| objective :In order to avoid the increase in the cancellation rate of transplantation after blastocyst culture,doctors in domestic reproductive centers usually freeze the remaining embryos after freezing some cleavage-stage embryos for re-breeding.Therefore,during the thawing cycle,doctors and patients often need to choose to thaw high-quality cleavage-stage embryos or blastocysts developed from non-high-quality cleavage-stage embryos? This study aims to provide data support for clinical work to answer this question by comparing the pregnancy outcomes of blastocysts from non-high-quality cleavage-stage sources and high-quality cleavage-stage embryos during single-embryo transfer in freeze-thaw cycles.Methods : This study is a retrospective study with data from 1874 cycles of frozen-thawed single-embryo transfer in Dalian Women and Children Medical Group Reproductive and Genetic Medicine Center from July 2018 to January 2022.A total of 749 cycles were included in the study after screening according to the selection criteria: a total of 229 cycles in the high-quality cleavage-stage embryo transfer group(D3 group),and a total of 204 high-quality blastocyst transfer groups on the fifth day of non-high-quality cleavage-stage sources(D5 excellent group).cycle,the non-high-quality blastocyst transfer group(D5 non-excellent group)formed on the fifth day of the non-high-quality cleavage stage source has a total of 195 cycles,and the high-quality blastocyst transfer group formed on the sixth day of the non-high-quality cleavage stage source(The D6 excellent group)had a total of 34 cycles,and the non-high-quality blastocyst transplantation group(D6 non-excellent group)formed on the sixth day of the non-high-quality cleavage stage had a total of87 cycles.The clinical and laboratory data,biochemical pregnancy rate,clinical pregnancy rate,incidence of monozygotic twins,miscarriage rate,ectopic pregnancy rate,induced labor rate,premature birth rate,live birth rate,cesarean section rate,and birth rate were compared among the patients in each group.Male/female sex ratio,incidence of low birth weight and macrosomia,etc.Results:(1)Basic data: There were no significant differences among the 5 groups in women’s age,infertility type,infertility duration,woman’s body mass index,etiology and endometrial preparation.(2)Clinical pregnancy rate: The clinical pregnancy rates of patients in D3 group,D5 excellent group,D5 non-excellent group,D6 excellent group,and D6 non-excellent group were 46.7%,77.0%,67.2%,67.6%,37.9%,respectively,5 The difference between the two groups was statistically significant(P<0.05).The results of comparison between groups after correction showed that there was no statistically significant difference between D3 group and D6non-excellent group,D5 excellent group and D6 excellent group,D5 non-excellent group and D6 excellent group(P>0.05),and the differences among other groups Both were statistically significant(P<0.05).That is to say,the clinical pregnancy rate of D5 excellent group and D6 excellent group was the highest,and the clinical pregnancy rate of blastocyst group except D6 non-excellent group was higher than that of D3high-quality embryos.(3)Live birth rate: The live birth rates of patients in D3 group,D5 excellent group,D5 non-excellent group,D6 excellent group,and D6non-excellent group were 31.0%,64.2%,48.2%,52.9%,23.0%,respectively,5 The difference between the two groups was statistically significant(P<0.05).The results of comparison between groups showed that there was no statistically significant difference between D3 group and D6 non-optimal group,D5 non-excellent group and D6 excellent group(P>0.05),and the differences among other groups were statistically significant(P<0.05).That is to say,the D5 excellent group had the highest live birth rate,and the live birth pregnancy rate of the blastocyst group except the D6 non-excellent group was higher than that of the D3 high-quality embryos.(4)Miscarriage rate: D3 group,D5 excellent group,D5 non-excellent group,D6 excellent group,D6 non-excellent group,the abortion rates were 26.2%,15.9%,26.0%,17.4%,36.3%,respectively,the 5 groups The difference was statistically significant(P<0.05).The results of comparison between groups showed that there was statistical significance between D5 excellent group and D3 group(P=0.007)and D6 non-excellent group(P=0.007),and there was no statistical significance among the other groups(P>0.05).(5)The inter-group comparison of the D5 excellent group,D5non-excellent group,D6 excellent group,and D6 non-excellent group showed that there was no statistically significant difference in pregnancy outcome between the D5 excellent group and the D6 excellent group(P>0.05).The biochemical pregnancy rate(74.9%VS47.1%),clinical pregnancy rate(67.2%VS37.9%),and live birth rate(48.3%VS23.0%)of the D5 non-optimal group were significantly different from those of the D6 non-optimal group learning meaning.The clinical pregnancy rate(77.0%VS 67.2%),live birth rate(64.2% VS 48.2%),and miscarriage rate(15.9% VS 26.0%)of the D5 excellent group were significantly different from those of the D5non-excellent group(P <0.05).The biochemical pregnancy rate(70.6%VS46.1%),clinical pregnancy rate(67.6%VS37.9%),and live birth rate(52.9%VS23.0%)of the D6 excellent group were significantly different from those of the D6 non-excellent group(P<0.05).The clinical pregnancy rate of the D6 excellent group(17.4VS26.0%)was significantly different from that of the D5 non-excellent group(P<0.05),that is,when the patient had one D5 non-excellent blastocyst and one D6 high-quality blastocyst,the D6 high-quality blastocysts are preferred for transplantation.Conclusion:(1)The pregnancy outcomes(clinical pregnancy rate,miscarriage rate,live birth rate,etc.)of D5 high-quality blastocysts,D5 non-high-quality blastocysts and D6 high-quality blastocysts from non-high-quality cleavage stages are better than those of D3 high-quality cleavage stages When thawing embryos,blastocysts from non-high-quality cleavage-stage embryos(except D6 non-high-quality blastocysts)can be preferentially selected for single blastocyst thawing and transplantation.(2)The order of thawing single blastocysts in the freeze-thaw cycle is: D5 high-quality blastocysts,D6 high-quality blastocysts,D5 non-high-quality blastocysts,and D6non-high-quality blastocysts. |
PDF Full Text Request