Fertility and neonatal outcomes of embryos achieving blastulation on Day 7: are they of clinical value?

Du, Tong; Wang, Yun; Fan, Yong; Zhang, Shiyi; Zhou, Yan; Yu, Weidong; Xi, Qianwen; Chen, Qiuju; Mol, Ben Willem J.; Lyu, Qifeng; Kuang, Yanping

doi:10.1093/humrep/dey092

Cited by 51 publications

(31 citation statements)

References 34 publications

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“…The final inclusion was 13 studies that met the selection criteria for our meta‐analysis. Hence, 23 studies were included in the following meta‐analyses . The main characteristics and assessment for risk of bias of the included studies are presented in Table .…”

Section: Resultsmentioning

confidence: 99%

“…Hence, 23 studies were included in the following meta-analyses. 4,6,7,[11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] The main characteristics and assessment for risk of bias of the included studies are presented in Table 1.…”

Section: Results Of the Searchesmentioning

confidence: 99%

“…Only three studies transfer euploid blastocysts. 13,16,22 Five studies only transfer one embryo per cycle, [12][13][14]16,23 while remaining studies transfer no more than two blastocysts 11,[18][19][20]22,24,27,28 or more than two blastocysts per cycle. 29,30 The decision of when blastocyst was transferred in all included studies was dependent on the day of expansion.…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

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Pregnancy outcomes after day 5 versus day 6 blastocyst‐stage embryo transfer: A systematic review and meta‐analysis

Wang²,

Sun

et al. 2020

J of Obstet and Gynaecol

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Aim To compare the pregnancy outcomes after day 5 blastocyst‐stage embryo transfers (BET) versus day 6 BET following vitrified‐warmed cycle and to evaluate whether the number of embryos transferred and the chromosomal status of embryo influence effect estimates. Methods A literature search (PubMed, Embase and MEDLINE) up to January 2019 was conducted to identify studies where women with day 6 BET were compared to women with day 5 BET. Only studies published in English language, on peer‐reviewed journal were considered eligible. The following subgroup analyses were performed: (i) number of embryos transferred and (ii) chromosomal status of embryo. Results From a total of 1956 articles identified, 23 observational studies were included in the meta‐analysis. We observed that day 6 BET were associated with lower implantation rate (risk ratio, RR: 1.17, 95% confidence interval, CI: 1.10–1.24), clinical pregnancy rate (RR: 1.17, 95% CI: 1.10–1.24), ongoing pregnancy rate (RR: 1.15, 95% CI: 1.07–1.24) and live birth rate (RR: 1.22, 95% CI: 1.11–1.33) than day 5 BET following vitrified‐warmed cycle. The subgroup analysis found that the superiority of day 5 BET compared with day 6 BET is influenced by the number of embryos transferred and chromosomal status of embryos. Conclusion Current evidence shows that day 5 BET is superior to day 6 BET following vitrified‐warmed cycle in clinical practice. Due to the overall low quality of available evidence, more larger and well‐conducted studies are needed to compare the pregnancy outcomes between day 5 and day 6 BET before drawing a clear conclusion.

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Section: Resultsmentioning

confidence: 99%

Section: Results Of the Searchesmentioning

confidence: 99%

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

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Pregnancy outcomes after day 5 versus day 6 blastocyst‐stage embryo transfer: A systematic review and meta‐analysis

Wang²,

Sun

et al. 2020

J of Obstet and Gynaecol

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“…Acceptable live birth rates have been obtained after Day 7 blastocyst transfers [6][7][8][9][10]. However, all of the data in these previous reports were from autologous and fresh donor oocyte IVF.…”

Section: Resultsmentioning

confidence: 99%

“…Although most human IVF laboratories culture human embryos to Day 6, an extended Day 7 culture is necessary for some patients, especially if patients have limited number of oocytes [6][7][8]. It has been reported that Day 7 blastocysts had lower implantation potential as compared with Day 5/6 blastocysts, however, transfer of Day 7 blastocysts can lead to acceptable live birth rates [9,10].…”

Section: Introductionmentioning

confidence: 99%

Is day 7 culture necessary for in vitro fertilization of cryopreserved/warmed human oocytes?

