Frozen-thawed Single Blastocyst Transfer Cycles Research Articles

Relation between newborn data and blastocyst quality of either ICM or TE grade in frozen-thawed single blastocyst transfer cycles

Relation between newborn data and blastocyst quality of either ICM or TE grade in frozen-thawed single blastocyst transfer cycles

Effect of blastocyst quality on the strategy of single blastocyst transfer in frozen-thawed cycles

To investigate the effect of blastocyst quality on the strategy of single blastocyst transfer in frozen-thawed cycles. A retrospective analysis was performed in Reproductive Medicine Center, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region on clinical data of single frozen-thawed blastocyst transfer cycles from January 2008 to December 2013. All cycles were divided into four groups (AA, AB/BA, BB, BC/CB) according to the blastocyst score, then the clinical outcomes were compared between groups. And on this basis, the clinical outcomes were further explored when the group of outcomes with single blastocyst transfer wasn't ideal, which would diverted to transfer two blastocyst. In single frozen blastocyst transfer cycles, the clinical pregnancy rate of each group with the blastocyst scored AA, AB/BA, BB, BC/CB were 61.4% (470/765), 51.2% (330/645), 40.5% (407/1 005), 22.9% (60/262), live births rate in each group were 52.2% (399/765), 41.2% (266/645), 30.4% (306/1 005), 13.7% (36/262), and the abortion rate were 13.6% (64/470), 16.7% (55/330), 21.4% (87/407), 35.0%(21/60), separately. This showed that the clinical pregnancy rate and live births rate decreased significantly with the decline of blastocyst quality (P<0.01), but the abortion rate showed significant upward trend (P<0.01). When single blastocyst scored ≥BB grade transferred, an acceptable clinical pregnancy rate (>40%) and live births rate (>30%) could be obtained, however, the clinical pregnancy rate of 22.9% and live births rate of 13.7% could only be acquired when blastocyst scored BC/CB only transferred one embryo, which significant lower than those of each group scored ≥BB grade (P<0.01). So, after that, the blastocyst scored BC/CB were further divided into two groups (single blastocyst transferred versus two blastocyst transferred) to investigate, then the result showed that the clinical pregnancy rate [22.9% versus 38.5%(67/174),P<0.01] and live births rate [13.7% versus 30.5%(16/67),P<0.01] were significantly increased in the group of two blastocyst transferred compared with the group of one blastocyst transferred, and the abortion rate was also significantly decreased from 35.0% to 17.9% (12/67;P<0.05). So when two blastocyst scored BC/CB were transferred, the clinical outcomes were similar to the group of one blastocyst scored BB transferred (P>0.05). Of single blastocyst transfer in frozen-thawed cycles, the clinical pregnancy rate and liver births rate showed significant upward trend, but the abortion rate showed significant downward trend, with the decline of blastocyst quality. When the blastocyst scored ≥BB grade, the single blastocyst transfer could be considered to be performed.

A retrospective study of single frozen-thawed blastocyst transfer.

ObjectiveTo study the clinical outcomes of single frozen-thawed blastocyst transfer cycles according to the hatching status of frozen-thawed blastocysts.MethodsFrozen-thawed blastocysts were divided into three groups according to their hatching status as follows: less-than-expanded blastocyst (≤EdB), hatching blastocyst (HgB), and hatched blastocyst (HdB). The female age and infertility factors of each group were evaluated. The quality of the single frozen-thawed blastocyst was also graded as grade A, tightly packed inner cell mass (ICM) and many cells organized in the trophectoderm epithelium (TE); grade B, several and loose ICM and TE; and grade C, very few ICM and a few cells in the TE. The clinical pregnancy and implantation rate were compared between each group. The data were analyzed by either t-test or chi-square analysis.ResultsThere were no statistically significant differences in average female ages, infertility factors, or the distribution of blastocyst grades A, B, and C in each group. There was no significant difference in the clinical pregnancy and implantation rate of each group according to their blastocyst grade. However, there was a significant difference in the clinical pregnancy and implantation rate between each group. In the HdB group, the clinical pregnancy and implantation rate were similar regardless of the blastocyst quality.ConclusionThere was an effect on the clinical outcomes depending on whether the blastocyst hatched during single frozen-thawed blastocyst transfer. When performing single frozen-thawed blastocyst transfer, the hatching status of the frozen-thawed blastocyst may be a more important parameter for clinical outcomes than the quality of the frozen-thawed blastocyst.

