|
|
Propensity score-matched study and meta-analysis of cumulative outcomes of day 2/3 versus day 5/6 embryo transfers |
Ye Yin1, Ge Chen1, Kezhen Li2, Qiuyue Liao1, Sijia Zhang1, Nieying Ma1, Jing Chen2, Yan Zhang2, Jihui Ai1() |
1. Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China 2. Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China |
|
|
Abstract The superiority of the cumulative outcomes of day 5/6 embryo transfer to those of day 2/3 embryo transfer in infertile couples has been debated. This retrospective study included data collected from 1051 patients from July 2011 to June 2014. Multiple maternal baseline covariates were subjected to propensity score matching analysis, and each day 5/6 group woman was matched to one day 2/3 group woman. A systematic meta-analysis was conducted to validate the results. After matching was completed, 217 patients on the day 2/3 group were matched with those on the day 5/6 group, and no significant differences in the baseline characteristics were observed between the two groups. The cumulative pregnancy rate (57.14% vs. 53.46%, OR 1.16, 95% CI 0.79–1.70) and cumulative live birth rate (53.00% vs. 49.77%, OR 1.14, 95% CI 0.78–1.66) of day 5/6 embryo transfers were higher than those of day 2/3 embryo transfers, but this difference was not significant. The mean cycles per live birth and mean days per live birth in the day 5/6 group were significantly lower than those in the day 2/3 group. This study demonstrated that day 5/6 embryo transfer is a more cost-effective and time-efficient policy than day 2/3 embryo transfer to produce a live baby.
|
Keywords
blastocyst
embryo transfer
cumulative pregnancy rate
cumulative live birth rate
IVF
|
Corresponding Author(s):
Jihui Ai
|
Just Accepted Date: 08 June 2017
Online First Date: 25 July 2017
Issue Date: 04 December 2017
|
|
1 |
Gardner DK, Schoolcraft WB, Wagley L, Schlenker T, Stevens J, Hesla J. A prospective randomized trial of blastocyst culture and transfer in in-vitro fertilization. Hum Reprod 1998; 13(12): 3434–3440
pmid: 9886530
|
2 |
Hsieh YY, Tsai HD, Chang FC. Routine blastocyst culture and transfer: 201 patients’ experience. J Assist Reprod Genet 2000; 17(8): 405–408
https://doi.org/10.1023/A:1009458215962
pmid: 11062848
|
3 |
Van der Auwera I, Debrock S, Spiessens C, Afschrift H, Bakelants E, Meuleman C, Meeuwis L, D’Hooghe TM. A prospective randomized study: day 2 versus day 5 embryo transfer. Hum Reprod 2002; 17(6): 1507–1512
https://doi.org/10.1093/humrep/17.6.1507
pmid: 12042269
|
4 |
Smith LP, Oskowitz SP, Dodge LE, Hacker MR. Risk of ectopic pregnancy following day-5 embryo transfer compared with day-3 transfer. Reprod Biomed Online 2013; 27(4): 407–413
https://doi.org/10.1016/j.rbmo.2013.06.015
pmid: 23953586
|
5 |
Huang B, Hu D, Qian K, Ai J, Li Y, Jin L, Zhu G, Zhang H. Is frozen embryo transfer cycle associated with a significantly lower incidence of ectopic pregnancy? An analysis of more than 30,000 cycles. Fertil Steril 2014; 102(5): 1345–1349
https://doi.org/10.1016/j.fertnstert.2014.07.1245
pmid: 25241365
|
6 |
Alper MM, Brinsden P, Fischer R, Wikland M. To blastocyst or not to blastocyst? That is the question. Hum Reprod 2001; 16(4): 617–619
https://doi.org/10.1093/humrep/16.4.617
pmid: 11278206
|
7 |
Tsirigotis M. Blastocyst stage transfer: pitfalls and benefits. Too soon to abandon current practice? Hum Reprod 1998; 13(12): 3285–3289
https://doi.org/10.1093/humrep/13.12.3285
pmid: 9886498
|
8 |
Glujovsky D, Blake D, Farquhar C, Bardach A. Cleavage stage versus blastocyst stage embryo transfer in assisted reproductive technology. Cochrane Database Syst Rev 2012; 7(7): CD002118
pmid: 22786480
|
9 |
Barnhart KT. Introduction: are we ready to eliminate the transfer of fresh embryos in in vitro fertilization? Fertil Steril 2014; 102(1): 1–2
https://doi.org/10.1016/j.fertnstert.2014.05.024
pmid: 24890272
|
10 |
Lintsen AME, Braat DDM, Habbema JDF, KremerJ AM, Eijkemans MJC. Can differences in IVF success rates between centres be explained by patient characteristics and sample size? Hum Reprod 2010; 25(1): 110–117
https://doi.org/10.1093/humrep/dep358
pmid: 19837684
|
11 |
