Pregnancy outcome of day 3 versus day 5 embryo transfer: A retrospective analysis

Alfaraj, Samaher; Alzaher, Fatima; Alshwaiaer, Sahar; Ahmed, Anwar

doi:10.12980/apjr.6.20170208

Cited by 7 publications

(5 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As in other studies comparing both transfer policies in unselected populations ( Papanikolaou et al , 2008 ; Glujovsky et al , 2016 ; Alfaraj et al , 2017 ), the stepwise change from a cleavage-stage to a blastocyst-stage transfer policy in our center resulted in a similar CLBR per OCC (25.9% for Day 3 versus 28.4% for Day 5, P = NS; De Croo et al , 2020 ). However, we observed a dramatic increase in transfer cancelation rates, especially in poor-prognosis women (1–4 zygotes available on Day 1).…”

Section: Discussionsupporting

confidence: 76%

“…There have been few studies targeting the best embryo transfer strategy for patients with different ovarian responses. Two studies ( Papanikolaou et al 2008 ; Alfaraj et al , 2017 ) indicated that in patients with low ovarian response, the LBR was higher in a blastocyst transfer than in a cleavage-stage transfer. The study of Freeman et al (2000) showed similar success rates in cleavage- and blastocyst-stage transfer strategies, with the exception of patients with few oocytes.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

No difference in cumulative live birth rates between cleavage versus blastocyst transfer in patients with four or fewer zygotes: results from a retrospective study

Croo

Colman

Sutter

et al. 2022

Human Reproduction Open

View full text Add to dashboard Cite

STUDY QUESTION Is the cumulative live birth rate (CLBR) per oocyte collection cycle (OCC) comparable after cleavage-stage or blastocyst-stage transfer in combination with supernumerary blastocyst vitrification on day 5 (D5) in patients with four or fewer zygotes on day 1? SUMMARY ANSWER The CLBR in a fresh blastocyst-transfer or cleavage-stage transfer policy followed by vitrification on D5 is comparable in patients with four or fewer zygotes. WHAT IS KNOWN ALREADY Blastocyst transfer enhances self-selection of the embryo and shortens time to pregnancy in patients with normal or high ovarian response. Whether these advantages are also present in patients with a low ovarian response and/or a limited number of available zygotes is a continuous debate. STUDY DESIGN, SIZE, DURATION This was a retrospective, observational cohort study of 2,359 consecutive OCCs between January 2014 and December 2018. According to a shift in transfer policy in our center, 571 OCCs had been scheduled for a fresh transfer on day 3 (D3) and 1,788 on D5. The D5 group was matched to the D3 group by propensity score (PS) matching according to multiple maternal baseline covariates. After PS matching, there were 571 OCCs in each group. PARTICIPANTS/MATERIALS, SETTING, METHODS OCC scheduled for a D3 transfer (n = 571) or for a D5 transfer (n = 1788) were matched by PS matching in a 1:1 ratio accounting for potential confounding factors associated with CLBR. The model included patient characteristics, such as maternal age and cycle rank, as well as treatment characteristics such as GnRH analogue regimen and ovarian response. Embryological variables included the number of zygotes and number of 6-7 and 8-cell embryos on D3. The delivery outcomes of the fresh treatment cycle and the consecutive vitrified-warmed embryo transfers were analysed up to the first live birth. The primary endpoint of this study was CLBR per OCC. Secondary outcomes were live birth rate per fresh transfer and embryo implantation rate per transferred embryo. MAIN RESULTS AND THE ROLE OF CHANCE The CLBR per OCC was comparable between the D5 and D3 groups (16.8% versus 17.7%, respectively, p = 0.600). Live birth rates per OCC did not differ between a cleavage-stage transfer and blastocyst-stage transfer policy (15.2% versus 12.4%, respectively, p = 0.160). In the D5 group, 201 cycles did not result in a blastocyst to perform an embryo transfer or cryopreservation; in the D3 group only 59 cycles did not have an embryo transfer because of poor embryo quality (35.2% versus 10.3%, respectively; p < 0.001). A significantly higher number of fresh double embryo transfers were performed in the D3 group compared to D5 (23.8% versus 7.0%, respectively, p < 0.001). LIMITATIONS, REASONS FOR CAUTION Although adjusted for important confounders in the PS matching, BMI and embryo quality of the transferred embryo(s) were not taken into account. This study is limited by its retrospective design and is a single centre study, which may limit the generalizability of our findings. WIDER IMPLICATIONS OF THE FINDINGS The CLBR in a fresh blastocyst-transfer or cleavage-stage transfer policy followed by vitrification on D5 is comparable. A fresh embryo transfer on D3 can still be considered in patients with a poor ovarian response and/or limited number of zygotes when combined with blastocyst vitrification without impacting the overall CLBR of the cycle. STUDY FUNDING/COMPETING INTEREST(S) No external funding was obtained for this study. The are no conflicts of interest to declare. TRIAL REGISTRATION NUMBER This retrospective study was approved by the local ethical committee at Ghent University Hospital (B 670201731234).

