Background: To ascertain whether couples with chromosomal abnormalities have a difference in cumulative clinical pregnancy rate and cumulative live birth rate among assisted reproductive technology population. Methods: Design: A retrospective cohort study. Setting: Department of reproduction and infertility in Chengdu Women's and Children's Central Hospital.Patients: A total of 112 couples were in exposed group with chromosomal abnormalities and 226 couples without chromosomal abnormalities in control group included in the study, totaling 338 cases. From 1st Jan 2017 to 31st Dec 2019. Control group (infertility couples without chromosomal abnormalities) was 1:2 matched by female age, type of infertility (primary, secondary), type of assisted reproductive technology (IVF, ICSI or IUI). Results: Primary outcomes: cumulative clinical pregnancy rate and cumulative live birth rate. The results indicated that chromosomes abnormalities had no statistical difference in primary outcomes. Further analysis revealed exposed group (couples with chromosomal abnormalities) had less 2 pronuclear stage count. The times of embryo transfer by ICSI was less than IVF in exposed group. We found out only female age had an effect on the primary results and the threshold was 33.5years old.Conclusions: There were no significant differences in cumulative clinical pregnancy rate and cumulative live birth rate between two groups. But 2 pronuclear stage count, and the times of embryo transfer were affected by chromosomal abnormalities. It may be better to choose ICSI and PGT in this population.

Purpose The window of implantation extends 3–6 days within the secretory phase in most normal women. The efficacy of such technique (sequential transfer) is still debatable in IVF/intracytoplasmic sperm injection (ICSI). The purpose of this systematic review was to investigate whether sequential transfer is more beneficial to pregnancy outcomes in IVF/ICSI. Method Search terms included “double embryo transfer”, “sequential transfer”, “consecutive transfer”, “IVF”, “ICSI”. The selection criteria were nonrandomized studies and randomized controlled studies. For data collection and analysis, the Review Manager software, Newcastle–Ottowa Quality Assessment Scale and GRADE approach were used. Results The clinical pregnancy rate and live birth rate showed that compared to the control protocol, the treatment group (sequential embryo transfer) were higher (RR 1.31, 95% CI (1.15 to 1.48), I2 = 49%, P < 0.0001), (RR 1.65, 95% CI (1.18 to 2.31), I2 = 0%, P = 0.003). The results were statistically significant. The multiple pregnancies rate and miscarriage rate were no statistical significance. Conclusion The sequential embryo transfer provided higher clinical pregnancy rate and live birth rate than the control protocol, with the same rate of multiple pregnancies and miscarriage. The sequential embryo transfer could be a safe option as a personalized protocol for infertile patients.

Background To evaluate the optimal time of blood pregnancy test for urine beta-human chorionic gonadotropin (β-HCG)-positive patients following embryo transfer. Methods A total of 1,106 women who underwent embryo transfer between January 2019 and December 2019 were divided into three groups based on the time of positive pregnancy test at the hospital: the ≤ 9 days group (n = 355), the 10–12 days group (n = 598), and the ≥ 13 days group (n = 153). Clinical pregnancy ratio, ectopic pregnancy rate, multiple pregnancy rate, early miscarriage rate, late pregnancy loss rate, live birth ratio, preterm birth rate, very preterm birth rate, gestational week of delivery, and congenital malformation rate of the three groups were compared. Results The time preference for pregnancy test was 10 days among patients with D3 embryo transfer and 11 days among those with blastocyst transfer. Patients in the ≥ 13 days group were older and had a higher proportion of previous childbirth(s). Patients in the ≤ 9 days group had a higher live birth ratio and a lower risk of early miscarriage than the other two groups; similar results were seen in a sensitivity analysis that excluded women aged over 35 years and those with previous childbirth(s). Nevertheless, no differences were observed in the clinical pregnancy ratio, ectopic pregnancy rate, late pregnancy loss rate, very preterm birth rate, gestational week of delivery, or congenital malformation rate for all ranges of pregnancy test time. The pregnancy test time to predict the early miscarriage and live birth based on receiver operating characteristic (ROC) curve was day 9 after embryo transfer. After excluding women aged over 35 years or those with previous childbirth(s), the optimal time to conduct pregnancy test based on ROC curve was day 9 or 10 after embryo transfer in predicting early miscarriage, the pregnancy test time to predict live birth should be conducted on day 9 after embryo transfer. Conclusion Patients with positive results for urine β-HCG after embryo transfer should receive blood pregnancy test on day 9–10 after embryo transfer, which probably facilitated the optimization of live birth.