The Association Between Embryo Quality, Number of Transferred Embryos and Live Birth Rate After Vitrified Cleavage-Stage Embryos and Blastocyst Transfer

Zhu, Qianqian; Lin, Jiaying; Gao, Haoyuan; Wang, Ningling; Wang, Bian; Wang, Yun

doi:10.3389/fphys.2020.00930

Cited by 24 publications

(27 citation statements)

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“…Since AMH is positively correlated with the number of highquality embryos, for patients with low AMH values, the clinicians should be optimistic about the assessment of their existing ovarian function and the possible number of high-quality embryos in IVF/ICSI. Embryo quality is an important guideline for successful implantation and live birth during the embryo transfer cycle [35]; it is also a new factor in uencing the adverse outcome of newborn [36]. Poor embryo quality is associated with an increased risk of miscarriage, ectopic pregnancy, and low birth weight [37].…”

Section: Discussionmentioning

confidence: 99%

Investigating the correlation between AMH and the number of high-quality embryos from IVF/ICSI in 30-44 year-old infertile women

chen

et al. 2022

Preprint

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Background To explore the effect of anti-Müllerian hormone (AMH) on embryonic development by studying the relationship between serum AMH concentration and the high-quality embryo number during the first cycle of in vitro fertilization (IVF) /intracytoplasmic sperm injection (ICSI) in 30-44 year-old infertile women.Methods A retrospective cohort study of 335 cycles was conducted. The study population was the patients who received the first IVF/ICSI cycle at the Reproductive Medicine Center of * * * * * * from January 2019 to December 2020. The basic characteristics, clinical medication and cycle outcome of patients were collected, and the correlation between AMH and the number of high-quality embryos was analyzed.Results After adjusted for confounding factors (female age, AFC and COH protocol), sensitivity analysis showed that high-quality embryo number in high AMH group increases by 2.2 units for each additional unit of AMH (≥8.5 ng/mL) (95%CI: (0.8, 3.7), P=0.003). The two-piecewise regression model identified the inflection point as AMH=7.1 ng/mL, and the effect size, 95% CI and P value on both sides of the inflection point were 0.5(0.3, 0.7), <0.001 and 0.1(-0.1, 0.2), 0.518, respectively. The results of stratified analysis and interaction test showed that the relationship between AMH and the high-quality embryo number was stable among different subgroups (P>0.05).Conclusion When AMH<7.1ng/mL, there is a positive correlation between AMH and the number of high-quality embryos in this study population. Therefore, the effect of age-related ovarian reserve biomarker AMH on reproductive prognosis can provide reference for ART clinical treatment.Plain English summary Diminished ovarian reserve (DOR) refers to a decrease in the number and/or quality of oocytes in the ovary, accompanied by a decrease in anti-Müllerian hormone (AMH) levels, a decrease in antral follicle count (AFC) and an increase in follicle stimulating hormone (FSH) levels. The most common clinical symptoms are shortened menstrual cycle and decreased menstrual flow. Most patients go to the hospital after long-term unsuccessful attempts to conceive, so delays in diagnosis are common. Assisted reproductive technology (ART) is the main means of achieving pregnancy in patients with DOR. With the improvement and adjustment of the ovulation induction program and the innovation of laboratory technology, the clinical pregnancy rate of ART has increased. However, DOR patients have poor ovarian response to gonadotropins (Gn), manifested as less follicle development, low blood estrogen levels, high Gn dosage, lower-than-expected oocyte retrieval, high cycle cancellation rate, and low clinical pregnancy rate in ovarian stimulation cycles. Therefore, this type of patients is a difficult point in the field of assisted reproduction. In the present study, elevated AMH was associated with an increased number of high-quality embryos in individuals aged 30-44 years at high risk for DOR. AMH can assess the potential reproductive prognosis of such patients and provide valuable data for clinical treatment of such patients.

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Section: Discussionmentioning

confidence: 99%

Investigating the correlation between AMH and the number of high-quality embryos from IVF/ICSI in 30-44 year-old infertile women

chen

et al. 2022

Preprint

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“…The longest duration of cryopreservation in this study was over four years, and our results mainly reflect the possible impact of short- to medium-term embryos cryopreservation on FET outcomes. Furthermore, maternal age at OPU, the stage, number, and quality of embryos transferred have been documented to be related to FET outcomes ( 31 , 47 ). This study provides a comprehensive stratification analysis based on these factors for the first time, and hence further explores the impact of cryopreservation duration on reproductive outcomes in different subpopulations.…”

Section: Discussionmentioning

confidence: 99%

Prolonged Cryopreservation Negatively Affects Embryo Transfer Outcomes Following the Elective Freeze-All Strategy: A Multicenter Retrospective Study

Zhang

Hao

et al. 2021

Front. Endocrinol.

