Pregnancy outcomes after day 5 versus day 6 blastocyst‐stage embryo transfer: A systematic review and meta‐analysis

Li, Yixin; Wang, Jin; Sun, Tianze; Lv, Mo-Qi; Ge, Pengfei; Li, Haonan; Zhou, Daohong

doi:10.1111/jog.14188

Cited by 20 publications

(11 citation statements)

References 40 publications

(101 reference statements)

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“…A meta-analysis from 2010 demonstrated that day 6 embryos that were at the same stage of development at cryopreservation as day 5 cryopreserved embryos, had similar clinical pregnancy and live birth rates 5 . A Recent meta-analysis found that day 5 blastocysts transfers have higher clinical pregnancy (CPR) and live birth rates (LBR) compared with day 6 embryos in both frozen and fresh cycles, regardless to embryo quality, in agreement with preceding retrospective studies 6 – 8 . The studies included were composed of heterogeneous patients, protocols and freezing methods.…”

Section: Introductionsupporting

confidence: 68%

Day 5 vitrified blastocyst transfer versus day 6 vitrified blastocyst transfer in oocyte donation program

Yerushalmi

Shavit

Avraham

et al. 2021

Sci Rep

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The superiority of day 5 blastocysts compared to day 6 blastocysts in fresh cycle transfers was previously demonstrated and attributed mainly to endometrial asynchrony. Data from frozen blastocysts transfers showed conflicting results, possibly due to heterogeneous patient population and embryo quality. The aim of this study was to compare clinical pregnancy rate (CPR) and live birth rate (LBR) between transfers of vitrified day 5 blastocysts and day 6 blastocysts in oocyte donation, blastocyst-only cycles. In a retrospective, multi-center study, with a single oocyte donation program, a total of 1840 frozen embryo transfers (FET’s) were analyzed, including 1180 day 5 blastocysts and 660 day 6 blastocysts transfers. Day 5 blastocyst transfers had better embryonic development and significantly higher CPRs (34.24% vs. 20.15%, P < 0.0001), higher LBRs (26.89% vs. 14.77%, P < 0.0001), less cycles to LBR (1.83 ± 0.08 vs. 2.39 ± 0.18, P = 0.003) and shorter time to LBRs (76.32 ± 8.7 vs. 123.24 ± 19.1 days, P = 0.01), compared to day 6 transfers, respectively. A multivariate stepwise logistic regression indicated, that day 5 transfer was an independent factor for CPRs (OR 1.91; 95% CI 1.43–2.54, P < 0.001) and LBRs (OR 2.26; 95% CI 1.19–4.28, P = 0.01), regardless of embryo quality, compared to day 6. In conclusion, day 5 blastocysts in oocyte donation program have significantly higher CPRs and LBRs, and present shorter time to delivery, compared to day 6 blastocysts, regardless of embryo quality.

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Section: Introductionsupporting

confidence: 68%

Day 5 vitrified blastocyst transfer versus day 6 vitrified blastocyst transfer in oocyte donation program

Yerushalmi

Shavit

Avraham

et al. 2021

Sci Rep

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“…In fresh embryo transfer cycles, the stimulation induced endometrial advancement causes a superiority of day 5 blastocysts compared to day 6 in terms of pregnancy and implantation potential [ 39 ]. Though a recent meta-analysis indicated the benefit of day 5 blastocysts in both fresh and frozen embryo transfer cycles [ 40 ], the available low quality of clinical evidence still questions the superiority of day 5 blastocysts [ 41 ]. More specifically, in case of euploid frozen embryo transfer cycles, day 5 and day 6 blastocysts have shown a similar pregnancy potential [ 38 ].…”

Section: Discussionmentioning

confidence: 99%

Marginal differences in preimplantation morphokinetics between conventional IVF and ICSI in patients with preimplantation genetic testing for aneuploidy (PGT-A): A sibling oocyte study

