. Intervention(s): Single ET (SET) with TQE (group 1) was set as control and compared with outcomes for SET with PQE (group 2), DET with 2 TQEs (group 3), PQE plus TQE (group 4), and 2 PQE (group 5). Main Outcome Measure(s): Live births and multiple births. Result(s): The live birth rates for group 4 were statistically similar to group 1 during fresh IVF (26.5% vs. 33.7%; odds ratio [OR], 0.95; 95% confidence interval [CI] 0.53-1.7) and frozen ET (24.2% vs. 32.7%; OR, 0.75; 95% CI 0.48-1.2), although there was a trend for lower success. Conversely, multiple births were higher in group 4 for fresh IVF (19% vs. 4.7%; OR, 2.9; 95% CI 1.3-6.6) and frozen ET (10.3% vs. 2.6%; OR, 2.4; 95% CI 1.2-4.9). The live birth rates for group 2 (12.2% for fresh IVF and 14.6% for frozen ET) and group 5 (21.2% for fresh IVF and 14% for frozen ET) were lower and for group 3 were higher (40.8% for fresh IVF and 40.3% for frozen ET) when compared with group 1. Multiple births were significantly higher with DET. Conclusion(s): This study does not support DET with one PQE along with a TQE, when there is only one TQE and one or more PQEs available for fresh IVF or frozen ET. (Fertil Steril Ò 2018;110:655-60. Ó2018 by American Society for Reproductive Medicine.) El resumen está disponible en Español al final del artículo.
Human Fertility, 2020
Reflecting the current trends, the utilization of frozen-thawed transfer cycles has been steadily increasing worldwide; outcome predictors of these cycles are therefore a major research goal. Our aim was to investigate whether the outcome of a fresh single blastocyst transfer (SBT) can serve as a prognostic factor for the subsequent vitrified-warmed SBT originating from the same cohort. A retrospective cohort study was performed at a single unit. Non-donor fresh cycles were analyzed as predictors of the following vitrified-warmed cycle. Only SBTs were included. Cycles designated to a freeze-all policy and cycles involving pre-implantation genetic analysis were excluded. A total of 1127 vitrified-warmed single blastocyst cycles were included. The indications for artificial reproductive technologies were comparable across the study groups. Vitrified-warmed cycles following a live birth outcome in the fresh cycle were more likely to result in a clinical pregnancy than those following a fresh cycle, which failed to reach a live birth. The same trend was observed for live birth rate following vitrified-warmed transfer in the fresh cycle. After correcting for possible confounders, age and embryo quality were significantly correlated with the chance for a live birth, but the previous fresh cycle did not affect the results. We therefore conclude that after adjustment for age, embryo quality and number of previous oocyte retrieval cycles, the fresh cycle outcome was not a significant influential factor for the following vitrified-warmed cycle.
Comparison of perinatal outcomes following fresh and frozen-thawed blastocyst transfer
International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics, 2016
To investigate the effect of ovarian stimulation on endometrial receptivity by comparing singleton pregnancy and perinatal outcomes following fresh or frozen-thawed blastocyst transfers. A retrospective cohort study enrolled patients undergoing fresh or frozen-thawed blastocyst transfers that resulted in live deliveries between January 1, 2010 and September 30, 2013 at a single academic center. Implantation, clinical pregnancy, spontaneous abortion, and live delivery rates were calculated. The incidence of term delivery, preterm delivery, low birth weight, term low birth weight, and very low birth weight were also recorded. To detect a 10% difference in the implantation rate, a minimum sample size of at least 415 transfer cycles in each group was estimated. The study included data from 918 fresh and 1273 frozen-thawed cycles. Patients in both groups were of similar age and there was no difference in the grading of blastocysts. No differences were observed in the implantation (37.3% ...
Romanian Journal of Medical Practice
Objectives. To evaluate which type of embryo transfer (ET) has a superior pregnancy rate. Material and method. Prospective observational non-randomized study including 79 women that underwent 145 ET. Outcomes. The results show that the highest biochemical pregnancy rate (BPR) was in the fresh day 3 ET group (47.62%), but in this group there were also the highest abortion rate (80%) and the highest premature birth rate (100%), giving that, after 21 fresh day 3 ET did not result any term live birth. The frozen day 3 embryo has the lowest BPR (30%), but also the lowest abortion rate (33.33%) and the lowest premature birth rate (0%), in the present study after 13 frozen day 3 ET resulting 2 full-term births (15.38%). The results for the fresh day 5 blastocyst show a good BPR (43.48%), a low abortion rate (33.33%) and the lowest premature birth rate (0%), giving that in the study performed after 23 day 5 ET resulted 4 newborns at term (15.38%). The frozen day 5 blastocyst has a very good...
