Does the transfer of a poor quality embryo with a good quality embryo benefit poor prognosis patients?
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(2020) 18:97
RESEARCH
Open Access
Does the transfer of a poor quality embryo with a good quality embryo benefit poor prognosis patients? Wenjie Wang, Jiali Cai, Lanlan Liu, Yingpei Xu, Zhenfang Liu, Jinghua Chen, Xiaoming Jiang, Xiaohua Sun and Jianzhi Ren*
Abstract Background: While single embryo transfer (SET) is widely advocated, double embryo transfer (DET) remains preferable in clinical practice to improve IVF success rate, especially in poor prognosis patients with only poor quality embryos (PQEs) available in addition to one or no good quality embryos (GQEs). Furthermore, previous studies suggest PQE might adversely affect the implantation of a GQE when transferred together. This study aims to evaluate the effect of transferring an additional PQE with a GQE on the outcomes in poor prognosis patients. Methods: A total of 5037 frozen-thawed blastocyst transfer (FBT) cycles between January 2012 and May 2019 were included. Propensity score matching was applied to control for potential confounders, and we used generalized estimating equations (GEE) models to identify the association between the effect of an additional PQE and the outcomes. Results: Overall, transferring a PQE with GQE (Group GP) achieved significantly higher pregnancy rate (PR), live birth rate (LBR) and multiple pregnancy rate (MPR) than GQE only (group G). The addition of a PQE increased LBR in patients aged 35 and over and in patients who received over 3 cycles of embryo transfer (ET) (48.1% vs 27.2%, OR: 2.56, 95% CI: 1.3–5.03 and 46.6% vs 35.4%, OR:1.6, 95% CI: 1.09–2.35), but not in women under 35 and in women who received less than 3 cycles of ET (48.7% vs 43.9%, OR:1.22, 95% CI: 0.93–1.59 and 48.3% vs 41.4%, OR:1.33, 95% CI: 0.96–1.85). Group GP resulted in significantly higher MPR than group G irrespective of age and the number of previous IVF cycles. Conclusions: An additional PQE does not negatively affect the implantation potential of the co-transferred GQE. Nevertheless, the addition of a PQE contributes to both live birth and multiple birth in poor prognosis patients. Physicians should still balance the benefits and risks of DET. Keywords: Poor quality embryo, Good quality embryo, Single embryo transfer, Poor prognosis patients, Propensity score matching
* Correspondence: [email protected] Reproductive Medicine Center, Xiamen University Affiliated Chenggong Hospital, Wenyuan Road No.94, Siming District, Xiamen, Fujian 361001, People’s Republic of China © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in th
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