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Pregnancy rates for single embryo transfer (SET) of day 5 and day 6 blastocysts after cryopreservation by vitrification and slow freeze

  • Assisted Reproduction Technologies
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Abstract

Purpose

The purpose of this study was to compare clinical and ongoing pregnancy rates in cycles with single embryo transfer (SET) of blastocysts cryopreserved on day 5 or day 6. Our aim was to determine whether day 6 blastocysts perform adequately to recommend SET.

Methods

Retrospective cohort study including 468 transfer cycles for 392 women younger than age 38 undergoing SET at a university-affiliated IVF clinic in the USA. A total of 261 day 5 blastocysts and 207 day 6 blastocysts for frozen-thawed SET between 2010 and 2016 were analyzed. Data included cryopreservation by both a slow freeze method and vitrification.

Results

In total, 59.0% of day 5 SET cycles resulted in a clinical pregnancy compared to 54.1% of day 6 blastocysts (p = 0.54). Ongoing pregnancy rates from day 5 frozen-thawed blastocysts (51.7%) were comparable to day 6 (44.9%, p = 0.14). When looking at vitrified blastocysts only, there were no significant differences between day 5 and day 6 blastocysts, with a clinical pregnancy rate of 69.2% for day 5 and 72.5% for day 6 (p = 0.68).

Conclusions

SETs of day 6 cryopreserved blastocysts resulted in similar clinical and ongoing pregnancy rates compared to day 5, particularly after vitrification.

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References

  1. Practice Committee of American Society for Reproductive Medicine S, Practice Committee of Society for Assisted Reproductive Technology J, Flowers L, Kulkarni A, Sentelle G, Jeng G, et al. Criteria for number of embryos to transfer: a committee opinion. Fertil Steril. 2013;99(1):44–6.

    Article  Google Scholar 

  2. Gardner DK, Surrey E, Minjarez D, Leitz A, Stevens J, Schoolcraft WB. Single blastocyst transfer: a prospective randomized trial. Fertil Steril. 2004;81(3):551–5.

    Article  CAS  PubMed  Google Scholar 

  3. Thurin A, Hausken J, Hillensjo T, Jablonowska B, Pinborg A, Strandell A, et al. Elective single-embryo transfer versus double-embryo transfer in in vitro fertilization. N Engl J Med. 2004;351(23):2392–402.

    Article  CAS  PubMed  Google Scholar 

  4. Gelbaya TA, Tsoumpou I, Nardo LG. The likelihood of live birth and multiple birth after single versus double embryo transfer at the cleavage stage: a systematic review and meta-analysis. Fertil Steril. 2010;94(3):936–45.

    Article  PubMed  Google Scholar 

  5. Roy TK, Bradley CK, Bowman MC, McArthur SJ. Single-embryo transfer of vitrified-warmed blastocysts yields equivalent live-birth rates and improved neonatal outcomes compared with fresh transfers. Fertil Steril. 2014;101(5):1294–301.

    Article  PubMed  Google Scholar 

  6. McLernon DJ, Harrild K, Bergh C, Davies MJ, de Neubourg D, Dumoulin JC, et al. Clinical effectiveness of elective single versus double embryo transfer: meta-analysis of individual patient data from randomised trials. BMJ. 2010;341:c6945.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Gardner DK, Lane M, Stevens J, Schlenker T, Schoolcraft WB. Blastocyst score affects implantation and pregnancy outcome: towards a single blastocyst transfer. Fertil Steril. 2000;73(6):1155–8.

    Article  CAS  PubMed  Google Scholar 

  8. Shapiro BS, Daneshmand ST, Garner FC, Aguirre M, Ross R. Contrasting patterns in in vitro fertilization pregnancy rates among fresh autologous, fresh oocyte donor, and cryopreserved cycles with the use of day 5 or day 6 blastocysts may reflect differences in embryo-endometrium synchrony. Fertil Steril. 2008;89(1):20–6.