et al. 2022

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Objective This study aimed to analyze the morphokinetic behaviour between conventional IVF and ICSI, in cycles with preimplantation genetic testing for aneuploidies (PGT-A). Materials A randomized controlled trial (NCT03708991) was conducted in a private fertility center. Thirty couples with non-male factor infertility were recruited between November 2018 and April 2019. A total of 568 sibling cumulus oocyte complexes were randomly inseminated with conventional IVF and ICSI and cultured in an Embryoscope time-lapse system. The morphokinetic behaviour of IVF/ICSI sibling oocytes was analysed as primary endpoint. As secondary endpoints, morphokinetic parameters that predict blastocysts that will be biopsied, the day of biopsy, gender and euploid outcome was assessed. Results When comparing IVF to ICSI, only the time to reach the 2-cell stage (t2) was significantly delayed for IVF embryos: OR: 1.282 [1.020–1.612], p = 0.033. After standardizing for tPNf (ct parameters), only Blast(tStartBlastulation-t2) remained significant: OR: 0.803 [0.648–0.994], p = 0.044. For the analysis of zygotes that will be biopsied on day 5/6 versus zygotes without biopsy, only early morphokinetic parameters were considered. All parameters were different in the multivariate model: ct2: OR: 0.840 [0.709–0.996], p = 0.045; ct6: OR: 0.943 [0.890–0.998], p = 0.043; cc2(t3-t2): OR: 1.148 [1.044–1.263], p = 0.004; cc3(t5-t3): OR: 1.177 [1.107–1.251], p<0.0001. When comparing the development between blastocysts biopsied on day 5 versus day 6, only three morphokinetic parameters were significant: cc2(t3-t2): OR: 1.394 [1.010–1.926], p = 0.044; ctBlastocyst: OR: 0.613 [0.489–0.768], p<0.0001 and ctExpandedBlastocyst: OR: 0.913 [0.868–0.960], p = 0.0004. Multivariate analysis of gender and ploidy did not reveal differences in morphokinetic behaviour. Conclusion Minor morphokinetic differences are observed between IVF and ICSI. Early in the development, distinct cleavage patterns are observed between embryos that will be biopsied or not.

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“…However, the high-quality blastocyst rate of D6 group is significantly higher than that of the overnight group, indicating that the embryos in the early degranulation group have more potential for continued development. However, the formation rate of D6 high-quality blastocysts is lower in both groups, and the euploidy rate and transfer success rate of D5 blastocysts are higher than those of D6 blastocysts, and the blastocysts formed by D5 are paid more attention [ 29 ]. At present, it is believed that the metabolites of sperm and granulosa cells in the fertilized fluid are not conducive to embryonic development, and the fertilized fluid should be transferred as soon as possible [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

Effect Analysis of Degranulated Cell in Early Fertilization on FET Outcome and Offspring Safety with Data Mining

Zhao

Li-ling

et al. 2022

Computational and Mathematical Methods in Medicine

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In vitro fertilization and embryo transfer is one type of assisted reproductive technology, although the technology is now more mature. Many factors, however, will have an impact on oocyte fertilization, embryo growth, pregnancy outcome, and child safety due to the journey from clinical to the laboratory. The influence of degranulated cells early in fertilization on frozen embryo transfer (FET) results is investigated in this study. This article analyzes 255 patients who underwent in vitro fertilization (IVF) and FET transplantation at the author’s central unit from January 1, 2015, to June 30, 2021. Among them, IVF-assisted conception is the early degranulation of homologous oocyte fertilization. Correlation analysis is performed by observing the embryonic outcome of the early degranulation group and the overnight fertilization group and the clinical outcome after FET. Through data mining analysis, the results show that the polyfertilization rate and 0PN rate for the early degranulation group are significantly higher than the overnight fertilization group (9.87% vs. 8.24% and 3.14% vs. 1.69%). In terms of normal fertilization rate, there is no significant difference between D3 high-quality embryo rate and D5 high-quality blastocyst rate (64.07% vs. 65.15%, 27.5% vs. 26.5%, and 15.97% vs. 17.35%). There is no significant difference in the complete recovery rate of embryos after thawing (93.24% vs. 93.46%), and the implantation rate, clinical pregnancy rate, abortion rate, and live birth rate are not significantly different between the two groups after FET. The offspring outcomes of singletons do not differ significantly between the two groups; however, twins born early degranulate have much greater rates of ultralow birth weight and ultrapreterm children than twins born overnight fertilization (14.29% vs. 0). Therefore, it can be concluded that degranulation of cells early in fertilization is a desirable method to prevent fertilization disorders. However, under the premise of ensuring that no fertilization disorder occurs, it is not appropriate to degranulate all the oocytes of the patient at the early stage of fertilization.

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Pregnancy outcomes after day 5 versus day 6 blastocyst‐stage embryo transfer: A systematic review and meta‐analysis

Cited by 20 publications

References 40 publications

Day 5 vitrified blastocyst transfer versus day 6 vitrified blastocyst transfer in oocyte donation program

Day 5 vitrified blastocyst transfer versus day 6 vitrified blastocyst transfer in oocyte donation program

Marginal differences in preimplantation morphokinetics between conventional IVF and ICSI in patients with preimplantation genetic testing for aneuploidy (PGT-A): A sibling oocyte study

Effect Analysis of Degranulated Cell in Early Fertilization on FET Outcome and Offspring Safety with Data Mining

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