Does Day 3 embryo status matter to reproductive outcomes of single blastocyst transfer cycles?: A cohort study

Jiaxin Qiu; Tong Du; Haiyan Guo; Ben W. Mol; Jiaying Lin; Dong Zhao; Yun Wang; Yanping Kuang; Wentao Li

doi:10.1111/1471-0528.17559

Does Day 3 embryo status matter to reproductive outcomes of single blastocyst transfer cycles? A cohort study

Jiaxin Qiu, Tong Du, Haiyan Guo, Ben W. Mol, Jiaying Lin, Dong Zhao, Yun Wang^*, Yanping Kuang^*, Wentao Li

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

Abstract

Objective: To investigate whether Day 3 (D3) embryo status matter to reproductive outcomes of blastocyst transfer cycles. Design: Retrospective cohort study. Setting: Assisted Reproduction Department of Shanghai Ninth People's Hospital, Shanghai, China. Population: A total of 6906 vitrified–thawed single blastocyst transfer cycles in 6502 women were included. Methods: Generalised estimated equation regression models were used to calculate adjusted odds ratios (aOR) and 95% confidence intervals (CI) for the associations between embryo status and pregnancy outcomes. Main outcome measures: Biochemical pregnancy, miscarriage, live birth. Results: High-quality blastocysts derived from poor-grade D3 embryos had comparable pregnancy outcomes to those derived from high-grade D3 embryos (40.0% versus 43.2%, aOR 1.00, 95% CI 0.85–1.17 for live birth rate; 8.3% versus 9.5%, aOR 0.82, 95% CI 0.63–1.07 for miscarriage rate). Cycles with low D3 cell number (five cells or fewer) had significantly higher miscarriage rate (9.2% versus 7.6%, aOR 1.33, 95% CI 1.02–1.75) compared with cycles with eight cells on D3. Conclusions: Poor-quality cleavage embryos should be cultivated to the blastocyst stage because high-quality blastocysts derived from poor-grade D3 embryos had acceptable pregnancy outcomes. When the blastocyst grade is identical, choosing embryos with higher D3 cell number (eight or more cells) for transfer could reduce the risk of early miscarriage.

Original language	English
Pages (from-to)	1669-1676
Number of pages	8
Journal	BJOG: An International Journal of Obstetrics and Gynaecology
Volume	130
Issue number	13
Early online date	12 Jun 2023
DOIs	https://doi.org/10.1111/1471-0528.17559
Publication status	Published - Dec 2023

Bibliographical note

Ben W. Mol reports consultancy for ObsEva and research funding from Ferring and Merck outside the work of this paper. Wentao Li reports grants from the Norman Beischer Medical Research Foundation outside the work of this paper. Other authors: none declared.

Funding Information:
This work was supported by Shanghai Sailing Programme (Grant no. 21YF1423200), Fundamental Research Programme of the Ninth People's Hospital (Grant no. JYZZ117), NSFC (Grant nos. 31770989, 82071615 and 82201912) and NHMRC Investigator grant (Grant no. 1176437).

Data Availability Statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Keywords

Day 3 cell number
Day 3 morphological grade
in vitro fertilisation/intracytoplasmic sperm injection
reproductive outcomes
single blastocyst transfer

Access to Document

10.1111/1471-0528.17559Licence: Unspecified

Cite this

@article{0fc36874d55c4c20ae66fd8b1f258ee0,

title = "Does Day 3 embryo status matter to reproductive outcomes of single blastocyst transfer cycles?: A cohort study",

abstract = "Objective: To investigate whether Day 3 (D3) embryo status matter to reproductive outcomes of blastocyst transfer cycles. Design: Retrospective cohort study. Setting: Assisted Reproduction Department of Shanghai Ninth People's Hospital, Shanghai, China. Population: A total of 6906 vitrified–thawed single blastocyst transfer cycles in 6502 women were included. Methods: Generalised estimated equation regression models were used to calculate adjusted odds ratios (aOR) and 95% confidence intervals (CI) for the associations between embryo status and pregnancy outcomes. Main outcome measures: Biochemical pregnancy, miscarriage, live birth. Results: High-quality blastocysts derived from poor-grade D3 embryos had comparable pregnancy outcomes to those derived from high-grade D3 embryos (40.0% versus 43.2%, aOR 1.00, 95% CI 0.85–1.17 for live birth rate; 8.3% versus 9.5%, aOR 0.82, 95% CI 0.63–1.07 for miscarriage rate). Cycles with low D3 cell number (five cells or fewer) had significantly higher miscarriage rate (9.2% versus 7.6%, aOR 1.33, 95% CI 1.02–1.75) compared with cycles with eight cells on D3. Conclusions: Poor-quality cleavage embryos should be cultivated to the blastocyst stage because high-quality blastocysts derived from poor-grade D3 embryos had acceptable pregnancy outcomes. When the blastocyst grade is identical, choosing embryos with higher D3 cell number (eight or more cells) for transfer could reduce the risk of early miscarriage.",

keywords = "Day 3 cell number, Day 3 morphological grade, in vitro fertilisation/intracytoplasmic sperm injection, reproductive outcomes, single blastocyst transfer",

author = "Jiaxin Qiu and Tong Du and Haiyan Guo and Mol, {Ben W.} and Jiaying Lin and Dong Zhao and Yun Wang and Yanping Kuang and Wentao Li",

