The effects of different fertilization methods on the formation of blastocyst from non high-quality cleavage stage embryos
Objective:To explore the impact of different fertilization modes on the formation of blastocyst in patients with no high-quality embryos on the third day(D3)of embryo culture.Methods:A retrospective analysis of clinical data of 1 686 patients who underwent conventional IVF/ICSI-ET treatment and with no high-quality embryos on D3 of embryo culture at Reproductive Medicine Center of The First Affiliated Hospital of Zhengzhou University from January 2015 to January 2023.Patients were divided into blastocyst formation group(n=251)and non blastocyst formation group(n=1 435)based on whether blastocyst was ultimately formed.And based on whether high-quality blastocyst was formed,the blastocyst formation group was further divided into two subgroups:the high-quality blastocyst group(n=41)and the non high-quality blastocyst group(n=2 10).The general characteristics of patients in each group were compared,and the relevant factors affecting blastocyst and high-quality blastocyst formation were analyzed with univariate analysis and multivariate logistic regression.Results:Compared with blastocyst formation group,the average age,the duration of infertility,the proportion of secondary infertility and ICSI fertilization as well as basal FSH(bFSH)level in non blastocyst formation group were significantly higher(P＜0.05).The basal LH(bLH)in the high-quality blastocyst group was significantly lower than that in the non high-quality blastocyst group(P＜O.05).The results of the univariate analysis showed that embryos with less than 35 of maternal age,6 D3 embryo cells,an odd number of D3 cells,not more than 15％of D3 fragmentation rate,and IVF had a higher blastocyst formation rate(P＜0.05).After adjusting for confounding factors such as the age of the female partner,the number of D3 embryo cells,and the rate of D3 embryo fragmentation using multivariate logistic regression,the results showed that the fertilization method was an independent influencing factor of the formation rate of D3 non high-quality embryos and high-quality embryos(P＜0.05).Conclusions:For patients with no high-quality embryos on D3 of embryo culture,IVF embryos have a higher rate of blastocyst formation and high-quality blastocyst formation than ICSI ones.
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