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Increased live births after day 5 versus day 6 transfers of vitrified-warmed blastocysts

  • Assisted Reproduction Technologies
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Abstract

Purpose

An investigation into the clinical implications of delayed blastulation (day 5 versus day 6) was carried out for cryo cycles, as heterogeneous results persist in the current literature.

Methods

We performed a retrospective study comparing clinical pregnancies and live births between 178 blastocysts vitrified and warmed on day 5 versus 149 on day 6. The stage of blastocyst development was taken into account and adjustment for confounding factors was performed.

Results

Our results demonstrate a significant difference in clinical pregnancy (43 versus 23% p value < 0.001) and live birth rates (34 versus 16% p value < 0.001) regarding the day of vitrification, in favour of day 5. This difference persisted after adjustment for confounding factors. The adjusted odds ratio for clinical pregnancies and deliveries for the day 5 group compared to that of the day 6 group was 2.83 (95%CI, 1.48 to 5.41) and 2.94 (95%CI, 1.39 to 6.22), respectively. When the stage of development of the blastocyst was taken into consideration, we still observed a significant advantage of day 5 versus day 6 vitrification.

Conclusions

Day of vitrification (day 5 versus day 6) appears to be an independent predictor of clinical outcomes. Stratification of our cohort was carried out according to the developmental stage, and significant differences persisted. Although the transfer of day 6 cryopreserved embryos remains a viable option, giving priority to a day 5 embryo would reduce the time to pregnancy.

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References

  1. Edgar DH, Gook DA. A critical appraisal of cryopreservation (slow cooling versus vitrification) of human oocytes and embryos. Hum Reprod Update. 2012;18(5):536–54.

    Article  PubMed  Google Scholar 

  2. Shaw JM, Jones GM. Terminology associated with vitrification and other cryopreservation procedures for oocytes and embryos. Hum Reprod Update. 2003;9(6):583–605.

    Article  CAS  PubMed  Google Scholar 

  3. Loutradi KE, Kolibianakis EM, Venetis CA, Papanikolaou EG, Pados G, Bontis I, et al. Cryopreservation of human embryos by vitrification or slow freezing: a systematic review and meta-analysis. Fertil Steril. 2008;90(1):186–93.

    Article  PubMed  Google Scholar 

  4. 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 

  5. Rienzi L, Gracia C, Maggiulli R, LaBarbera AR, Kaser DJ, Ubaldi FM, et al. Oocyte, embryo and blastocyst cryopreservation in ART: systematic review and meta-analysis comparing slow-freezing versus vitrification to produce evidence for the development of global guidance. Hum Reprod Update. 2016;23:139–55.

    PubMed Central  Google Scholar 

  6. Casper RF, Yanushpolsky EH. Optimal endometrial preparation for frozen embryo transfer cycles: window of implantation and progesterone support. Fertil Steril. 2016;105(4):867–72.

    Article  CAS  PubMed  Google Scholar 

  7. Hartshorne G. The embryo. Hum Reprod Oxf Engl. 2000;15(Suppl 4):31–41.

    Article  Google Scholar 

  8. Ubaldi FM, Capalbo A, Colamaria S, Ferrero S, Maggiulli R, Vajta G, et al. Reduction of multiple pregnancies in the advanced maternal age population after implementation of an elective single embryo transfer policy coupled with enhanced embryo selection: pre- and post-intervention study. Hum Reprod Oxf Engl. 2015;30(9):2097–106.

    Article  Google Scholar 

  9. 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 Oxf Engl. 2010;25(8):1906–15.

    Article  Google Scholar 

  10. 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  PubMed Central  Google Scholar 

  11. Hashimoto S, Amo A, Hama S, Ito K, Nakaoka Y, Morimoto Y. Growth retardation in human blastocysts increases the incidence of abnormal spindles and decreases implantation potential after vitrification. Hum Reprod Oxf Engl. 2013;28(6):1528–35.

    Article  Google Scholar 

  12. 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. https://doi.org/10.1016/j.fertnstert.2016.07.1095.