show abstract

Section: Discussionsupporting

confidence: 76%

Section: Discussionmentioning

confidence: 99%

No difference in cumulative live birth rates between cleavage versus blastocyst transfer in patients with four or fewer zygotes: results from a retrospective study

Croo

Colman

Sutter

et al. 2022

Human Reproduction Open

View full text Add to dashboard Cite

show abstract

“…Some reports suggest that blastocyst transfer is more favorable than cleavage transfer (Levron et al, 2002;Gardner et al, 1998;Schwärzler et al, 2004;Papanikolaou et al, 2005;Karaki et al, 2002). However, other reports indicate that there are no differences in success rates between blastocyst and cleavage transfers (Bungum et al, 2003;Hatırnaz & Kanat Pektaş, 2017;Coskun et al, 2000;Alfaraj et al, 2017). Results of Cochrane studies, that examine day-3 compared to day-5 embryo transfer, are also variable and inconsistent (Glujovsky et al, 2012;2016).…”

Section: Discussionmentioning

confidence: 99%

Day-3 vs. Day-5 fresh embryo transfer

Garbhini¹,

Suardika²,

Anantasika³

et al. 2022

JBRA

View full text Add to dashboard Cite

Objective: Embryo transfer on day-5 has been associated with higher success rates, therefore our IVF clinics started to extend embryo culture until blastocyst stage. This study aimed to compare the success rates of day-3 vs. day-5 embryo transfers.Methods: We had 266 patients included, all having undergone ICSI, with 221 patients having undergone day-3 embryo transfers, and 45 patients having undergone day-5 embryo transfers. Patients with more than five good quality embryos on day-3 were chosen to prolong the culture of embryos into day-5.Results: There were no significant differences in patient characteristics, including baseline LH, FSH, Prolactin and Estradiol hormone levels. In addition, there were also no significant differences in rFSH total dosage and duration of stimulation day. Final estradiol levels, number of follicles, retrieved oocytes, matured oocytes, fertilized oocytes and number of embryos were significantly higher in day-5 compared to day-3 embryo transfer groups. Number of embryos transferred on day-3, were significantly higher compared to day-5. Neither group showed any significant differences in clinical pregnancy, implantation, multiple pregnancy or living birth rates. There were no differences in birth weights and lengths, head circumstances and Apgar Scores between both groups either in singleton or twin group.Conclusions: Transferring embryos at day-3 may provide the same benefits as day-5 embryo transfers to patients. However, more embryos were required to be transferred to achieve these comparable results.

show abstract

“…The studies of Papanikolaou and Alfaraj [3,18] indicated that in the patients with low ovarian response, the cycle cancellation rate (38% vs 25.2%) was higher, but the pregnancy, clinical pregnancy, and live birth rates were still higher in blastocyst transfer than in embryo transfer. In the patients who had low ovarian response and received oocyte freezing and thawing, the very low cycle cancellation rate (0.01%) and the high blastocyst development capacity were greatly conducive to blastocyst culture, so blastocyst transfer after whole embryo cryopreservation was strongly recommended for the patients with low ovarian response.…”

Section: Discussionmentioning

confidence: 99%

Comparative study on the pregnancy outcomes of in vitro fertilization–embryo transfer between patients with different ovarian responses (a STROBE-compliant article)

Jin

et al. 2019

Medicine

View full text Add to dashboard Cite

There have been few studies on large-sample data of cleavage-stage embryo and blastocyst transfers. We compared the pregnancy outcomes of patients with different ovarian responses after the transfer of different numbers of embryos in different developmental stages. Patients were divided into 3 groups including low response group, medium response group, and high response group according to different ovarian responses. Patients in each group were further divided into 4 subgroups including group A: transfer of 1 D3 embryo, group B: transfer of 2 D3 embryos; group C: transfer of 1 D5 blastocyst; and group D: transfer of 2 D5 blastocysts. In low ovarian responders, the implantation rate, clinical pregnancy rate and live birth rate were significantly lower in the group A than in the groups B and C. In medium ovarian responders, the implantation rate was significantly higher, but the multiple pregnancy rate was significantly lower in the group C than in the group B. The multiple pregnancy rate was significantly higher in the group D than in the group C. In high ovarian responders, the implantation rate was significantly lower, but the multiple pregnancy rate was significantly higher in the group B than in group C. Based on the above results, the single blastocyst transfer is preferable for the patients with different ovarian responses.

show abstract

Pregnancy outcome of day 3 versus day 5 embryo transfer: A retrospective analysis

Cited by 7 publications

References 23 publications

No difference in cumulative live birth rates between cleavage versus blastocyst transfer in patients with four or fewer zygotes: results from a retrospective study

No difference in cumulative live birth rates between cleavage versus blastocyst transfer in patients with four or fewer zygotes: results from a retrospective study

Day-3 vs. Day-5 fresh embryo transfer

Comparative study on the pregnancy outcomes of in vitro fertilization–embryo transfer between patients with different ovarian responses (a STROBE-compliant article)

Contact Info

Product

Resources

About