Transferring two grades I cleavage-stage embryo might not be a good protocol

Abstract

Purpose: The aim of this study was to explore whether transferring two grades I cleavage-stage embryo was suitable for the patients in the first fresh transfer.

Methods: This study included 202 single grades I cleavage-stage, 229 single grades III cleavage-stage, 743 single excellent blastocyst, 522 double grades I cleavage-stage, and 596 double grades III cleavage-stage embryo transfers. Main clinical outcomes: clinical pregnancy and twin-pregnancy rate.

Results: Among single excellent blastocyst, single grades I and single grades III group, the clinical pregnancy rate was significantly higher in single excellent blastocyst group than single grades I and grades III group (67.16% versus 42.08% versus 23.97%; p < 0.001). When transferred double grades I cleavage-stage embryos, the clinical pregnancy rate reached 68.20% which was no significant difference compared with the single excellent blastocyst group (67.16%). However, the twin-pregnancy rate was significantly higher in double grades I group than double grades III and single excellent blastocyst group (43.26% versus 26.70% versus 0.60%; p < 0.001).

Conclusions: Because of higher twin-pregnancy incidence rate, transferring two grades I cleavage-stage embryo might not be a good protocol. Extended culture to blastocyst-stage could be considered for the patient with only two grades I cleavage-stage embryos.

Chinese abstract

目的：本研究旨在探讨G?卵裂期双胚胎移植是否适宜于初次鲜胚移植的患者。

方法：本研究包括202个G ?卵裂期单胚胎移植, 229个G ?卵裂期单胚胎移植, 743个单个优质囊胚移植, 522个G ?卵裂期双胚胎移植, 596个G ?卵裂期双胚胎移植。主要临床结局：临床妊娠率和双胎妊娠率。

结果：在单个优质囊胚移植组、G ?卵裂期单胚胎移植组及G ?卵裂期单胚胎移植组中, 单个优质囊胚移植组的临床妊娠率明显高于其他2组(67.16% 、42.08%及23.97%; p < 0.001)。当G ?卵裂期双胚胎移植时, 临床妊娠率达到68.20%, 与单个优质囊胚移植组(67.16%)比较差异无统计学意义。然而, G ?卵裂期双胚胎移植组的双胎妊娠率明显高于G ?卵裂期双胚胎移植组及单个优质囊胚移植组(43.26%、26.70%及0.60%; p < 0.001)。

结论：由于双胎妊娠发病率较高, G ?卵裂期双胚胎移植可能不是一个好方案。对于只有2个G ?卵裂期胚胎的患者来说, 继续培养到囊胚期可能更适宜。

Keywords:

• Cleavage-stage
• clinical pregnancy
• blastocyst-stage

Declaration of interest

The authors report no conflicts of interest.