The influence of morphologic grading and COS protocol on the outcomes of Day 5 versus Day 6 single fresh blastocyst transfers: a retrospective analysis of clinical outcomes from one center experience
Introduction The purpose of this study was to evaluate whether the blastocyst morphologic grading and the protocol of controlled ovarian stimulation (COS) would influence pregnancy outcomes, aiming to provide guidance when choosing blastocyst transfer. Methods The clinical data of 612 patients who r...
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| Veröffentlicht in: | Archives of gynecology and obstetrics 2022-11, Vol.306 (5), p.1739-1752 |
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| description | Introduction
The purpose of this study was to evaluate whether the blastocyst morphologic grading and the protocol of controlled ovarian stimulation (COS) would influence pregnancy outcomes, aiming to provide guidance when choosing blastocyst transfer.
Methods
The clinical data of 612 patients who received single fresh blastocyst transfer for first cycle, as well as the data of 253 patients who had already delivered were analyzed retrospectively. The patients were divided into two groups according to blastocyst formation time (D5 or D6). The following subgroup analyses were performed: (i) the morphologic grading of blastocyst and (ii) the protocol of COS
.
Results
We observed that D5 single embryo transfer (SET) were associated with higher clinical pregnancy rate (CPR, 59.04% vs. 31.73%,
P
|
| doi_str_mv | 10.1007/s00404-022-06702-1 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2703418106</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2703418106</sourcerecordid><originalsourceid>FETCH-LOGICAL-c303t-b0b59feaaca4d70b542111f7ca76e6ed28d9cdc897d757620970419307e092b23</originalsourceid><addsrcrecordid>eNp9kU9v1DAQxSNEJUrbL8BpJC5cQsdONk64oeVfpUo90J4jrzPZdeXYweNU7Cfka-HdRSriwMke6ffes-cVxRuB7wWiumbEGusSpSyxUShL8aI4F3WVRyXEy7_ur4rXzI-IQrZtc178ut8RWD-6hbwhCCNMIc674MLWGthGPVi_Be0HWN99hzmGFExwEDykLAxLMmEiPug-6T2s4IkiL3wcGuCsdQRjJN7BxmnO4j0nSFF7HjP5ATRESjHwTCbZJ8pJ2u3ZHh2Ns94a7Z5jxhimnE1gyCeKQD9nivbw8svibNSO6erPeVE8fPl8v_5W3t59vVl_vC1NhVUqN7hZdSNpbXQ9qDzUUggxKqNVQw0Nsh06M5i2U4NaqUZip7AWXYWKsJMbWV0U706-eRU_FuLUT5YNOac9hYV7qbCqRSuwyejbf9DHsMT8vwMlWpWj6zpT8kSZvAWONPZztJOO-15gf-i2P3Xb5277Y7e9yKLqJOIM-y3FZ-v_qH4DV3GqLw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2718742144</pqid></control><display><type>article</type><title>The influence of morphologic grading and COS protocol on the outcomes of Day 5 versus Day 6 single fresh blastocyst transfers: a retrospective analysis of clinical outcomes from one center experience</title><source>SpringerLink Journals - AutoHoldings</source><creator>Chen, Zhilan ; Li, Wei ; Xiao, Cong ; Li, Yanmin ; Gong, Aidong</creator><creatorcontrib>Chen, Zhilan ; Li, Wei ; Xiao, Cong ; Li, Yanmin ; Gong, Aidong</creatorcontrib><description>Introduction
The purpose of this study was to evaluate whether the blastocyst morphologic grading and the protocol of controlled ovarian stimulation (COS) would influence pregnancy outcomes, aiming to provide guidance when choosing blastocyst transfer.
Methods
The clinical data of 612 patients who received single fresh blastocyst transfer for first cycle, as well as the data of 253 patients who had already delivered were analyzed retrospectively. The patients were divided into two groups according to blastocyst formation time (D5 or D6). The following subgroup analyses were performed: (i) the morphologic grading of blastocyst and (ii) the protocol of COS
.