Niu¹,

Wang

et al. 2020

Reprod Biol Endocrinol

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Background: Human embryos are usually cultured to blastocyst stage by Day 5 or 6 after insemination. However, some embryos grow slowly and reach blastocyst stage at Day 7. Acceptable live birth rates have been reported after transfer of Day 7 blastocysts resulted from fresh oocyte in vitro fertilization (IVF). It is unknown whether an extended embryo culture to Day 7 is necessary for cryopreserved oocyte IVF to obtain more transferrable blastocysts. Methods: In this study, 455 oocytes from 57 cycles were warmed, inseminated, and the resulting embryos were cultured by Day 7 to examine blastocyst development after extended culture. Fifty one blastocysts from 16 cycles were biopsied to examine embryo aneuploidies. Results: It was found that 35.1% of the cycles had Day 7 blastocysts, and 3.5% of the cycles had only Day 7 blastocysts. Day 7 blastocysts accounted for 15.6% of total blastocysts. The proportion of top quality of blastocysts was lower at Day 7 than at Day 5 or 6. However, no differences were observed on aneuploid blastocyst rates among Days 5, 6 and 7. Similar clinical pregnancy, ongoing pregnancy and embryo implantation rates were obtained after Day 7 blastocyst transfer as compared with Day 5 or 6 blastocyst transfer. Conclusion: These results indicate that embryos from oocyte warming cycles should be cultured to Day 7 if they do not reach to blastocyst stage by Day 6 so that number of usable blastocysts can be increased.

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Reproductive history does not compromise subsequent live birth and perinatal outcome following in‐vitro fertilization: analysis of 25 329 first frozen–thawed embryo transfer cycles without preimplantation genetic testing for aneuploidy

Chen

Mao

et al. 2023

Ultrasound in Obstet & Gyne

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ObjectiveTo investigate the effect of women's reproductive history on live‐birth rate and perinatal outcome after first frozen–thawed embryo transfer (FET) without preimplantation genetic testing for aneuploidy.MethodsThis was a retrospective cohort study of women who had undergone their first FET cycle between January 2014 and December 2020 at a university‐affiliated fertility center. No transferred embryo underwent preimplantation genetic testing for aneuploidy. The women were categorized into five groups based on their reproductive history: no previous pregnancy; previous termination of pregnancy (TOP); previous pregnancy loss; previous ectopic pregnancy (EP); and previous live birth. The women with no previous pregnancy were considered as the reference group. The primary outcome was the live‐birth rate and secondary endpoints included rates of positive pregnancy test, clinical pregnancy, pregnancy loss and EP as well as perinatal outcomes such as birth weight and preterm birth. Multivariable logistic regression analyses were used to control for a number of potential confounders, including age, body mass index, education level, duration and cause of infertility, insemination method, type of endometrial preparation, number of embryos transferred, embryo developmental stage, quality of the embryos transferred, year of treatment and endometrial thickness. Additionally, propensity score matching (PSM) was used to check the robustness of the main findings.ResultsIn total, 25 329 women were included in the final analysis. On univariate analysis, each reproductive‐history type except for previous EP was significantly associated with worse pregnancy outcome following in‐vitro fertilization (IVF), including rates of positive pregnancy test, clinical pregnancy, pregnancy loss and live birth, when compared with the group of women with no previous pregnancy. However, after correcting for several potential confounders, the differences in rates of live birth, pregnancy loss, positive pregnancy test and clinical pregnancy were no longer significant between the study and control groups on multivariable regression models, while the risk of EP after embryo transfer was elevated among women with a previous TOP or EP. There was no increased risk of adverse perinatal outcome associated with reproductive history compared with the control group. Notably, similar results were obtained from the PSM models, confirming the robustness of the main findings.ConclusionRelative to women without a previous pregnancy, those with a prior TOP, pregnancy loss, EP or live birth did not have compromised live‐birth rate or perinatal outcomes following FET without preimplantation genetic testing for aneuploidy, with the exception of an increased risk of EP in those with prior TOP or EP. © 2023 International Society of Ultrasound in Obstetrics and Gynecology.

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Fertility and neonatal outcomes of embryos achieving blastulation on Day 7: are they of clinical value?

Abstract: Not applicable.

Cited by 51 publications

References 34 publications

Pregnancy outcomes after day 5 versus day 6 blastocyst‐stage embryo transfer: A systematic review and meta‐analysis

Pregnancy outcomes after day 5 versus day 6 blastocyst‐stage embryo transfer: A systematic review and meta‐analysis

Is day 7 culture necessary for in vitro fertilization of cryopreserved/warmed human oocytes?

Reproductive history does not compromise subsequent live birth and perinatal outcome following in‐vitro fertilization: analysis of 25 329 first frozen–thawed embryo transfer cycles without preimplantation genetic testing for aneuploidy

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