Clinical outcomes after transfer of blastocysts derived from frozen–thawed cleavage embryos: a retrospective propensity-matched cohort study
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To evaluate the clinical outcomes after fresh transfer of blastocysts cultured from vitrified–thawed cleavage embryos (VTCE) compared with conventional frozen–thawed blastocysts transfer (FBT), or with the usual fresh blastocysts transfer (FRBT).
A total of 155 cycles undergoing fresh transfer of VTCE blastocysts, 4904 cycles undergoing FBT, and 1014 cycles undergoing FRBT were retrospectively analyzed from August 2014 to July 2017. Pregnancy, delivery, and neonatal outcomes were compared after propensity score matching.
VTCE blastocysts’ transfer resulted in a lower risk of early miscarriage (8.82% versus 19.70%, P < 0.05) and a decreased fetal birth weight (2611.90 ± 618.65 g versus 2931.86 ± 546.52 g, P < 0.01) compared to FBT. No significant difference was found regarding live birth rate, gestational age, and cesarean section. Correspondingly, VTCE blastocysts’ transfer led to significantly compromised pregnancy outcomes regarding clinical pregnancy rate and implantation, and even a slightly compromised live birth rate when compared with FRBT. Moreover, a higher occurrence of cesarean Section (88.89% versus 71.29%, P < 0.05) and a shorter gestational age (262.04 ± 14.99 days versus 268.06 ± 14.07, P < 0.05) were also found. Nevertheless, the risk of small for gestational age and large for gestational age, and the neonatal birth weight were comparable.
VTCE blastocysts’ transfer results in a comprehensively moderate outcome, which is an acceptable option for patients. Our results can provide efficient value for patients’ counseling. Furthermore, these findings indicate directions for exploring the mechanisms of low birth weight and short gestational age.
KeywordsVitrified–thawed Extended culture Blastocyst transfer Obstetric outcome Neonatal outcome
FX: project development, data collection, manuscript writing. GGL and QS: data analysis, statistical support. SSW: methodology. CYW, PLC, ZHY and HXZ: manuscript editing. YZ: supervision and funding acquisition.
Funding has been received form Basic Research Program of Shenzhen with Grant no. (JCYJ20160427113153295), Sanming Project of Medicine in Shenzhen with Grant no. (SZSM201502035), National Natural Science Foundation of China with Grant no. (21807072) and clinical research special fund of Chinese Medical Association with Grant no. (18010120741).
Compliance with ethical standards
Conflict of interest
We declared that we have no conflict of interest.
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