Cleavage-stage versus blastocyst-stage embryo transfer in assisted reproductive technology

Glujovsky, Demián; Retamar, Andrea Marta Quinteiro; Sedo, Cristian Roberto Alvarez; Ciapponi, Agustín; Cornelisse, Simone; Blake, Deborah

doi:10.1002/14651858.cd002118.pub6

Cited by 61 publications

(45 citation statements)

References 114 publications

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“…In addition, patients should be informed of high miscarriage rates. During the warming cycles, the implantation rate of blastocysts decreased and the abortion rate of later development increased, which could be explained that more viable embryos would reach the expanded blastocyst earlier [5,19] . However, another important question is, whether extended in vitro culture itself would decrease the competence of embryos to interact with endometrium?…”

Section: Discussionmentioning

confidence: 99%

Outcomes of embryo vitrification at different developmental stages

Gao

Jiang

et al. 2022

Medicine

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Introduction: Advances in cell culture media have led to a shift from cleavage stage embryo transfer to blastocyst stage transfer. Extended embryo culture to the blastocyst stage provides some theoretical advantages and disadvantages. There has been controversy. This study is sought to evaluate the clinical outcomes of vitrified-warmed cleavage-stage and blastocyst-stage embryo transfers in patients undergoing Artificial Reproductive Technique treatments.Material and method: The study was performed on 2740 women undergoing frozen embryo thawing transfer. Patients' basic situation, status of frozen embryo transfer cycle, clinical pregnancy rate, early abortion rate, sex ratio of birth, and birth weight were retrospectively analyzed. We compared the main clinical results of recovery of frozen embryo on the cleavage stage and blastocyst stage. Furthermore, we evaluated the clinical outcomes of blastocyst cryopreservation on Day 5, 6, or 7 after oocyte retrieval according to the day of blastocyst expansion were evaluated.Results: The implantation ratio of cleavage stage embryos was 21.62% compared with 43.52% on D5 (P < .05). The D5, D6, and D7 implanting rates were statistically different. The pregnancy rates were 57.56%, 51.76%, and 35.95% versus 37.79%, respectively for embryos cryopreserved on D5, D6, D7, and D3. The ectopic pregnancy rate and early abortion rate were statistically different between D5 and D3. The sex ratio, the birth weight, and birth defect were not statistically different among the four groups.Conclusions: Blastocyst transfer achieved a higher implantation rate than vitrified cleavage stage embryo and decreased ectopic pregnancy rate. With increased incubation days before expansion blastocyst formed, the implantation rate is reduced and the early abortion rate increases.

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Section: Discussionmentioning

confidence: 99%

Outcomes of embryo vitrification at different developmental stages

Gao

Jiang

et al. 2022

Medicine

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“…Previous studies had investigated that women with repeated implantation failure (RIF), personalized timing for transfer resulted in a higher clinical pregnancy rate compared with routine protocol [23][24][25]. Thus, although there is a bene t favoring blastocyst transfer in fresh cycle, it remains unclear whether the day of transfer impacts on pregnancy rate [4]. In a 5-year multicentre, international, randomized controlled trial (RCT), Carlos suggested statistically signi cant improvement in pregnancy, implantation and cumulative live birth rates in personalized embryo transfer (PET) compared with frozen embryo transfer (FET) and fresh embryo transfer arms, indicating the potential utility of PET guided by the endometrial receptivity analysis (ERA) test at the rst appointment [26].…”

Section: Discussionmentioning

confidence: 99%

“…Advance in the embryo culture up to the blastocyst stage enables a better selection of embryos with a superior developmental capacity and consequently a higher implantation potential [2,3]. The rationale for blastocyst transfer is to improve both uterine and embryonic synchronicity and enable self-selection of available embryos, thus resulting in better live birth rates [4]. Embryo transfer at the blastocyst stage increases the pregnancy rate per embryo transferred, and this is especially important in the context of single embryo transfer (SET) policies, intending to reduce multiple gestations [5,6].…”

Section: Introductionmentioning

confidence: 99%

Association between Available Blastocyst Formation Rate and Pregnancy Outcome Following Fresh Embryo Transfer