Results
We observed that D5 single embryo transfer (SET) were associated with higher clinical pregnancy rate (CPR, 59.04% vs. 31.73%,
P
< 0.001) and live birth rate (LBR, 43.90% vs. 24.04%,
P
< 0.001) than D6 SET following fresh cycle. Patients in D5 group experienced more good blastocysts transfer (45.47%vs. 13.46%,
P
< 0.001) and less poor blastocysts transfer (9.64%vs. 45.19%,
P
< 0.001) than patients in D6 group. As to early stage and good quality blastocysts, the CPR and LBR were similar between D5 and D6 group. GnRH antagonist protocol had a demonstrable inferiority comparing with the early-follicular-phase long-acting GnRH-agonist long protocol (EFLL) or the mid-luteal-phase long-acting GnRH-agonist long protocol (MLLL) with regard to the CPR and LBR in D6-SET group.
Conclusions
The analysis found that ovarian reserve of patients in D6-SET group was comparatively worse than that of patients in D5-SET group and D6-SET patients represented a subgroup of infertility patients usually having relatively poor embryo quality. The results should be interpreted with caution as the very low numbers in the respective group limited the use of statistical tests and the real significance values.</description><identifier>ISSN: 1432-0711</identifier><identifier>ISSN: 0932-0067</identifier><identifier>EISSN: 1432-0711</identifier><identifier>DOI: 10.1007/s00404-022-06702-1</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Birth rate ; Clinical outcomes ; Drug dosages ; Embryos ; Endocrinology ; Gynecologic Endocrinology and Reproductive Medicine ; Gynecology ; Hospitals ; Human Genetics ; In vitro fertilization ; Infertility ; Medicine ; Medicine & Public Health ; Morphology ; Obstetrics ; Obstetrics/Perinatology/Midwifery ; Ovaries ; Ovulation ; Pregnancy ; Reproductive health ; Ultrasonic imaging</subject><ispartof>Archives of gynecology and obstetrics, 2022-11, Vol.306 (5), p.1739-1752</ispartof><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2022. Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c303t-b0b59feaaca4d70b542111f7ca76e6ed28d9cdc897d757620970419307e092b23</cites><orcidid>0000-0002-6923-4273</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00404-022-06702-1$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00404-022-06702-1$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids></links><search><creatorcontrib>Chen, Zhilan</creatorcontrib><creatorcontrib>Li, Wei</creatorcontrib><creatorcontrib>Xiao, Cong</creatorcontrib><creatorcontrib>Li, Yanmin</creatorcontrib><creatorcontrib>Gong, Aidong</creatorcontrib><title>The influence of morphologic grading and COS protocol on the outcomes of Day 5 versus Day 6 single fresh blastocyst transfers: a retrospective analysis of clinical outcomes from one center experience</title><title>Archives of gynecology and obstetrics</title><addtitle>Arch Gynecol Obstet</addtitle><description>Introduction
The purpose of this study was to evaluate whether the blastocyst morphologic grading and the protocol of controlled ovarian stimulation (COS) would influence pregnancy outcomes, aiming to provide guidance when choosing blastocyst transfer.
Methods
The clinical data of 612 patients who received single fresh blastocyst transfer for first cycle, as well as the data of 253 patients who had already delivered were analyzed retrospectively. The patients were divided into two groups according to blastocyst formation time (D5 or D6). The following subgroup analyses were performed: (i) the morphologic grading of blastocyst and (ii) the protocol of COS
.