The clinical significance of blastocyst grade at post-thawing: from an analysis of 2,425 single frozen-thawed blastocyst transfer cycles

The clinical significance of blastocyst grade at post-thawing: from an analysis of 2,425 single frozen-thawed blastocyst transfer cycles

Prediction of live birth in frozen-thawed single blastocyst transfer cycles by pre-freeze and post-thaw morphology

What pre-freeze and post-thaw morphological parameters can be used to predict live birth outcomes after frozen-thawed blastocyst transfer cycles? Pre-freeze blastocoele expansion and trophectoderm (TE) grade and post-thaw degree of re-expansion are the most significant predictors of live birth in frozen-thawed blastocyst transfer cycles. Currently, blastocoele re-expansion after thawing is used to indicate blastocyst cryosurvival and reproductive potential. The predictive roles of other pre-freeze and post-thaw morphological parameters are neglected. This was a retrospective study of all the patients who received a frozen-thawed single blastocyst transfer (n = 1089) at our clinic between March 2008 and October 2011. Pre-freeze morphological parameters analyzed for all blastocysts included grade of blastocoele expansion, inner cell mass and TE. A group of blastocysts (n = 243) were also graded for post-thaw parameters: degree of blastocoele re-expansion, viability and cell contour. Univariate and multivariate generalized estimating equations (GEEs) models were used to identify the confounders that statistically significantly affected live birth outcomes and to investigate the independent effect of significant pre-freeze and post-thaw morphological parameters. Stepwise logistic regression analysis was used to select the best independent morphological predictors of live birth. Pearson correlations and linear regression analyses were performed to determine the relationship between morphological parameters and possible covariates. Multivariate GEE models estimated that the odds of live birth increased by ∼36% for each grade of expansion (P = 0.0061) and decreased by 29% for blastocysts with grade B TE compared with grade A TE (P = 0.0099). Furthermore, the odds of live birth increased by ∼39% (P = 0.0042) for each 10% increase in degree of re-expansion. Blastocoele expansion and TE grade were selected as the most significant pre-freeze morphological predictors of live birth and degree of re-expansion was selected as the best post-thaw parameter for prediction of live birth. Blastocysts with poorer grades of morphology were not cryopreserved or transferred, limiting the ability to generalize our findings for grades of morphology not included in this study. Blastocysts with higher pre-freeze grades of expansion and TE, irrespective of day of cryopreservation, should be given priority when thawing. Subsequently, re-expanding blastocysts, assessed within 2-4 h, with >60% viability should be transferred. No external funding was obtained for this study. There was no competing interest. not applicable.

Trophectoderm morphology significantly affects the rates of ongoing pregnancy and miscarriage in frozen-thawed single-blastocyst transfer cycle in vitro fertilization

To determine which parameter of blastocyst morphology is the most important predictor of ongoing pregnancy or miscarriage. Retrospective analysis. One in vitro fertilization (IVF) center. Women who underwent a total of 1,087 frozen-thawed single-blastocyst transfer cycles. First IVF treatment with blastocysts after frozen-thawed cycle. Ongoing pregnancy and miscarriage rates as related to blastocyst morphology (blastocyst expansion, inner cell mass, and trophectoderm), and interaction tests in unadjusted logistic regression models to assess clinical factors affecting outcomes. After adjustment for trophectoderm, inner cell mass, and age as confounders, trophectoderm was determined to be statistically significantly related to the rate of ongoing pregnancy. Trophectoderm was also statistically significantly related to the miscarriage rate. By contrast, neither inner cell mass nor blastocyst expansion was statistically significantly related. In frozen-thawed embryo transfer cycles, trophectoderm morphology is statistically significantly related to the rates of ongoing pregnancy and miscarriage after adjusting for confounders. Trophectoderm morphology may be the most important parameter when selecting a single blastocyst for transfer.

