Should all embryos be cultured to blastocyst for advanced maternal age women with low ovarian reserve: a single center retrospective study

Abstract

The purpose of this study is to determine whether all-blastocyst-culture can benefit advanced maternal age (AMA) patients with low ovarian reserve. We retrospectively analyze AMA patients with low ovarian reserve undergoing IVF/ICSI in Reproductive Medicine Research Center of the Sixth Affiliated Hospital of Sun Yat-sen University from May 2016 to August 2017. We divide them into group A (all-blastocyst-culture) and group B (none-blastocystculture) based on different culture approach of D3 transferrable embryo. We compared the cumulative biochemical pregnancy rate and cumulative clinical pregnancy rate between them. A total of 261 eligible patients are included, with 151 in group A and 110 in group B. The basic conditions of the two groups show no difference. Cumulative biochemical pregnancy rate/clinical pregnancy rate in group A is higher than that of group B, though not statistically significant (p > .05). After removing patients canceling embryo transfer due to failure in blastocyst culture, the cumulative biochemical pregnancy rate/clinical pregnancy rate in group A is significantly higher than group B (p < .05). Multivariate analysis showed that female age and the number of D3 transferrable embryo are risk factors for the failure of blastocyst culture (OR = 0.672 and 2.270, 95%CI 0.511–0.883 and 1.203–4.284, p = .004 and p = .011, respectively). Hence, we drew to conclusion that all-blastocyst-culture will not adversely affect the pregnancy outcome of AMA patients with low ovarian reserve.

Chinese abstract

本研究目的是明确全囊胚培养对卵巢储备下降的高龄产妇是否有益。我们回顾性分析了2016年5月至2017年8月于中山大学第六附属医院生殖医学研究中心行IVF/ICSI的卵巢储备下降的高龄产妇。我们基于D3转移胚胎的不同培养方法分为A组（全囊胚培养）和B组（非囊胚培养）。我们比较两组的累积生化妊娠率以及累积临床妊娠率。共纳入261名符合条件的患者, A组151名、B组110名。两组的基本情况没有差异。A组累积生化妊娠率/临床妊娠率高于B组, 尽管没有统计学差异（p>0.05）。去除因囊胚培养失败而取消胚胎移植的患者, A组累积生化妊娠率/临床妊娠率明显高于B组（P＜0.05）。多变量分析表明女性年龄和D3移植胚胎数是囊胚培养失败的危险因素（OR值分别为0.672、2.270, 95%CI分别为0.511-0.883、1.203-4.284, p值分别为0.004、0.011）。因此, 我们得出结论：全囊胚培养不会对卵巢储备下降的高龄产妇的妊娠结局有不良影响。

Keywords:

• Advanced maternal age
• low ovarian reserve
• all blastocyst culture
• cumulative biochemical pregnancy rate
• cumulative clinical pregnancy rate

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This study was funded by the National Natural Science Foundation of China [81070495].