Does Post-Warming Extended Culture Duration Affect the Clinical and Obstetric Outcomes of Patients of Advanced Maternal Age? A Single-Center Study

Abstract

Background The single vitrified-warmed blastocyst transfer (SVBT) cycle has been increasingly utilized for assisted reproductive technology. Women of advanced maternal age (AMA) comprise a significant portion of patients who have undergone ‘freeze-all’ cycles. This study investigated the association between the post-warming extended culture duration and pregnancy outcomes in patients of AMA. Methods This retrospective cohort study analyzed the outcomes of 697 SVBT cycles between January 2016 and December 2017. The cycles were divided into 3 groups based on the age of the female partners: group I: < 35 years (n = 407), group II: 35–37 years (n = 176); and group III, 38–40 years (n = 114). Data are shown as the mean ± standard error of the mean. Data were analyzed using one-way ANOVA followed by Duncan’s multiple range test. Statistical significance was set at P < 0.001. Results The blastocyst rate, clinical pregnancy rate, and live birth rate (LBR) was significantly lower in the AMA groups. However, there were no significant differences in LBR in the transfer between the AMA and younger groups according to blastocyst morphology and post-warming extended culture duration. Conclusion Post-warming extended culture of blastocysts is not harmful to patients of AMA. It could be a useful parameter in clinical counseling and decision making for fertility treatments.

Efficacy of Laser-Assisted Hatching on Pregnancy and Live-Birth Rates of Human Frozen-Thawed Embryos

“…The discovery that fertilized embryos with artificial gaps in their zona pellucida appear to have high implantation rates and that divided embryos with an excellent prognosis for implantation have lessened the thickness of the zona led to the clinical introduction of assisted hatching. In addition, other studies reported that at the early stage of development some embryos showed dissimilarity in zona thickness and that zona thinning is an active development [26][27].…”

Clinical Usability of Embryo Development Using a Combined Qualitative and Quantitative Approach in a Single Vitrified-Warmed Blastocyst Transfer: Assessment of Pre-Vitrified Blastocyst Diameter and Post-Warmed Blastocyst Re-Expansion Speed

“…Dynamic change in speed is a potential indicator of developmental potential because the embryo changes prominently within a short period [ 42 , 43 ]. Most significantly, our previous study showed that morphological characteristics are the most important indicators of clinical outcomes and live birth [ 30 , 44 ]. Concordantly, in this study, we demonstrated that blastocyst diameter and re-expansion speed are closely related to embryo quality.…”

“…The vitrified-warmed blastocyst survival and grading assessments were performed as described in our previous study [ 10 , 30 ]. In brief, embryologists assessed the degree of post-warming blastocyst survival by identifying viable cells (clear margin and homogeneous content) in comparison to dead cells (dark and granular) and defined fully surviving embryos when >50% of intact cells were observed.…”