Improving the clinical outcomes by extended culture of day 3 embryos with low blastomere number to blastocyst stage foll
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GYNECOLOGIC ENDOCRINOLOGY AND REPRODUCTIVE MEDICINE
Improving the clinical outcomes by extended culture of day 3 embryos with low blastomere number to blastocyst stage following frozen–thawed embryo transfer Bo Li1 · Jianlei Huang1 · Li Li1 · Xiao He1 · Ming Wang1 · Hengde Zhang1 · Yuping He1 · Bin Kang1 · Yongqian Shi1 · Shuqiang Chen1 · Xiaohong Wang1 Received: 21 April 2020 / Accepted: 26 August 2020 © The Author(s) 2020
Abstract Purpose This study aimed to investigate whether the extended culture of day 3 (D3) embryos with low blastomere number to blastocyst following frozen–thawed embryo transfer improved the clinical outcomes. Methods This was a retrospective study of clinical data of women undergoing in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) cycles in the Tangdu Hospital. The patients were divided into groups with 4–5, 6, 7–9 and > 9 cells based on the blastomere number of D3 embryos. The clinical outcomes were compared. Results In fresh transfer cycles, the implantation and clinical pregnancy rates significantly decreased, while the abortion rate significantly increased in the groups with 4–5 and 6 cells compared with those with 7–9 and > 9 cells. In frozen–thawed transfer cycles, the clinical pregnancy and implantation rates for a single blastocyst transfer cycle showed no significant differences in the groups with 4–5 and 6 cells compared with those with 7–9 and > 9 cells. However, the abortion rate was significantly higher in the group with 4–5 cells than in that with 7–9 and > 9 cells. In the double blastocyst transfer cycle, the clinical pregnancy rate showed no significant differences among the groups with 4–5, 6, and 7–9 cells. Conclusion The implantation and clinical pregnancy rates of D3 embryos with 6 cells significantly decreased; these embryos were not considered as high-quality embryos. Extended culture of D3 embryos with ≤ 6 blastomeres to blastocysts, particularly 6-cell embryos, resulted in a similar clinical pregnancy rate as that of blastocysts derived from D3 embryos with ≥ 7 blastomeres. Keywords Retarded embryos · Blastocyst culture · Implantation rate · Clinical pregnancy rate · Abortion rate
Introduction Embryos obtained from assisted reproductive technology (ART) are transferred into a woman’s uterus on day 3 after egg collection (D3). For achieving satisfactory pregnancy outcomes, embryos are usually graded according to the standardized scoring criteria for transfer. Currently, the Bo Li and Jianlei Huang contributed equally to this work. * Xiaohong Wang [email protected] Shuqiang Chen [email protected] 1
Department of Obstetrics and Gynecology, Tangdu Hospital, The Air Force Military Medical University, Xi’an 710038, China
criteria for evaluating embryo quality mainly depend on the number of blastomeres, degree of fragmentation, evenness of blastomeres, and other morphological indicators [1]. The number of blastomeres on D3 represents the cleavage rate of embryos and is regarded as the most critical indicator for predicting the develo
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