Comparison of clinical outcomes and maternal and fetal outcomes between day 4 and day 5 embryo transfer in fresh cycle
Objective To investigate the effects of day 4(D4)embryo transfer on clinical outcomes and maternal and infant outcomes in vitro fertilization(IVF)or intracytoplasmic sperm injection(ICSI)in fresh cycles.Methods We retrospectively analyzed the clinical data of 361 IVF and ICSI cycles from January 2019 to December 2021 in the Reproductive Medicine Center of Xingtai Infertility Specialist Hospitals in a cohort study.In all cycles,one of the best quality embryo was transferred at D4 or D5 after fertilization.The clinical outcomes and maternal and fetal outcomes of D4 transfer group and D5 transfer group were compared.Results Compared with D4 transfer group,the estradiol value on human chorionic gonadotropin(hCG)injection day significantly increased in D5 transfer group[3 516(2 273,4 116)ng/L vs.2 940(1 935,3 877)ng/L,P=0.023],and the luteinizing hormone(LH)value on hCG injection day significantly decreased[0.82(0.63,1.11)μg/L vs.0.94(0.69,1.20)μg/L,P=0.026],two pronuclei(2PN)fertilization rate[71.13%(929/1 306)]and the available embryo rate[51.73%(509/984)]in D5 transfer group were significantly higher than those in D4 transfer group[67.26%(2 539/3 775),P=0.010;48.00%(1 306/2 721),P=0.045].The clinical pregnancy rate[63.37%(173/273)]and the live birth rate[53.11%(145/273)]in D4 transfer group were significantly higher than those in D5 transfer group[46.59%(41/88),P=0.005;36.36%(32/88),P=0.006].There were no significant differences in ectopic pregnancy rate,monozygotic twins rate,abortion rate,preterm birth rate,stillbirth rate,caesarean section rate,delivery gestation,male/female ratio and birth weight(all P>0.05).The results of logistic regression analysis showed that the days of embryo transfer had a significant correlation with the pregnancy rate and the live birth rate(OR=0.468,95%CI:0.266-0.824,P=0.009;OR=0.481,95%CI:0.273-0.847,P=0.011).Conclusion In IVF/ICSI of fresh cycles,the clinical pregnancy rate and the live birth rate of D4 transplantation are better than that of D5 transplantation,and the maternal and fetal outcomes are similar.Therefore,D4 embryo transplantation can be preferred in clinical work.
Embryo transfer,day 4Embryo transfer,day 5Pregnancy outcomeMaternal and fetal outcomes
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