Comparison of clinical outcomes and maternal and fetal outcomes between different transplantation schemes on day 4 in fresh cycle
Objective To explore the effect of different transplantation schemes on the clinical outcomes and maternal and fetal outcomes of fresh cycle on day 4.Methods The clinical data of 745 cycles of in vitro fertilization(IVF)and intracytoplasmic sperm injection(ICSI)in Reproductive Medicine Center of Xingtai Infertility Specialist Hospitals from January 2019 to December 2021 were analyzed retrospectively.In all cycles,1-2 embryos were transferred on day 4 after fertilization.According to different embryo transfer schemes,they were divided into five groups:one partial compaction embryo group(group A,n=17),two partial compaction embryos group(group B,n=236),one full compaction above embryo group(group C,n=241),partial compaction+full compaction above group(group D,n=72),and two full compaction above embryos group(group E,n=179),the effects of different transfer schemes on clinical outcomes and maternal and fetal outcomes were compared.Results There were no significant differences in two pronuclei(2PN)fertilization rate,2PN cleavage rate,endometrial thickness,monozygotic twins rate,surgical reduction rate,abortion rate,stillbirth rate,cesarean section rate,male infant/female infant ratio among the five groups(all P>0.05).The clinical pregnancy rate in groups D and E[83.33%(60/72),72.63%(130/179)]was significantly higher than that in group B[59.32%(140/236),P<0.001,P= 0.005].The live birth rate of group E[65.36%(117/179)]was significantly higher than that of group B[50.00%(118/236),P=0.002].The implantation rate of groups C,D and E[64.73%(156/241),59.72%(86/144),54.19%(194/358)]was significantly higher than that of group B[39.83%(188/472),all P<0.001].The multiple birth rate[43.33%(26/60),49.23%(64/130)]and the premature delivery rate[23.33%(14/60),26.15%(34/130)]in groups D and E were significantly higher than those in group C[0%,all P<0.001;7.69%(12/156),P=0.002,P<0.001].The gestational weeks of delivery in group E[38.0(36.0,39.0)weeks]was significantly lower than that in group C[39.0(38.0,39.3)weeks,P<0.001].Compared with the one embryo transfer group(group A,group C),the birth weight of the two embryos transfer group(group B,group D,group E)was significantly lower(P<0.001).The low birth weight infants rate in group D[20.90%(14/67)]and group E[28.40%(48/169)]was significantly higher than that in group C[3.85%(5/130),P<0.001].Logistic regression analysis showed that after adjusted,the pregnancy rate in group C was significantly higher than that in group A(OR=0.353,95%CI:0.125-0.997,P=0.049).The live birth rate of group E was significantly higher than that of group C(OR=1.842,95%CI:1.172-2.895,P=0.008),and the premature delivery rate of groups B,D and E was significantly higher than that of group C(OR=2.546,95%CI:1.079-6.005,P= 0.033;OR=6.737,95%CI:2.566-17.689,P<0.001;OR=5.863,95%CI:2.494-13.785,P<0.001).Conclusion On day 4 of the fresh cycle,the pregnancy rate and the live birth rate of the full compaction or above embryos are significantly higher than those of the partial compaction embryos.In clinical work,it is recommended to select full compaction embryos or above,and then select partially compaction embryos for single embryo transfer to achieve optimal pregnancy outcomes while reducing the multiple pregnancy rate,premature delivery rate,and low birth weight infant rate.
Pregnancy outcomeTransplantation schemesMaternal and fetal outcomes
NETL
NSTL
万方数据