Outcome of stimulation of endometrium embryo transfer (SEET): from an analysis of 2,168 single frozen-thawed blastocyst transfer cycles

SEET is a variant method of blastocyst transfer, which is characterized by the injection of the embryo culture supernatant into the uterus before blastocyst transfer. We reported that SEET improved the implantation rate and the pregnancy rate in single frozen-thawed blastocyst transfer cycles (Fertil Steril 2007, 2009). Thereafter, we primarily select SEET method in frozen-thawed blastocyst transfer cycles. In this study, we retrospectively analyzed the outcome of SEET cycles in our ART center. Retrospective analysis. In this study, we collected a total of 2168 cycles of SEET cycles between January 2009 and December 2010. SEET method was performed as previously described (Fertil Steril 2007). We stratified data according to age, previous ART history, and morphological grade of blastocyst, and then investigated the clinical outcome in each group. The average age was 36.3, the average number of previous ART cycles was 2.4, and the total clinical pregnancy rate was 38.4%. The more previous ART cycles led to the lower clinical pregnancy rate (Table1). The clinical pregnancy rates of patients under 37 years of age and above 38 years of age were 45.1% and 27.8%, respectively. The clinical pregnancy rates after high grade blastocyst transfer and low grade blastocyst transfer were 57.0% and 31.9%, respectively.Tabled 1Number of previous ART cycles and Clinical outcome.No. of previous ART12345≤No. of transfer cycles141040016663129Age of patient (y)35.5 ± 4.036.2 ± 3.937.5 ± 3.639.9 ± 3.741.0 ± 3.8No. of chemical pregnancies9342451022650Implantation rate per embryo (%)66.261.361.441.338.8No. of clinical pregnancies582150591526Clinical pregnancy rate per transfer (%)41.337.535.523.820.2No. of pregnancy loss102361836pregnancy loss rate (%)17.52430.52023.1 Open table in a new tab In this study, we showed the good clinical outcome of SEET. SEET is a simple and effective method for single blastocyst transfer.

Frozen-thawed blastocyst transfer reduces ectopic pregnancy risk: an analysis of single embryo transfer cycles in Japan

To evaluate the effect of frozen-thawed blastocyst transfer on ectopic pregnancy (EP) rate. Retrospective analysis. Japanese registry of assisted reproductive medicine. Women who were registered during 2008. None. Rates of live birth, EP, and spontaneous abortion in single blastocyst and cleavage-stage ET cycles in both fresh and frozen-thawed were determined. In the frozen-thawed single blastocyst transfer cycles, 84 EPs of 10,312 clinical pregnancies (0.81%) were reported. There were 25 EPs of 1,361 clinical pregnancies (1.8%) in fresh IVF single blastocyst transfer cycles and 19 of 1,352 (1.4%) in fresh intracytoplasmic sperm injection single blastocyst transfer cycles. The rate of EPs after frozen-thawed single blastocyst transfers varied between 0.56% and 0.97% after stratification by age group. Frozen-thawed blastocyst transfers have reduced EP rates significantly compared with fresh blastocyst transfers.

