- Volume 47 Issue 2
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Associations of post-warming embryo or blastocyst development with clinical pregnancy in vitrified embryo or blastocyst transfer cycles
- Hong, Yeon Hee (Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital) ;
- Lee, Jang Mi (Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital) ;
- Kim, Seul Ki (Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital) ;
- Youm, Hye Won (Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital) ;
- Jee, Byung Chul (Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital)
- Received : 2019.09.09
- Accepted : 2019.12.05
- Published : 2020.06.30
Objective: To investigate whether the degree of post-warming embryo or blastocyst development is associated with clinical pregnancy in vitrified embryo or blastocyst transfer cycles. Methods: Ninety-six vitrified cleavage-stage embryos and 58 vitrified blastocyst transfer cycles were selected. All transfer cycles were performed from February 2011 to March 2019, and all vitrified embryos or blastocysts were warmed from 4 PM to 6 PM and then transferred the next morning from 9 AM to 10 AM. The scores of the cleavage-stage embryos and blastocysts were assessed at warming and at transfer using the modified Steer method and the Gardner method, respectively. The mean embryo or blastocyst score, score of the single top-quality embryo or blastocyst, and the difference in the score between warming and transfer were compared between nonpregnant and pregnant women. Results: In the cleavage-stage embryo transfer cycles, both the top-quality embryo score at transfer and the difference in the score between warming and transfer were significantly associated with clinical pregnancy. A top-quality embryo score at transfer of ≥ 60.0 (area under the curve [AUC], 0.673; 95% confidence interval [CI], 0.531-0.815) and a difference in the score between warming and transfer of ≥ 23.0 (AUC, 0.675; 95% CI, 0.514-0.835) were significant predictors of clinical pregnancy. In blastocyst transfer cycles, the top-quality blastocyst score at transfer was the only significant factor associated with clinical pregnancy. A top-quality blastocyst score at transfer of ≥ 38.3 was a significant predictor of clinical pregnancy (AUC, 0.666; 95% CI, 0.525-0.807). Conclusion: The top-quality embryo score at transfer and the degree of post-warming embryo development were associated with clinical pregnancy in vitrified cleavage-stage embryo transfer cycles. In vitrified blastocyst transfer cycles, the top-quality blastocyst score at transfer was the only significant factor affecting clinical pregnancy.
- Gerris J, De Neubourg D, De Sutter P, Van Royen E, Mangelschots K, Vercruyssen M. Cryopreservation as a tool to reduce multiple birth. Reprod Biomed Online 2003;7:286-94.
- Pandian Z, Templeton A, Serour G, Bhattacharya S. Number of embryos for transfer after IVF and ICSI: a Cochrane Review. Hum Reprod 2005;20:2681-7.
- Wong KM, Mastenbroek S, Repping S. Cryopreservation of human embryos and its contribution to in vitro fertilization success rates. Fertil Steril 2014;102:19-26.
- Ghobara T, Gelbaya TA, Ayeleke RO. Cycle regimens for frozenthawed embryo transfer. Cochrane Database Syst Rev 2017;7:CD003414.
- Wang JX, Yap YY, Matthews CD. Frozen-thawed embryo transfer: influence of clinical factors on implantation rate and risk of multiple conception. Hum Reprod 2001;16:2316-9.
- Salumets A, Suikkari AM, Makinen S, Karro H, Roos A, Tuuri T. Frozen embryo transfers: implications of clinical and embryological factors on the pregnancy outcome. Hum Reprod 2006;21:2368-74.
- Goto S, Kadowaki T, Tanaka S, Hashimoto H, Kokeguchi S, Shiotani M. Prediction of pregnancy rate by blastocyst morphological score and age, based on 1,488 single frozen-thawed blastocyst transfer cycles. Fertil Steril 2011;95:948-52.
- Honnma H, Baba T, Sasaki M, Hashiba Y, Ohno H, Fukunaga T, et al. Trophectoderm morphology significantly affects the rates of ongoing pregnancy and miscarriage in frozen-thawed singleblastocyst transfer cycle in vitro fertilization. Fertil Steril 2012;98:361-7.
- Zhang H, Zhou Y, Li Y, Zheng Y, Xiao S, Wu Y, et al. Prediction of clinical pregnancy in vitrified-warmed single blastocyst transfer cycles by pre-freeze morphology. Iran J Reprod Med 2014;12:567-72.
- Irani M, Reichman D, Robles A, Melnick A, Davis O, Zaninovic N, et al. Morphologic grading of euploid blastocysts influences implantation and ongoing pregnancy rates. Fertil Steril 2017;107:664-70.
- Hur YS, Ryu EK, Song SH, Yoon SH, Lim KS, Lee WD, et al. A retrospective study of single frozen-thawed blastocyst transfer. Clin Exp Reprod Med 2016;43:106-11.
- Van der Elst J, Van den Abbeel E, Vitrier S, Camus M, Devroey P, Van Steirteghem AC. Selective transfer of cryopreserved human embryos with further cleavage after thawing increases delivery and implantation rates. Hum Reprod 1997;12:1513-21.
- Ziebe S, Bech B, Petersen K, Mikkelsen AL, Gabrielsen A, Andersen AN. Resumption of mitosis during post-thaw culture: a key parameter in selecting the right embryos for transfer. Hum Reprod 1998;13:178-81.
- Van Landuyt L, Van de Velde H, De Vos A, Haentjens P, Blockeel C, Tournaye H, et al. Influence of cell loss after vitrification or slowfreezing on further in vitro development and implantation of human day 3 embryos. Hum Reprod 2013;28:2943-9.
- Fernandez Gallardo E, Spiessens C, D'Hooghe T, Debrock S. Effect of embryo morphology and morphometrics on implantation of vitrified day 3 embryos after warming: a retrospective cohort study. Reprod Biol Endocrinol 2016;14:40.
- Ahlstrom A, Westin C, Wikland M, Hardarson T. Prediction of live birth in frozen-thawed single blastocyst transfer cycles by prefreeze and post-thaw morphology. Hum Reprod 2013;28:1199-209.
- Shin JJ, Jeong Y, Nho E, Jee BC. Clinical outcomes of frozen embryo transfer cycles after freeze-all policy to prevent ovarian hyperstimulation syndrome. Obstet Gynecol Sci 2018;61:497-504.
- Steer CV, Mills CL, Tan SL, Campbell S, Edwards RG. The cumulative embryo score: a predictive embryo scoring technique to select the optimal number of embryos to transfer in an in-vitro fertilization and embryo transfer programme. Hum Reprod 1992;7:117-9.
- Schoolcraft WB, Gardner DK, Lane M, Schlenker T, Hamilton F, Meldrum DR. Blastocyst culture and transfer: analysis of results and parameters affecting outcome in two in vitro fertilization programs. Fertil Steril 1999;72:604-9.