Is there still a role for a cleavage-stage embryo transfer?

Autor:	Neblett MF 2nd; Division of Reproductive Endocrinology and Infertility, Mayo Clinic, Rochester, Minnesota.; Department of Obstetrics and Gynecology, Mayo Clinic College of Medicine, Rochester, Minnesota., Kim T; Reproductive Medicine and Infertility Associates, Woodbury, Minnesota., Jones TL; Conceive Fertility Center, Dallas, Texas., Baumgarten SC; Department of Obstetrics and Gynecology, Mayo Clinic College of Medicine, Rochester, Minnesota., Coddington CC; Division of Reproductive Endocrinology and Infertility, Mayo Clinic, Rochester, Minnesota.; Department of Obstetrics and Gynecology, Mayo Clinic College of Medicine, Rochester, Minnesota., Zhao Y; Division of Reproductive Endocrinology and Infertility, Mayo Clinic, Rochester, Minnesota.; Department of Obstetrics and Gynecology, Mayo Clinic College of Medicine, Rochester, Minnesota., Shenoy CC; Division of Reproductive Endocrinology and Infertility, Mayo Clinic, Rochester, Minnesota.; Department of Obstetrics and Gynecology, Mayo Clinic College of Medicine, Rochester, Minnesota.
Jazyk:	angličtina
Zdroj:	F&S reports [F S Rep] 2021 Jun 29; Vol. 2 (3), pp. 269-274. Date of Electronic Publication: 2021 Jun 29 (Print Publication: 2021).
DOI:	10.1016/j.xfre.2021.06.004
Abstrakt:	Objective: To determine whether pregnancy outcomes are poor or futile when an intended day 5 transfer is converted to a cleavage-stage transfer because of poor embryo development or a lower number of embryos. Design: Retrospective cohort study. Setting: Academic medical center. Patients: Women with a limited number of embryos, defined as ≤6 two pronuclear embryos, after in vitro fertilization. Interventions: Patients who had a cleavage-stage transfer were age matched with patients who had a day 5 transfer. Main Outcome Measures: Live birth rate. Results: A total of 146 women were included in the study with 73 women in each group. Cleavage-stage transfer was associated with significantly lower implantation and clinical pregnancy rates compared with those of day 5 transfer. Although the live birth rate of the cleavage-stage transfer group was lower than that of the day 5 transfer group (25% vs. 40%, respectively), the cleavage-stage transfer still resulted in a live birth rate of 25%. A subanalysis comparing women who did and did not achieve live birth after cleavage-stage transfer demonstrated a live birth rate of 27% when at least one grade A embryo was transferred vs. 17% when a lesser quality embryo (grade B or C) was transferred. Conclusions: As expected, the live birth rate after cleavage-stage transfer was lower than that after day 5 transfer. However, the live birth rate of cleavage-stage transfer still fell into acceptable practice, >5%, for patients who were otherwise at very high risk of having no day 5 embryo transfer. Extended culture may not be necessary for all patients.
Databáze:	MEDLINE
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