The impact of double vitrification and warming procedures on pregnancy and neonatal outcomes following single euploid blastocyst transfer.

IF 2.7 3区医学 Q2 GENETICS & HEREDITY

Journal of Assisted Reproduction and Genetics Pub Date : 2025-09-14 DOI:10.1007/s10815-025-03642-y

Miaomiao Jia, Juanzi Shi, Wenhao Shi, Xia Xue

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引用次数: 0

Abstract

Purpose: To evaluate the impact of multiple vitrification-warming on clinical outcomes of embryos that have undergone preimplantation genetic testing (PGT).

Methods: This retrospective, single-center study involved 512 single frozen euploid blastocyst transfer cycles conducted between January 2018 and January 2024. Using propensity score matching, 105 patients who underwent double vitrification-warming with single biopsy (DVSB) were matched in a 1:4 ratio with 407 patients in the control group, who underwent single biopsy with single vitrification-warming (SVSB). Post-warming suitability for biopsy and clinical outcomes of subsequent frozen-thawed embryo transfer (FET) cycles were evaluated. Obstetrical and neonatal outcomes were also assessed.

Results: A total of 453 blastocysts were warmed, of which 417 (92.1%) exhibited sufficient quality to undergo trophectoderm biopsy. In FET cycles, a significant reduction in the live birth rate was observed with the additional vitrification-warming step (DVSB: 49.5% vs. SVSB: 61.2%). The pregnancy loss rate in the DVSB group was significantly higher compared to the SVSB group (20.6% vs. 12.2%). Neonatal outcomes, including sex ratio, preterm birth rate, and low birth weight rate, did not differ significantly between the two groups.

Conclusion: This study suggests that the inclusion of an additional vitrification-warming step in PGT may adversely affect pregnancy outcomes. Furthermore, only a portion of thawed embryos are able to re-expand and progress to the biopsy stage. PGT patients should be informed that undergoing a second vitrification-warming cycle may reduce the likelihood of a successful pregnancy.

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单整倍体囊胚移植后，双重玻璃化和加热程序对妊娠和新生儿结局的影响。

目的：评价多次玻璃化-升温对胚胎着床前基因检测（PGT）临床结局的影响。方法：本回顾性单中心研究涉及2018年1月至2024年1月期间进行的512个单冷冻整倍体囊胚移植周期。采用倾向评分匹配法，将105例双活检+单活检（DVSB）患者与407例单活检+单活检（SVSB）对照组患者按1:4的比例匹配。评估温后活检的适宜性和随后冻融胚胎移植（FET）周期的临床结果。还评估了产科和新生儿结局。结果：共加热453个囊胚，其中417个（92.1%）质量合格，可行滋养外胚层活检。在FET循环中，观察到额外的玻璃化升温步骤显著降低了活产率（DVSB: 49.5% vs. SVSB: 61.2%）。DVSB组的流产率明显高于SVSB组（20.6% vs. 12.2%）。新生儿结局，包括性别比、早产率和低出生体重率，在两组之间没有显著差异。结论：本研究表明，在PGT中加入额外的玻璃化升温步骤可能会对妊娠结局产生不利影响。此外，只有一部分解冻的胚胎能够重新扩展并进展到活检阶段。应告知PGT患者，进行第二次玻璃化-升温循环可能会降低妊娠成功的可能性。

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

Journal of Assisted Reproduction and Genetics 医学-妇产科学

CiteScore

5.70

自引率

9.70%

发文量

286

审稿时长

1 months

期刊介绍： The Journal of Assisted Reproduction and Genetics publishes cellular, molecular, genetic, and epigenetic discoveries advancing our understanding of the biology and underlying mechanisms from gametogenesis to offspring health. Special emphasis is placed on the practice and evolution of assisted reproduction technologies (ARTs) with reference to the diagnosis and management of diseases affecting fertility. Our goal is to educate our readership in the translation of basic and clinical discoveries made from human or relevant animal models to the safe and efficacious practice of human ARTs. The scientific rigor and ethical standards embraced by the JARG editorial team ensures a broad international base of expertise guiding the marriage of contemporary clinical research paradigms with basic science discovery. JARG publishes original papers, minireviews, case reports, and opinion pieces often combined into special topic issues that will educate clinicians and scientists with interests in the mechanisms of human development that bear on the treatment of infertility and emerging innovations in human ARTs. The guiding principles of male and female reproductive health impacting pre- and post-conceptional viability and developmental potential are emphasized within the purview of human reproductive health in current and future generations of our species. The journal is published in cooperation with the American Society for Reproductive Medicine, an organization of more than 8,000 physicians, researchers, nurses, technicians and other professionals dedicated to advancing knowledge and expertise in reproductive biology.