Wang

Qiu

Jiang

et al. 2022

Preprint

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Background: Embryo quality usually has been regarded as a key predictor of successful implantation and pregnancy potential. The identification of embryos that have the capacity to implant and result in a healthy pregnancy is a crucial part of in vitro fertilization (IVF). Usually, the morphologically high quality embryos are chosen for embryo transfer in IVF treatment. The aim of this study was to assess the association between available blastocyst formation rate with pregnancy outcome following first fresh embryo transfer cycles. Our objective was to predict pregnancy outcome according to embryonic development potential, and provide a systematical individual treatment to adjust endometrial receptivity for the next transfer cycle. Methods: This retrospective, single-center study including 512 fresh embryo transfers conducted between 11/2019–08/2021, which consisted of 385 cleavage-stage (day 3) and 127 blastocyst-stage (day 5) transfers. The two groups were divided into clinical pregnancy group and non-clinical pregnancy group respectively for comparison. The association with available blastocyst formation rate and the clinical pregnancy rate between day 3 or day 5 transfer groups were concerned. Results: In the day 3 group, there were 275 clinical pregnancies, and the clinical pregnancy rate was 71.43%. Although the 2PN oocytes rate and available embryo rate at day 3 were significantly higher in clinical pregnancy group compared with non-clinical pregnancy group (P < 0.05), the blastocyst formation rate and the available blastocyst formation rate had no significant differences between the clinical pregnancy group and non-clinical pregnancy group (P > 0.05). In the day 5 group, there were 81 clinical pregnancies, and the clinical pregnancy rate was 63.78%. All the baseline characteristics had no obvious differences between the clinical pregnancy group and non-clinical pregnancy group (P > 0.05). The blastocyst formation rate in the non-clinical pregnancy group was higher than that in the clinical pregnancy group, but the difference was not statistically significant (81.06% vs. 77.03%, P = 0.083). Interestingly, the available blastocyst formation rate was significantly higher than the clinical pregnancy group (66.19% vs. 60.79%, P = 0.014). Conclusions: In fresh cycles, available blastocyst formation rate was not associated with pregnancy outcome with a day 3 embryo transfer. However, available blastocyst formation rate was negatively associated with pregnancy outcome with a day 5 embryo transfer.

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“…PGT, when indicated, is now also performed at the blastocyst stage. However, it remains unclear whether the day of transfer has a beneficial effect on live birth and pregnancy rates 31,32 …”

Section: Embryonic and Fetal Developmentmentioning

confidence: 99%

Assisted reproductive technology: Short‐ and long‐term outcomes

Graham

Jelin

Hoon

et al. 2022

Develop Med Child Neuro

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In 1978 Louise Joy Brown was the first infant born by in vitro fertilization (IVF), as the result of the pioneering work of Robert Edwards, Patrick Steptoe, and Jean Purdy in the successful development of this procedure. 1,2 This dramatic success was followed 14 years later by the first infant born after intracytoplasmic sperm injection (ICSI), 3 a method that was initially developed for male infertility.These and subsequent advances in the rapidly developing field of assisted reproductive technology (ART) have provided hope for people struggling with the medical, emotional, and financial effects of infertility and for those wanting to conceive where there are risks of the recurrence of monogenic disorders. 4,5 As of 2020, an estimated 8 million children had been conceived by ART. 6 ART refers to in vitro procedures with carefully orchestrated sequential steps, which are overall termed an ART cycle: ovarian stimulation; surgical removal of eggs from the ovary; fertilization with sperm in a laboratory; and then returning embryo(s) to the female reproductive tract. ART can involve donor eggs, donor sperm, and gestational carriers. Procedures include IVF and ICSI. There are situational indications for either fresh or frozen embryo transfer. 7,8

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Cleavage-stage versus blastocyst-stage embryo transfer in assisted reproductive technology

Cited by 61 publications

References 114 publications

Outcomes of embryo vitrification at different developmental stages

Outcomes of embryo vitrification at different developmental stages

Association between Available Blastocyst Formation Rate and Pregnancy Outcome Following Fresh Embryo Transfer

Assisted reproductive technology: Short‐ and long‐term outcomes

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