    Article  PubMed  Google Scholar 

  13. Delvigne A, Kostyla K, Murillo D, et al. Oocyte quality and IVF outcome after coasting to prevent ovarian hyper stimulation syndrome. Int J Fertil Womens Med. 2003;48(1):25–31.

    PubMed  Google Scholar 

  14. Shaw-Jackson C, Bertrand E, Becker B, Colin J, Beaudoin-Chabot C, Rozenberg S, et al. Vitrification of blastocysts derived from fair to poor quality cleavage stage embryos can produce high pregnancy rates after warming. J Assist Reprod Genet. 2013;30(8):1035–42. https://doi.org/10.1007/s10815-013-0037-7.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Gardner DK, Schoolcraft WB. In vitro culture of human blastocyst. In: Jansen R, Mortimer D, editors. Towards reproductive certainty: infertility and genetics beyond. Carnforth: Parthernon Press; 1999. p. 378–88.

    Google Scholar 

  16. Shapiro BS, Richter KS, Harris DC, Daneshmand ST. A comparison of day 5 and day 6 blastocyst transfers. Fertil Steril. 2001;75(6):1126–30.

    Article  CAS  PubMed  Google Scholar 

  17. Poulsen V, Ingerslev HJ, Kirkegaard K. Elective embryo transfers on day 6 reduce implantation compared with transfers on day 5. Hum Reprod. 2017;32(6):1238–43. https://doi.org/10.1093/humrep/dex059.

    Article  CAS  PubMed  Google Scholar 

  18. 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. https://doi.org/10.1016/j.fertnstert.2013.06.021.

    Article  PubMed  Google Scholar 

  19. 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. https://doi.org/10.1007/s10815-016-0712-6.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Kaye L, Will EA, Bartolucci A, Nulsen J, Benadiva C, Engmann L. 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. 2017;34(7):913–9.

    Article  PubMed  Google Scholar 

  21. 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. https://doi.org/10.1111/j.1471-0528.2011.03101.x.

    Article  CAS  PubMed  Google Scholar 

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

    Article  PubMed  Google Scholar 

  23. 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. https://doi.org/10.1093/humrep/deu033.

    Article  PubMed  Google Scholar 

  24. Alfarawati S, Fragouli E, Colls P, Stevens J, Gutiérrez-Mateo C, Schoolcraft WB, et al. The relationship between blastocyst morphology, chromosomal abnormality, and embryo gender. Fertil Steril. 2011;95(2):520–4. https://doi.org/10.1016/j.fertnstert.2010.04.003.

    Article  PubMed  Google Scholar 

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Acknowledgments

The authors are grateful to the CHU St-Pierre IVF team and Pierre Vanderzwalmen for participating in scientific discussions.

Author information

Authors and Affiliations

  1. Department of Gynaecology, CHU St-Pierre (Université Libre de Bruxelles), Rue Haute 322, 1000, Brussels, Belgium

    Alice Tubbing, Chloë Shaw-Jackson, Jérôme Colin, Serge Rozenberg & Candice Autin

  2. Data Centre, Jules Bordet Institute (Université Libre de Bruxelles), Rue Hégèr Bordet 1, 1000, Brussels, Belgium

    Lieveke Ameye

Authors
  1. Alice Tubbing
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  2. Chloë Shaw-Jackson
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  3. Lieveke Ameye
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  4. Jérôme Colin
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  5. Serge Rozenberg
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  6. Candice Autin
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Corresponding author

Correspondence to Chloë Shaw-Jackson.

Ethics declarations

All our protocols have been approved by the local Ethics Committee and all our patients have given their informed, written consent prior to treatment. The current study was approved by the Ethics Committee of the CHU St-Pierre (AK/16-11-139/4734).

Conflict of interest

The authors declare that they have no conflict of interest.

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Cite this article

Tubbing, A., Shaw-Jackson, C., Ameye, L. et al. Increased live births after day 5 versus day 6 transfers of vitrified-warmed blastocysts. J Assist Reprod Genet 35, 417–424 (2018). https://doi.org/10.1007/s10815-017-1097-x

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  • DOI: https://doi.org/10.1007/s10815-017-1097-x

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