Elective single versus double blastocyst-stage embryo transfer in women aged 36 years or older: a retrospective cohort study.

IF 2.1 4区医学 Q2 OBSTETRICS & GYNECOLOGY

Human Fertility Pub Date : 2023-12-01 Epub Date: 2023-01-31 DOI:10.1080/14647273.2022.2153348

He Cai, Ben Mol, Stephan Gordts, Hui Wang, Juanzi Shi

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Abstract

We evaluated if elective single-blastocyst transfer (eSBT) could be adopted in women aged 36 or older. In this retrospective cohort, women aged ≥36 years received IVF ovarian stimulation cycles and had ≥ two blastocysts. A total of 240 women underwent eSBT and 189 double-blastocyst transfer (DBT) in the first transfer cycle. The subsequent frozen-thawed embryo transfer cycles were a combination of single- and double- blastocyst transfers. Analysis was stratified for patients in age groups 36-37, 38-39 and ≥40, considering the quality of the blastocyst transferred. The cumulative live birth rates (cLBR) were 74.2% (178/240) versus 63.0% (119/189) after eSBT versus DBT, respectively (aOR: 1.09 (0.68, 1.75)). Time to live birth did not vary significantly between the two groups (HR: 0.85 (0.68, 1.08)). The total number of children born was 194 after eSBT (162 singletons and 16 pairs of twins) versus 154 (84 singletons and 35 twins) after DBT. The odds ratios for preterm birth (0.37 (0.21-0.64)), and low birth weight (0.31 (0.16, 0.60)) were all lower in eSBT. In women aged ≥36 years, cLBR following single- versus double- blastocyst transfer was comparable while the odds of multiple live births and adverse perinatal outcomes were reduced.

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36 岁或以上女性选择性单囊胚期胚胎移植与双囊胚期胚胎移植：一项回顾性队列研究。

我们评估了 36 岁或以上女性是否可以采用选择性单囊胚移植（eSBT）。在这个回顾性队列中，年龄≥36 岁的女性接受了体外受精卵巢刺激周期，且囊胚数量≥两个。共有 240 名妇女接受了 eSBT，189 名妇女在第一个移植周期接受了双囊胚移植（DBT）。随后的冷冻解冻胚胎移植周期是单囊胚移植和双囊胚移植的组合。考虑到移植囊胚的质量，对 36-37 岁、38-39 岁和≥40 岁年龄组的患者进行了分层分析。eSBT 和 DBT 的累积活产率（cLBR）分别为 74.2%（178/240）和 63.0%（119/189）（aOR：1.09 (0.68, 1.75)）。两组间的活产时间差异不大（HR：0.85 (0.68, 1.08)）。eSBT 后出生的婴儿总数为 194 个（162 个单胎和 16 对双胞胎），而 DBT 后出生的婴儿总数为 154 个（84 个单胎和 35 对双胞胎）。早产（0.37（0.21-0.64））和低出生体重（0.31（0.16-0.60））的几率比均低于 eSBT。在年龄≥36 岁的妇女中，单囊胚移植与双囊胚移植的 cLBR 值相当，而多胎活产和围产期不良结局的几率则有所降低。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Human Fertility OBSTETRICS & GYNECOLOGY-REPRODUCTIVE BIOLOGY

CiteScore

3.30

自引率

5.30%

发文量

期刊介绍： Human Fertility is a leading international, multidisciplinary journal dedicated to furthering research and promoting good practice in the areas of human fertility and infertility. Topics included span the range from molecular medicine to healthcare delivery, and contributions are welcomed from professionals and academics from the spectrum of disciplines concerned with human fertility. It is published on behalf of the British Fertility Society. The journal also provides a forum for the publication of peer-reviewed articles arising out of the activities of the Association of Biomedical Andrologists, the Association of Clinical Embryologists, the Association of Irish Clinical Embryologists, the British Andrology Society, the British Infertility Counselling Association, the Irish Fertility Society and the Royal College of Nursing Fertility Nurses Group. All submissions are welcome. Articles considered include original papers, reviews, policy statements, commentaries, debates, correspondence, and reports of sessions at meetings. The journal also publishes refereed abstracts from the meetings of the constituent organizations.