Pregnancy Outcomes of Single/Double Blastocysts and Cleavage Embryo Transfers: a Retrospective Cohort Study of 24,422 Fr
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REPRODUCTIVE ENDOCRINOLOGY: ORIGINAL ARTICLE
Pregnancy Outcomes of Single/Double Blastocysts and Cleavage Embryo Transfers: a Retrospective Cohort Study of 24,422 Frozen-Thawed Cycles Xiaoyu Long 1,2 & Yuanyuan Wang 1,2 & Fangrong Wu 3 & Rong Li 1,2 & Lixue Chen 1,2 & Weiping Qian 3 & Jie Qiao 1,2 Received: 13 March 2020 / Revised: 1 June 2020 / Accepted: 30 June 2020 # The Author(s) 2020
Abstract This study aims to evaluate the effect of blastocyst- and cleavage-stage embryo transfers with different numbers of transferred embryos on pregnancy outcomes in China. This was a retrospective cohort study that collected 24,422 frozen-thawed embryo transfer (FET) cycles in two affiliated hospitals of Peking University Health Science Center between January 2015 and May 2018. They were divided into four groups: the single cleavage-stage embryo transfer group (C-1) (763 cycles), double cleavage-stage embryo transfer group (C-2) (13,004 cycles), single blastocyst-stage embryo transfer group (B-1) (7913 cycles), and double blastocyst-stage embryo transfer group (B-2) (2046 cycles). Of the four groups, the live birth rate was the lowest in the C-1 group (11.8%) while it was the highest in the B-2 group (33.6%). However, the B-2 group was accompanied with higher risks of miscarriages, maternal complications, twin births, preterm births, and low birth weight. Compared with the C-2 group, the B-1 group had a lower live birth rate (23.0 vs 29.0%; aOR, 0.78; 95% CI, 0.72–0.85), but also had a lower risk for twin births (1.9 vs 23.4%; aOR, 0.06; 95% CI, 0.04–0.09) and preterm births (9.6 vs 16.1%; aOR, 0.51; 95% CI, 0.41–0.65). The probability of live birth in the B-1 group declined from 0.25 at 20–29 years old to 0.08 at > 40 years old, while the probabilities of adverse outcomes went up with maternal age. It can be concluded that single-blastocyst embryo transfer seems to be the best choice for all maternal ages. This group of embryo transfer has significantly reduced adverse neonatal outcomes. Especially, women with younger maternal age in this group appear to prominently benefit from single-blastocyst transfer. Keywords Transfer strategy . Double-cleavage embryo transfer . Single-blastocyst embryo transfer
Introduction Xiaoyu Long and Yuanyuan Wang contributed equally to this work. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s43032-020-00247-x) contains supplementary material, which is available to authorized users. * Weiping Qian [email protected] * Jie Qiao [email protected] 1
Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, No.49 North Huayuan Road, Haidian District, Beijing 100191, China
2
National Clinical Research Center for Obstetrics and Gynecology, Beijing 100191, China
3
Department of Reproductive Medicine, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
It has been over 40 years since the development of assisted reproductive technology. With improvements such as ovulation induction,
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