Abstract
BackgroundPrevious studies have reported the association between embryo quality and perinatal outcomes in fresh cycles, after cleavage-stage or blastocyst embryo transfer, and found no significant difference. However, in terms of vitrified-warmed embryo transfer cycles, the impact of embryo quality on neonatal and maternal outcomes has not been evaluated.ObjectivesTo explore the association between the quality of a single vitrified-warmed embryo and perinatal outcomes.MethodsThis retrospective study included 2403 live-born singletons derived from single vitrified-warmed embryo transfer cycles during January 2006 and July 2018. Neonatal and maternal outcomes were compared between singletons resulting from the use of single good quality embryo (GQE) (n = 1854) and single poor quality embryo (PQE) (n = 549) and analyzed in the group of cleavage-stage embryo transfer and the group of blastocyst transfer, respectively.ResultsA significantly higher risk of low birthweight (LBW, birthweight <2500 g) was observed in the singletons derived from the transfer of single PQE compared with those derived from the transfer of single GQE both in cleavage and blastocyst stages (cleavage-stage, AOR 2.62, 95% CI 1.27–5.37; blastocyst stage, AOR 1.98, 95% CI 1.06–3.70). An increased risk of preterm birth (PTB, gestational age <37 weeks) was also observed in singletons born after transfer of a PQE of cleavage-stage compared with those after a GQE of cleavage-stage (AOR 2.40, 95% CI 1.28–4.49). The transfer of single poor quality blastocyst was associated with a higher risk of placenta previa compared with the transfer of single good quality blastocyst (AOR 2.65, 95% CI 1.26–5.57). Other maternal complications, neonatal malformations, and neonatal complications were similar between compared groups.ConclusionIn vitrified-warmed cycles with single embryo transfer, poor embryo quality would result in a significantly higher risk of LBW, regardless of cleavage-stage or blastocyst embryo transfer. Meanwhile, the transfer of poor cleavage-stage embryo was also associated with an increased incidence of PTB.
Highlights
MATERIALS AND METHODSThe technology of cryopreservation has been refined by the use of vitrification and optimized the process of frozen embryo transfer (FET)
Previous studies involving fresh cycles found no difference between singletons born after the transfer of PQE and those born after GQE in risks of LBW, PTB, small for gestational age (SGA) and other adverse perinatal outcomes (Oron et al, 2014a,b; Zhu et al, 2014; Bouillon et al, 2017)
We retrospectively evaluated 2403 infertile women who delivered live-born singletons originating from single vitrified-warmed embryo transfer, after in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI), between January 2006 to July 2018 at the Department of Assisted Reproduction of Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine
Summary
MATERIALS AND METHODSThe technology of cryopreservation has been refined by the use of vitrification and optimized the process of frozen embryo transfer (FET). Previous studies involving fresh cycles found no difference between singletons born after the transfer of PQE and those born after GQE in risks of LBW, PTB, small for gestational age (SGA) and other adverse perinatal outcomes (Oron et al, 2014a,b; Zhu et al, 2014; Bouillon et al, 2017). Despite these reassuring findings, patients with only poor embryos available for transfer were likely to be predisposed to worse prognosis with the underlying pathology of decreased oocyte quality or poor response to ovarian stimulation (van Rooij et al, 2003; Check et al, 2007; Morin et al, 2018). In terms of vitrified-warmed embryo transfer cycles, the impact of embryo quality on neonatal and maternal outcomes has not been evaluated
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