Journal of Assisted Reproduction and Genetics, 2020
Purpose To investigate whether live birth rates from euploid blastocyst frozen-thawed embryo transfer (FET) cycles are associated with infertility diagnosis or oocyte source. Design Retrospective analysis of FET cycles reported to SART CORS in 2014. Methods Data from fresh IVF cycles with preimplantation genetic testing for aneuploidy (PGT-A), linked to the first FET cycles, were collected from the 2014 SART CORS database for autologous and donor oocyte cycles. Inclusion criteria were patients undergoing FET with euploid embryos (n = 4148). Demographic data including age, BMI, prior fertility, and etiology of infertility were collected from the retrieval cycle and analyzed. Patients with uterine anomalies, preimplantation genetic testing-mutation (PGT-M) for genetic diseases, gender selection, HLA determination, or systemic and immunologic disorders were excluded. The primary outcome measure was live birth (LB) rate. Potential confounders such as age, prior fertility, and maximum baseline FSH values were analyzed with regression models as indicated. Results Though age, maximum baseline FSH, and infertility diagnosis were significantly different, LB was similar between patients undergoing autologous or donor oocyte FET cycles. Etiology of infertility was not significantly associated with LB in autologous cycles (p = 0.95). Potential confounders such as maternal age, prior fertility, and maximum baseline FSH were not associated with outcomes; however, maternal BMI was inversely related to LB in autologous cycles, with an odds ratio of 0.97 (95% CI: 0.96-0.98 (rho = − 0.08, p < 0.01)). Conclusions After controlling for confounding variables, a euploid embryo derived from a donor or autologous oocyte results in similar LB in women with different infertility diagnoses.
The Egyptian Journal of Fertility of Sterility
Frozen embryo transfer (FET) is an important part of present-day IVF/ ICSI treatment. There is limited understanding of the factors affecting success rates after FET. The aim of this work to study the Clinical and laboratory factors which affect clinical pregnancy rate after frozen-thawed embryo transfer. Study design: This is three-center prospective study. Analysis was carried out on 150 consecutive FET cycles during the period from 2011-2015. The primary outcome was clinical pregnancy per cycle. We assessed the independent effect on clinical pregnancy of the following variables: female age, female age at embryo freezing, BMI, primary versus secondary infertility, cause & duration of infertility, LH/FSH ratio, protocol of fresh cycle, serum estradiol level before Human Chronic Gonadotropin (HCG) at fresh cycle, sperm source (testicular or ejaculated), day of freezing, pregnancy in the fresh cycle, storage duration of embryos, cause of, thawing method as well as number of thawed transferred embryo (s). Main results: Pregnancy rate in FET was 31%. Pregnancy rate was 21.6% in patient younger than 30 years old at fresh cycle with RR 2.31 with CI (1.72-7.37). Patients of age at FET more than 35 years to have positive outcome 9.4% of FET with 95% CI= (1.72-7.37).There was absolute risk increase of 2.91 between the two BMI groups (>=30 & <30) with 95% CI: (1.13-7.50) %. patients having explained cause of infertility would be 0.26 times as likely as patients having unexplained infertility to have positive outcome of FET with 95% CI= (0.12-0.55). Patients having abnormal semen analysis would be 1.44 times as likely as patients having normal analysis to have positive outcome of FET with 95% CI= (0.20-0.99). Patients having Negative Pregnancy outcome at fresh cycle would be 0.9 times as likely as patients having Positive Pregnancy outcome at fresh cycle but this is not significant 95% CI= (0.38-2.66). Patients with excess number of embryos as a cause of freezing would be 0.38 times as likely as patients of unusual Cause of freezing to have positive outcome of FET16.2% with 95% CI=(0.14-0.99). The chance of pregnancy increases significantly if >3 thawed embryos was transferred (odds ratio (OR) 0.34 95% confidence interval (CI) (0.12-0.97). Conclusion: Increased number of transferred thawed embryos is associated with increased clinical pregnancy; Age, BMI, cause of infertility, semen parameters, pregnancy at fresh cycle, endometrial thickness on the thawed embryo transfer day and cause of freezing. Number of transferred thawed embryos affected independently the clinical pregnancy rate in FET.
2021
ObjectiveThis study aimed to determine whether blastocyst quality affect on sex ratio at birth through in single blastocyst frozen thawed embryo transfer cycle.Materials and MethodsWe ran this retrospective study on 4205 singleton infants born following single blastocyst frozen thawed embryo transfer from January 2016 to October 2020 at a single institution. We compared the sex ratios of these infants with respect to blastocyst quality, embryo growth rate and morphology.ResultsThe main outcomes of this study were that the sex ratio at birth of single blastocyst frozen thawed embryo transfer babies was 56.67% which was higher than the normal level (51.22%). The sex ratio of mothers older than 40 years was significantly lower than that of mothers younger than 40 years (0.39vs1.3, P<0.05). Transplanting good quality blastocysts significantly increased the proportion of boys (1.35vs0.94, P<0.05). Transplanting grade 5 and 6 blastocysts significantly increased the proportion of mal...