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BackgroundWith the development of embryo freezing and warming technology, frozen-thawed embryo transfer (FET) has been widely utilized. However, studies investigating the association between cryopreservation duration and FET outcomes are limited and controversial, and previous studies did not conduct stratification analyses based on demographic or clinical characteristics.MethodsThis multicenter retrospective study included 17,826 women who underwent their first FET following the freeze-all strategy during the period from January 2014 to December 2018. Duration of cryopreservation was categorized into five groups: 3–8 weeks, 8–12 weeks, 12–26 weeks, 26–52 weeks, and >52 weeks. Modified Poisson regression and multivariate logistic regression were used to assess the association between cryostorage time of vitrified embryos and transfer outcomes. Moreover, further stratification analyses were performed according to variables with p <0.05 in multivariate models.ResultsIn this large multicenter study, we observed that storage duration was inversely associated with the possibility of pregnancy and live birth (p <0.001), but not with the risk of ectopic pregnancy and miscarriage. Stratification analyses based on maternal age, the number of oocytes retrieved, and condition of embryo transferred indicated that the inverse correlation was significant in the subpopulation with characteristics: (1) less than 40 years old, (2) more than 3 oocytes retrieved, and (3) only high-quality blastocysts transferred.ConclusionThe results of this large, multicenter, retrospective study suggested that prolonged cryopreservation was inversely associated with the probability of pregnancy and live birth. Therefore, for patients who adopt a freeze-all strategy, early FET might achieve a better outcome.

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“…With the development of in vitro culture technology, elective single blastocyst transfer has become a tendency, and this practice has led to a remarkable increase in LBR and decrease in MPR. 18,19 However, the failure to form blastocysts in patients with few day 3 cleavage stage embryos would lead to an increase in cycle cancelation. Therefore, a cleavage transfer policy is still adopted in most centers, as this practice can be used for a wider range of infertility patients.…”

Section: Discussionmentioning

confidence: 99%

The effects of different post-thawed culture periods on clinical outcomes in frozen embryo transfer cycle: a retrospective study

Li¹,

Cai²,

Ma³

et al. 2021

Preprint

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Objective To evaluate the effects of different post-thawed culture periods on the clinical outcomes Design A retrospective study. Setting Two IVF centers. Population Women undergoing first cleavage-stage embryo transfer in frozen-thawed cycles. Methods 9832 FET cycles were divided into three groups according to female age: < 35, 35-39 and > 39 years, and two groups depending on post-thawed culture period: short and long culture groups. The long culture group divided into three groups depending on blastomere growth number: ≤ 2, one ≤ 2 and the other > 2, and > 2 groups. Main Outcome Measures Implantation rate (IR), clinical pregnancy rate (CPR), multiple pregnancy rate (MPR), live birth rate (LBR) and neonatal characteristics. Results Long post-thawed culture caused a significant increase in the IR, CPR, MPR and LBR (P/CI = 0.002/1.034-1.162, 0.027/1.011-1.194, 0.028/1.014-1.255 and 0.001/1.054-1.245 respectively), and blastomere growth number had a significant effect on IR, CPR, MPR and LBR (P = 0.000, 0.000, 0.000 and 0.000 respectively). No significant differences were present in neonatal characteristics between the two post-thawed culture groups. Singleton group had a higher average gestational age and birthweight as well as a lower cesarean section rate, preterm labor rate and low birthweight rate. Conclusions Long post-thawed culture was associated with higher IR, CPR, MPR and LBR, and transferring a well-developed embryo after long post-thawed culture might be a viable embryo transfer strategy to decrease MPR while maintaining CPR and LBR. Funding None Keywords Post-thawed culture, blastomere growth, neonatal characteristics, live birth rate.

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The Association Between Embryo Quality, Number of Transferred Embryos and Live Birth Rate After Vitrified Cleavage-Stage Embryos and Blastocyst Transfer

Cited by 24 publications

References 24 publications

Investigating the correlation between AMH and the number of high-quality embryos from IVF/ICSI in 30-44 year-old infertile women

Investigating the correlation between AMH and the number of high-quality embryos from IVF/ICSI in 30-44 year-old infertile women

Prolonged Cryopreservation Negatively Affects Embryo Transfer Outcomes Following the Elective Freeze-All Strategy: A Multicenter Retrospective Study

The effects of different post-thawed culture periods on clinical outcomes in frozen embryo transfer cycle: a retrospective study

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