Results
We observed that D5 single embryo transfer (SET) were associated with higher clinical pregnancy rate (CPR, 59.04% vs. 31.73%,
P
< 0.001) and live birth rate (LBR, 43.90% vs. 24.04%,
P
< 0.001) than D6 SET following fresh cycle. Patients in D5 group experienced more good blastocysts transfer (45.47%vs. 13.46%,
P
< 0.001) and less poor blastocysts transfer (9.64%vs. 45.19%,
P
< 0.001) than patients in D6 group. As to early stage and good quality blastocysts, the CPR and LBR were similar between D5 and D6 group. GnRH antagonist protocol had a demonstrable inferiority comparing with the early-follicular-phase long-acting GnRH-agonist long protocol (EFLL) or the mid-luteal-phase long-acting GnRH-agonist long protocol (MLLL) with regard to the CPR and LBR in D6-SET group.
Conclusions
The analysis found that ovarian reserve of patients in D6-SET group was comparatively worse than that of patients in D5-SET group and D6-SET patients represented a subgroup of infertility patients usually having relatively poor embryo quality. The results should be interpreted with caution as the very low numbers in the respective group limited the use of statistical tests and the real significance values.</description><subject>Birth rate</subject><subject>Clinical outcomes</subject><subject>Drug dosages</subject><subject>Embryos</subject><subject>Endocrinology</subject><subject>Gynecologic Endocrinology and Reproductive Medicine</subject><subject>Gynecology</subject><subject>Hospitals</subject><subject>Human Genetics</subject><subject>In vitro fertilization</subject><subject>Infertility</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Morphology</subject><subject>Obstetrics</subject><subject>Obstetrics/Perinatology/Midwifery</subject><subject>Ovaries</subject><subject>Ovulation</subject><subject>Pregnancy</subject><subject>Reproductive health</subject><subject>Ultrasonic imaging</subject><issn>1432-0711</issn><issn>0932-0067</issn><issn>1432-0711</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kU9v1DAQxSNEJUrbL8BpJC5cQsdONk64oeVfpUo90J4jrzPZdeXYweNU7Cfka-HdRSriwMke6ffes-cVxRuB7wWiumbEGusSpSyxUShL8aI4F3WVRyXEy7_ur4rXzI-IQrZtc178ut8RWD-6hbwhCCNMIc674MLWGthGPVi_Be0HWN99hzmGFExwEDykLAxLMmEiPug-6T2s4IkiL3wcGuCsdQRjJN7BxmnO4j0nSFF7HjP5ATRESjHwTCbZJ8pJ2u3ZHh2Ns94a7Z5jxhimnE1gyCeKQD9nivbw8svibNSO6erPeVE8fPl8v_5W3t59vVl_vC1NhVUqN7hZdSNpbXQ9qDzUUggxKqNVQw0Nsh06M5i2U4NaqUZip7AWXYWKsJMbWV0U706-eRU_FuLUT5YNOac9hYV7qbCqRSuwyejbf9DHsMT8vwMlWpWj6zpT8kSZvAWONPZztJOO-15gf-i2P3Xb5277Y7e9yKLqJOIM-y3FZ-v_qH4DV3GqLw</recordid><startdate>20221101</startdate><enddate>20221101</enddate><creator>Chen, Zhilan</creator><creator>Li, Wei</creator><creator>Xiao, Cong</creator><creator>Li, Yanmin</creator><creator>Gong, Aidong</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-6923-4273</orcidid></search><sort><creationdate>20221101</creationdate><title>The influence of morphologic grading and COS protocol on the outcomes of Day 5 versus Day 6 single fresh blastocyst transfers: a retrospective analysis of clinical outcomes from one center experience</title><author>Chen, Zhilan ; Li, Wei ; Xiao, Cong ; Li, Yanmin ; Gong, Aidong</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c303t-b0b59feaaca4d70b542111f7ca76e6ed28d9cdc897d757620970419307e092b23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Birth rate</topic><topic>Clinical outcomes</topic><topic>Drug dosages</topic><topic>Embryos</topic><topic>Endocrinology</topic><topic>Gynecologic Endocrinology and Reproductive Medicine</topic><topic>Gynecology</topic><topic>Hospitals</topic><topic>Human Genetics</topic><topic>In vitro fertilization</topic><topic>Infertility</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Morphology</topic><topic>Obstetrics</topic><topic>Obstetrics/Perinatology/Midwifery</topic><topic>Ovaries</topic><topic>Ovulation</topic><topic>Pregnancy</topic><topic>Reproductive health</topic><topic>Ultrasonic