    Article  PubMed  Google Scholar 

  9. Behr B, Gebhardt J, Lyon J, Milki AA. Factors relating to a successful cryopreserved blastocyst transfer program. Fertil Steril. 2002;77(4):697–9.

    Article  PubMed  Google Scholar 

  10. Mukaida T, Nakamura S, Tomiyama T, Wada S, Oka C, Kasai M, et al. Vitrification of human blastocysts using cryoloops: clinical outcome of 223 cycles. Hum Reprod. 2003;18(2):384–91.

    Article  CAS  PubMed  Google Scholar 

  11. Hiraoka K, Hiraoka K, Kinutani M, Kinutani K. Blastocoele collapse by micropipetting prior to vitrification gives excellent survival and pregnancy outcomes for human day 5 and 6 expanded blastocysts. Hum Reprod [Internet]. 2004;19(12):2884–8.

    Article  Google Scholar 

  12. Hiraoka K, Hiraoka K, Miyazaki M, Fukunaga E, Horiuchi T, Kusuda T, et al. Perinatal outcomes of vitrified human day-5, day-6 and day-7 blastocyst transfer. J Exp Clin Assist Reprod. 2009;6:4.

  13. Liebermann J, Tucker MJ. Comparison of vitrification and conventional cryopreservation of day 5 and day 6 blastocysts during clinical application. Fertil Steril. 2006;86(1):20–6.

    Article  PubMed  Google Scholar 

  14. El-Toukhy T, Wharf E, Walavalkar R, Singh A, Bolton V, Khalaf Y, et al. Delayed blastocyst development does not influence the outcome of frozen-thawed transfer cycles. BJOG. 2011;118(13):1551–6.

  15. Yang H, Yang Q, Dai S, Li G, Jin H, Yao G, et al. Comparison of differences in development potentials between frozen-thawed D5 and D6 blastocysts and their relationship with pregnancy outcomes. J Assist Reprod Genet. 2016;33(7):865–72.

    Article  PubMed  Google Scholar 

  16. Kovalevsky G, Carney SM, Morrison LS, Boylan CF, Neithardt AB, Feinberg RF. Should embryos developing to blastocysts on day 7 be cryopreserved and transferred: an analysis of pregnancy and implantation rates. Fertil Steril. 2013;100(4):1008–12.

    Article  PubMed  Google Scholar 

  17. Marek D, Langley M, McKean C, Weiand L, Doody KM, Doody KJ. Frozen embryo transfer (FET) of day 5 blastocyst embryos compared to transfer of day 6 blastocyst embryos. Fertil Steril. 2000;74(3):S52–3.

    Article  Google Scholar 

  18. Levens ED, Whitcomb BW, Hennessy S, James AN, Yauger BJ, Larsen FW. Blastocyst development rate impacts outcome in cryopreserved blastocyst transfer cycles. Fertil Steril. 2008;90(6):2138–43.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Sunkara SK, Siozos A, Bolton VN, Khalaf Y, Braude PR, El-Toukhy T. The influence of delayed blastocyst formation on the outcome of frozen-thawed blastocyst transfer: a systematic review and meta-analysis. Hum Reprod. 2010;25(8):1906–15.

    Article  PubMed  Google Scholar 

  20. Richter KS, Ginsburg DK, Shipley SK, Lim J, Tucker MJ, Graham JR, et al. Factors associated with birth outcomes from cryopreserved blastocysts: experience from 4,597 autologous transfers of 7,597 cryopreserved blastocysts. Fertil Steril. 2016;106(2):354–362.e2.

  21. Desai N, Ploskonka S, Goodman L, Attaran M, Goldberg JM, Austin C, et al. Delayed blastulation, multinucleation, and expansion grade are independently associated with live-birth rates in frozen blastocyst transfer cycles. Fertil Steril 2016;106(6):1370–8.

  22. Haas J, Meriano J, Laskin C, Bentov Y, Barzilay E, Casper RF, et al. Clinical pregnancy rate following frozen embryo transfer is higher with blastocysts vitrified on day 5 than on day 6. J Assist Reprod Genet. 2016;33(12):1553–7.

