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Blastocyst development rate influences singleton gestational age of similarly graded blastocysts after vitrified–warmed single embryo transfer cycles

  • Author Footnotes
    # Contributed equally.
    Lihua Zhu
    Footnotes
    # Contributed equally.
    Affiliations
    Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Zhongshan Road 321#, 210008 Nanjing, People's Republic of China

    Center for Molecular Reproductive Medicine, Nanjing University, Zhongshan North Road 53#, 210008 Nanjing, People's Republic of China
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  • Author Footnotes
    # Contributed equally.
    Jie Wang
    Footnotes
    # Contributed equally.
    Affiliations
    Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Zhongshan Road 321#, 210008 Nanjing, People's Republic of China

    Center for Molecular Reproductive Medicine, Nanjing University, Zhongshan North Road 53#, 210008 Nanjing, People's Republic of China
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  • Linjun Chen
    Affiliations
    Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Zhongshan Road 321#, 210008 Nanjing, People's Republic of China

    Center for Molecular Reproductive Medicine, Nanjing University, Zhongshan North Road 53#, 210008 Nanjing, People's Republic of China
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  • Weihua Jiang
    Affiliations
    Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Zhongshan Road 321#, 210008 Nanjing, People's Republic of China

    Center for Molecular Reproductive Medicine, Nanjing University, Zhongshan North Road 53#, 210008 Nanjing, People's Republic of China
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  • Junshun Fang
    Affiliations
    Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Zhongshan Road 321#, 210008 Nanjing, People's Republic of China

    Center for Molecular Reproductive Medicine, Nanjing University, Zhongshan North Road 53#, 210008 Nanjing, People's Republic of China
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  • Shanshan Wang
    Affiliations
    Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Zhongshan Road 321#, 210008 Nanjing, People's Republic of China

    Center for Molecular Reproductive Medicine, Nanjing University, Zhongshan North Road 53#, 210008 Nanjing, People's Republic of China
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  • Fei Lin
    Correspondence
    Corresponding authors.
    Affiliations
    Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Zhongshan Road 321#, 210008 Nanjing, People's Republic of China

    Center for Molecular Reproductive Medicine, Nanjing University, Zhongshan North Road 53#, 210008 Nanjing, People's Republic of China
    Search for articles by this author
  • Ningyuan Zhang
    Correspondence
    Corresponding authors.
    Affiliations
    Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Zhongshan Road 321#, 210008 Nanjing, People's Republic of China

    Center for Molecular Reproductive Medicine, Nanjing University, Zhongshan North Road 53#, 210008 Nanjing, People's Republic of China
    Search for articles by this author
  • Author Footnotes
    # Contributed equally.
Published:November 26, 2021DOI:https://doi.org/10.1016/j.rbmo.2021.11.014

      Abstract

      Research question

      Does the development rate of blastocysts influence neonatal outcomes after blastocyst transfer cycles when the morphological score of the transferred blastocysts is similar?

      Design

      A retrospective study involving singleton live births born to 1280 women undergoing single frozen blastocyst transfers (FBTs) between January 2016 and December 2018 at a tertiary care centre. Patients were grouped into day-5 or day-6 groups depending on the development rate of blastocysts. These were further grouped into four groups based on the blastocyst inner cell mass and trophectoderm scoring: excellent (AA); good (AB or BA); average (AC, CA or BB); and poor (BC or CB). The primary outcomes were gestational age and singleton birth weight.

      Results

      Singletons resulting from day-5 single FBT were at a lower risk of preterm birth than those resulting from day-6 single FBT (adjusted OR 0.63, 95% CI 0.41 to 0.97, P = 0.035). In the day-5 good-quality blastocyst group and day-5 average-quality blastocyst group, singletons were at a lower risk of preterm birth than those resulting from day-6 groups, respectively (adjusted OR 0.22, 95% CI 0.08 to 0.63, P = 0.005 and adjusted OR 0.52, 95% CI 0.29 to 0.94, P = 0.03).

      Conclusions

      Day-6 single FBT was associated with a higher risk of preterm birth compared with day-5 single FBT in good and average morphological scoring blastocysts. Our analysis was restricted to women with singleton births from single FBTs. Future prospective studies are required to confirm the findings.

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      Biography

      Lihua Zhu received her MD degree from Nanjing Normal University in 2013. She has been working in the field of assisted reproductive technology for 8 years. Dr Zhu uses frozen–thawed embryo transfer in artificial and natural endometrial preparation cycles in her everyday practice.
      Key message
      Day-6 single frozen blastocyst transfer was associated with a higher risk of being preterm birth compared with day-5 single frozen blastocyst transfer in good and average morphological scoring blastocysts. Extended in-vitro culture may affect the health of offspring by triggering genetic or epigenetic changes of the transferred embryos.