imaging</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chen, Zhilan</creatorcontrib><creatorcontrib>Li, Wei</creatorcontrib><creatorcontrib>Xiao, Cong</creatorcontrib><creatorcontrib>Li, Yanmin</creatorcontrib><creatorcontrib>Gong, Aidong</creatorcontrib><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection (Proquest)</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Archives of gynecology and obstetrics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chen, Zhilan</au><au>Li, Wei</au><au>Xiao, Cong</au><au>Li, Yanmin</au><au>Gong, Aidong</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The influence of morphologic grading and COS protocol on the outcomes of Day 5 versus Day 6 single fresh blastocyst transfers: a retrospective analysis of clinical outcomes from one center experience</atitle><jtitle>Archives of gynecology and obstetrics</jtitle><stitle>Arch Gynecol Obstet</stitle><date>2022-11-01</date><risdate>2022</risdate><volume>306</volume><issue>5</issue><spage>1739</spage><epage>1752</epage><pages>1739-1752</pages><issn>1432-0711</issn><issn>0932-0067</issn><eissn>1432-0711</eissn><abstract>Introduction
The purpose of this study was to evaluate whether the blastocyst morphologic grading and the protocol of controlled ovarian stimulation (COS) would influence pregnancy outcomes, aiming to provide guidance when choosing blastocyst transfer.
Methods
The clinical data of 612 patients who received single fresh blastocyst transfer for first cycle, as well as the data of 253 patients who had already delivered were analyzed retrospectively. The patients were divided into two groups according to blastocyst formation time (D5 or D6). The following subgroup analyses were performed: (i) the morphologic grading of blastocyst and (ii) the protocol of COS
.
Results
We observed that D5 single embryo transfer (SET) were associated with higher clinical pregnancy rate (CPR, 59.04% vs. 31.73%,
P
< 0.001) and live birth rate (LBR, 43.90% vs. 24.04%,
P
< 0.001) than D6 SET following fresh cycle. Patients in D5 group experienced more good blastocysts transfer (45.47%vs. 13.46%,
P
< 0.001) and less poor blastocysts transfer (9.64%vs. 45.19%,
P
< 0.001) than patients in D6 group. As to early stage and good quality blastocysts, the CPR and LBR were similar between D5 and D6 group. GnRH antagonist protocol had a demonstrable inferiority comparing with the early-follicular-phase long-acting GnRH-agonist long protocol (EFLL) or the mid-luteal-phase long-acting GnRH-agonist long protocol (MLLL) with regard to the CPR and LBR in D6-SET group.
Conclusions
The analysis found that ovarian reserve of patients in D6-SET group was comparatively worse than that of patients in D5-SET group and D6-SET patients represented a subgroup of infertility patients usually having relatively poor embryo quality. The results should be interpreted with caution as the very low numbers in the respective group limited the use of statistical tests and the real significance values.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><doi>10.1007/s00404-022-06702-1</doi><tpages>14</tpages><orcidid>https://orcid.org/0000-0002-6923-4273</orcidid></addata></record> |
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| source | SpringerLink Journals - AutoHoldings |
| subjects | Birth rate Clinical outcomes Drug dosages Embryos Endocrinology Gynecologic Endocrinology and Reproductive Medicine Gynecology Hospitals Human Genetics In vitro fertilization Infertility Medicine Medicine & Public Health Morphology Obstetrics Obstetrics/Perinatology/Midwifery Ovaries Ovulation Pregnancy Reproductive health Ultrasonic imaging |
| title | The influence of morphologic grading and COS protocol on the outcomes of Day 5 versus Day 6 single fresh blastocyst transfers: a retrospective analysis of clinical outcomes from one center experience |
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