    Article  PubMed  Google Scholar 

  23. Kang SM, Lee SW, Yoon SH, Kim JC, Lim JH, Lee SG. Comparison of clinical outcomes between single and double vitrified-warmed blastocyst embryo transfer according to the day of vitrification. J Assist Reprod Genet. 2013;30(6):779–85.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Engmann L, DiLuigi A, Schmidt D, Nulsen J, Maier D, Benadiva C. The use of gonadotropin-releasing hormone (GnRH) agonist to induce oocyte maturation after cotreatment with GnRH antagonist in high-risk patients undergoing in vitro fertilization prevents the risk of ovarian hyperstimulation syndrome: a prospective randomized controlled study. Fertil Steril. 2008;89(1):84–91.

    Article  CAS  PubMed  Google Scholar 

  25. Gardner DK, Schoolcraft WB. Culture and transfer of human blastocysts. Curr Opin Obs Gynecol. 1999;11(3):307–11.

    Article  CAS  Google Scholar 

  26. Berin I, Engmann LL, Benadiva CA, Schmidt DW, Nulsen JC, Maier DB. Transfer of two versus three embryos in women less than 40 years old undergoing frozen transfer cycles. Fertil Steril. 2010;93(2):355–9.

    Article  CAS  PubMed  Google Scholar 

  27. Criteria for number of embryos to transfer: a committee opinion. Fertil Steril 2013;99(1):44–6.

  28. 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 single-blastocyst transfer cycle in vitro fertilization. Fertil Steril. 2012;98(2):361–7.

    Article  PubMed  Google Scholar 

  29. 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(3):948–52.

    Article  PubMed  Google Scholar 

  30. Van Landuyt L, Stoop D, Verheyen G, Verpoest W, Camus M, Van de Velde H, et al. Outcome of closed blastocyst vitrification in relation to blastocyst quality: evaluation of 759 warming cycles in a single-embryo transfer policy. Hum Reprod. 2011;26(3):527–34.

    Article  CAS  PubMed  Google Scholar 

  31. Capalbo A, Rienzi L, Cimadomo D, Maggiulli R, Elliott T, Wright G, et al. Correlation between standard blastocyst morphology, euploidy and implantation: an observational study in two centers involving 956 screened blastocysts. Hum Reprod. 2014;29(6):1173–81.

    Article  PubMed  Google Scholar 

  32. 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(2):106–11.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Alfarawati S, Fragouli E, Colls P, Stevens J, Gutierrez-Mateo C, Schoolcraft WB, et al. The relationship between blastocyst morphology, chromosomal abnormality, and embryo gender. Fertil Steril. 2011;95(2):520–4.

    Article  PubMed  Google Scholar 

  34. Kroener L, Ambartsumyan G, Briton-Jones C, Dumesic D, Surrey M, Munne S, et al. The effect of timing of embryonic progression on chromosomal abnormality. Fertil Steril. 2012;98(4):876–80.

    Article  PubMed  Google Scholar 

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Acknowledgments

We would like to acknowledge our research coordinator Evelyn Neuber for her assistance.

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Authors and Affiliations

  1. Center for Advanced Reproductive Services, Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Connecticut Health Center, 2 Batterson Park Road, Farmington, CT, 06032-6224, USA

    Leah Kaye, Erica Anspach Will, Alison Bartolucci, John Nulsen, Claudio Benadiva & Lawrence Engmann

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  1. Leah Kaye
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  2. Erica Anspach Will
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Correspondence to Lawrence Engmann.

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The authors declare that they have no conflict of interest.

Human and animal rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

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Kaye, L., Will, E.A., Bartolucci, A. et al. Pregnancy rates for single embryo transfer (SET) of day 5 and day 6 blastocysts after cryopreservation by vitrification and slow freeze. J Assist Reprod Genet 34, 913–919 (2017). https://doi.org/10.1007/s10815-017-0940-4

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  • DOI: https://doi.org/10.1007/s10815-017-0940-4

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