note = "Ben W. Mol reports consultancy for ObsEva and research funding from Ferring and Merck outside the work of this paper. Wentao Li reports grants from the Norman Beischer Medical Research Foundation outside the work of this paper. Other authors: none declared. Funding Information: This work was supported by Shanghai Sailing Programme (Grant no. 21YF1423200), Fundamental Research Programme of the Ninth People's Hospital (Grant no. JYZZ117), NSFC (Grant nos. 31770989, 82071615 and 82201912) and NHMRC Investigator grant (Grant no. 1176437). ",

year = "2023",

month = dec,

doi = "10.1111/1471-0528.17559",

language = "English",

volume = "130",

pages = "1669--1676",

journal = "BJOG: An International Journal of Obstetrics and Gynaecology",

issn = "1470-0328",

publisher = "John Wiley & Sons, Ltd (10.1111)",

number = "13",

}

TY - JOUR

T1 - Does Day 3 embryo status matter to reproductive outcomes of single blastocyst transfer cycles?

T2 - A cohort study

AU - Qiu, Jiaxin

AU - Du, Tong

AU - Guo, Haiyan

AU - Mol, Ben W.

AU - Lin, Jiaying

AU - Zhao, Dong

AU - Wang, Yun

AU - Kuang, Yanping

AU - Li, Wentao

N1 - Ben W. Mol reports consultancy for ObsEva and research funding from Ferring and Merck outside the work of this paper. Wentao Li reports grants from the Norman Beischer Medical Research Foundation outside the work of this paper. Other authors: none declared. Funding Information: This work was supported by Shanghai Sailing Programme (Grant no. 21YF1423200), Fundamental Research Programme of the Ninth People's Hospital (Grant no. JYZZ117), NSFC (Grant nos. 31770989, 82071615 and 82201912) and NHMRC Investigator grant (Grant no. 1176437).

PY - 2023/12

Y1 - 2023/12

N2 - Objective: To investigate whether Day 3 (D3) embryo status matter to reproductive outcomes of blastocyst transfer cycles. Design: Retrospective cohort study. Setting: Assisted Reproduction Department of Shanghai Ninth People's Hospital, Shanghai, China. Population: A total of 6906 vitrified–thawed single blastocyst transfer cycles in 6502 women were included. Methods: Generalised estimated equation regression models were used to calculate adjusted odds ratios (aOR) and 95% confidence intervals (CI) for the associations between embryo status and pregnancy outcomes. Main outcome measures: Biochemical pregnancy, miscarriage, live birth. Results: High-quality blastocysts derived from poor-grade D3 embryos had comparable pregnancy outcomes to those derived from high-grade D3 embryos (40.0% versus 43.2%, aOR 1.00, 95% CI 0.85–1.17 for live birth rate; 8.3% versus 9.5%, aOR 0.82, 95% CI 0.63–1.07 for miscarriage rate). Cycles with low D3 cell number (five cells or fewer) had significantly higher miscarriage rate (9.2% versus 7.6%, aOR 1.33, 95% CI 1.02–1.75) compared with cycles with eight cells on D3. Conclusions: Poor-quality cleavage embryos should be cultivated to the blastocyst stage because high-quality blastocysts derived from poor-grade D3 embryos had acceptable pregnancy outcomes. When the blastocyst grade is identical, choosing embryos with higher D3 cell number (eight or more cells) for transfer could reduce the risk of early miscarriage.

AB - Objective: To investigate whether Day 3 (D3) embryo status matter to reproductive outcomes of blastocyst transfer cycles. Design: Retrospective cohort study. Setting: Assisted Reproduction Department of Shanghai Ninth People's Hospital, Shanghai, China. Population: A total of 6906 vitrified–thawed single blastocyst transfer cycles in 6502 women were included. Methods: Generalised estimated equation regression models were used to calculate adjusted odds ratios (aOR) and 95% confidence intervals (CI) for the associations between embryo status and pregnancy outcomes. Main outcome measures: Biochemical pregnancy, miscarriage, live birth. Results: High-quality blastocysts derived from poor-grade D3 embryos had comparable pregnancy outcomes to those derived from high-grade D3 embryos (40.0% versus 43.2%, aOR 1.00, 95% CI 0.85–1.17 for live birth rate; 8.3% versus 9.5%, aOR 0.82, 95% CI 0.63–1.07 for miscarriage rate). Cycles with low D3 cell number (five cells or fewer) had significantly higher miscarriage rate (9.2% versus 7.6%, aOR 1.33, 95% CI 1.02–1.75) compared with cycles with eight cells on D3. Conclusions: Poor-quality cleavage embryos should be cultivated to the blastocyst stage because high-quality blastocysts derived from poor-grade D3 embryos had acceptable pregnancy outcomes. When the blastocyst grade is identical, choosing embryos with higher D3 cell number (eight or more cells) for transfer could reduce the risk of early miscarriage.

KW - Day 3 cell number

KW - Day 3 morphological grade

KW - in vitro fertilisation/intracytoplasmic sperm injection

KW - reproductive outcomes

KW - single blastocyst transfer

UR - http://www.scopus.com/inward/record.url?scp=85163051441&partnerID=8YFLogxK

U2 - 10.1111/1471-0528.17559

DO - 10.1111/1471-0528.17559

M3 - Article

C2 - 37308804

AN - SCOPUS:85163051441

SN - 1470-0328

VL - 130

SP - 1669

EP - 1676

JO - BJOG: An International Journal of Obstetrics and Gynaecology

JF - BJOG: An International Journal of Obstetrics and Gynaecology

IS - 13

ER -