Prediction of pregnancy and delivery rates by blastocyst morphological score and age, based on 1488 single frozen-thawed blastocyst transfer cycles

OBJECTIVE: To present an estimation of pregnancy and delivery rates after IVF or ICSI stratified by blastocyst (BL) morphology and age. DESIGN: Retrospective analysis. MATERIALS AND METHODS: A total of 1488 single frozen-thawed BL transfer cycles were analyzed. All frozen-thawed BLs used in the study were obtained in the patient's first oocytes retrieval cycles. Viable pregnancy rate (VPR; number of viable pregnancy cycles/number of transfer cycles) and delivery rate (DR; number of delivery cycles/number of transfer cycles) according to BL morphological score (Gardner system) in three different age groups; women aged 22-33, 34-37 and 38-45 years were analyzed. RESULTS: The quality of BLs degraded as age group increased. Within the same BL quality, VPR and DR tended to be lower with increased age.Table 1Viable pregnancy rate and delivery rate by blastocyst quality (BL1-6) and age groups (Age1-3)VPRBL-1(a)BL-2BL-3BL-4BL-5BL-6Age1 (22-33)67.0 (175/261)63.6 (56/88)45.0 (27/60)52.3 (34/65)38.1 (24/63)17.4 (4/23)Age2 (34-37)57.3 (122/213)52.8 (47/89)46.7 (28/60)41.5 (34/82)33.8 (22/65)18.5 (5/27)Age3 (38-45)43.0 (40/93)23.5 (16/68)36.8 (21/57)23.8 (19/80)17.5 (10/57)2.7 (1/37)DR (b)Age1 (22-33)59.9 (148/247)50.6 (40/79)33.9 (20/59)41.9 (26/62)29.5 (18/61)4.5 (1/22)Age2 (34-37)47.8 (96/201)41.0 (34/83)43.1 (25/58)29.5 (23/78)26.6 (17/64)11.1 (3/27)Age3 (38-45)32.6 (29/89)17.2 (11/64)29.8 (17/57)20.0 (16/80)12.3 (7/57)2.7 (1/37)a; BL-1 (G6, G5, and G4AA, 4AB, 4BA by Gardner system), BL-2 (G4 except AA, AB, BA), BL-3 (G3AA, 3AB, 3BA), BL-4 (G3 except AA, AB, BA), BL-5 (G2), and BL-6 (G1). b; Among 685 viable pregnancy cycles, the delivery of 63 cycles could not be confirmed, thus we excluded these cases for calculating the delivery rate. Open table in a new tab a; BL-1 (G6, G5, and G4AA, 4AB, 4BA by Gardner system), BL-2 (G4 except AA, AB, BA), BL-3 (G3AA, 3AB, 3BA), BL-4 (G3 except AA, AB, BA), BL-5 (G2), and BL-6 (G1). b; Among 685 viable pregnancy cycles, the delivery of 63 cycles could not be confirmed, thus we excluded these cases for calculating the delivery rate. CONCLUSION: There was a significant correlation between BL quality and both VPR and DR in addition to the influence of age. The findings may help predict successful pregnancy in single BL transfer.

Prediction of pregnancy rate by blastocyst morphological score and age, based on 1,488 single frozen-thawed blastocyst transfer cycles

To present an estimation of the pregnancy rate after IVF or intracytoplasmic sperm injection stratified by blastocyst morphology and age. Retrospective analysis. Private IVF clinic. A total of 1,488 single frozen-thawed blastocyst transfer cycles. All frozen-thawed blastocysts used in the study were obtained in the patients' first oocytes retrieval cycles. Clinical pregnancy rate (CPR), viable pregnancy rate (VPR), and delivery rate (DR) according to blastocyst morphological score (Gardner and Schoolcraft score) in three different age groups: women aged 22-33 years, 34-37 years, and 38-45 years. The quality of blastocysts degraded as age group increased. The proportions of good-quality blastocysts (grades 4 and above) were 62.3%, 56.3%, and 41.1% in age groups of 22-33 years, 34-37 years, and 38-45 years. Within the same blastocyst quality, CPR, VPR, and DR tended to be lower with increased age. Chances of pregnancy were reduced by 60% or more for women 38 years and older with blastocyst morphology of grades 1 and 2. Significant trends were observed for both age and blastocyst morphology groups. There was a significant correlation between blastocyst quality and CPR, VPR, and DR in addition to the influence of age on the three rates. The findings may help predict successful pregnancy in single-blastocyst transfer.