Bodri D, Kawachiya S, De Brucker M, Tournaye H, Kondo M, Kato R, Matsumoto T. Cumulative success rates following mild IVF in unselected infertile patients: a 3-year, single-centre cohort study. Reprod Biomed Online 2014; 28(5): 572–581
https://doi.org/10.1016/j.rbmo.2014.01.002
pmid: 24631167
|
12 |
Trokoudes KM, Pavlides C, Zhang X. Comparison outcome of fresh and vitrified donor oocytes in an egg-sharing donation program. Fertil Steril 2011; 95(6): 1996–2000
https://doi.org/10.1016/j.fertnstert.2011.02.035
pmid: 21406304
|
13 |
Cobo A, de los Santos MJ, Castellò D, Gámiz P, Campos P, Remohí J. Outcomes of vitrified early cleavage-stage and blastocyst-stage embryos in a cryopreservation program: evaluation of 3,150 warming cycles. Fertil Steril 2012; 98(5): 1138–1146.e1
https://doi.org/10.1016/j.fertnstert.2012.07.1107
pmid: 22862909
|
14 |
Loutradi KE, Kolibianakis EM, Venetis CA, Papanikolaou EG, Pados G, Bontis I, Tarlatzis BC. Cryopreservation of human embryos by vitrification or slow freezing: a systematic review and meta-analysis. Fertil Steril 2008; 90(1): 186–193
https://doi.org/10.1016/j.fertnstert.2007.06.010
pmid: 17980870
|
15 |
AbdelHafez FF, Desai N, Abou-Setta AM, Falcone T, Goldfarb J. Slow freezing, vitrification and ultra-rapid freezing of human embryos: a systematic review and meta-analysis. Reprod Biomed Online 2010; 20(2): 209–222
https://doi.org/10.1016/j.rbmo.2009.11.013
pmid: 20113959
|
16 |
Gleicher N, Kushnir VA, Barad DH. Is it time for a paradigm shift in understanding embryo selection? Reprod Biol Endocrinol 2015; 13(1): 3
https://doi.org/10.1186/1477-7827-13-3
pmid: 25577140
|
17 |
Xi QS, Zhu LX, Hu J, Wu L, Zhang HW. Should few retrieved oocytes be as an indication for intracytoplasmic sperm injection? J Zhejiang Univ Sci B 2012; 13(9): 717–722
https://doi.org/10.1631/jzus.B1100370
pmid: 22949362
|
18 |
Yu Z, Dong X, Rui W, Wei Y, Zhang H, Zhu G, Ai J. The criteria for optimal down-regulation with gonadotropin-releasing hormone-agonist: a retrospective cohort study. Gynecol Endocrinol 2015; 31(12): 959–965
https://doi.org/10.3109/09513590.2015.1101437
|
19 |
Papanikolaou EGD, D’haeseleer E, Verheyen G, Van de Velde H, Camus M, Van Steirteghem A, Devroey P, Tournaye H. Live birth rate is significantly higher after blastocyst transfer than after cleavage-stage embryo transfer when at least four embryos are available on day 3 of embryo culture. A randomized prospective study. Hum Reprod 2005; 20(11): 3198–3203
https://doi.org/10.1093/humrep/dei217
pmid: 16055454
|
20 |
Yu Z, Dong X, Wei Y, Zhang H, Ai J. The artificial cycle method improves the pregnancy outcome in freeze–thawed embryo transfer: a retrospective cohort study. Gynecol Endocrinol 2015; 31(1): 70–74
https://doi.org/10.3109/09513590.2014.958988
|
21 |
Huang B, Ren X, Wu L, Zhu L, Xu B, Li Y, Ai J, Jin L. Elevated progesterone levels on the day of oocyte maturation may affect top quality embryo IVF cycles. PLoS One 2016; 11(1): e0145895
pmid: 26745711
|
22 |
Elgindy EA, Abou-Setta AM, Mostafa MI. Blastocyst-stage versus cleavage-stage embryo transfer in women with high oestradiol concentrations: randomized controlled trial. Reprod Biomed Online 2011; 23(6): 789–798
https://doi.org/10.1016/j.rbmo.2011.08.011
pmid: 22050864
|
23 |
Emiliani S, Delbaere A, Vannin AS, Biramane J, Verdoodt M, Englert Y, Devreker F. Similar delivery rates in a blastocyst cryopreservation to optimize outcomes of warming cycles 159 selected group of patients, for day 2 and day 5 embryos both cultured in sequential medium: a randomized study. Hum Reprod 2003; 18(10): 2145–2150
https://doi.org/10.1093/humrep/deg394
pmid: 14507836
|
24 |
Rienzi L, Ubaldi F, Iacobelli M, Ferrero S, Minasi MG, Martinez F, Tesarik J, Greco E. Day 3 embryo transfer with combined evaluation at the pronuclear and cleavage stages compares favourably with day 5 blastocyst transfer. Hum Reprod 2002; 17(7): 1852–1855
https://doi.org/10.1093/humrep/17.7.1852
pmid: 12093851
|
25 |
Fernández-Shaw S, Cercas R, Braña C, Villas C, Pons I. Ongoing and cumulative pregnancy rate after cleavage-stage versus blastocyst-stage embryo transfer using vitrification for cryopreservation: impact of age on the results. J Assist Reprod Genet 2015; 32(2): 177–184
pmid: 25403438
|
|
Viewed |
|
|
|
Full text
|
|
|
|
|
Abstract
|
|
|
|
|
Cited |
|
|
|
|
|
Shared |
|
|
|
|
|
Discussed |
|
|
|
|