Does IVF cleavage stage embryo quality affect pregnancy complications and neonatal outcomes in singleton gestations after double embryo transfers?

Abstract

Our study suggests that transfer of poor-quality embryos did not increase the risk of adverse outcomes; however, the quality of cleavage stage embryos significantly affected the miscarriage rate and ongoing pregnancies.

Does the transfer of a poor quality embryo together with a good quality embryo affect the In Vitro Fertilization (IVF) outcome?

“…Embryo quality is one of the main predictors of success in IVF cycles [1, 2]. Many studies have shown a strong association between embryo morphology, implantation, and clinical pregnancy rates.…”

Comparative study of obstetric and neonatal outcomes of live births between poor‐ and good‐quality embryo transfers

“…One report reviewed 340 singleton births after single‐cleavage embryo transfers and observed no significant difference in the parameters of the mean birthweight and infant height, umbilical blood analysis, placental weight, or umbilical cord length between the poor‐ and the good‐quality embryo transfers . One of the reports reviewed 11 721 cleavage‐stage double embryo transfers and demonstrated that the live births after the poor‐quality embryo transfers achieved the same pregnancy outcomes as those after the good‐quality embryo transfers did in terms of mean gestational week, delivery mode, SGA, LGA, PTD rate, and LBW . In agreement with these reports, this review's results demonstrate that the poor‐quality embryos did not increase the prevalence of adverse obstetric and neonatal complications.…”

“…Many studies have demonstrated a strong association between morphologically poor‐quality embryos, a low clinical pregnancy rate, and low live birth rate per transfer . However, relatively few studies have reported associations between the embryo quality and miscarriage and live birth rates of clinical pregnancies due to the lack of evidence in evaluating these issues.…”

“…One previous study reported that once clinical pregnancy was achieved, the subsequent miscarriage and live birth rates of the clinical pregnancies were equivalent between the poor‐ and good‐quality embryo transfer groups . On the other contrary, another previous study demonstrated that a poor‐quality embryo transfer resulted in higher miscarriage rates and lower ongoing pregnancy rates after achieving clinical pregnancy . While the former study combined both cleavage and blastocyst embryos, the latter study evaluated only cleavage embryos and speculated that the embryo quality at the cleavage stage might affect the subsequent pregnancy outcomes of clinical pregnancy .…”

“…Recently, one study reported that the obstetric and neonatal outcomes of live births after poor‐quality embryo transfers were equivalent to those after good‐quality embryo transfers . In contrast, another study demonstrated that poor‐quality embryo transfers resulted in higher miscarriage rates and lower ongoing pregnancy rates after implantation, although the obstetric and neonatal outcomes of live births after poor‐quality embryo transfers were equivalent to those after good‐quality embryo transfers . However, there have been few studies that have evaluated the association between embryo quality and pregnancy outcome till date.…”