Comparative Embryo Development Outcomes following Extending Embryo Culture to Day 6: A Retrospective Cohort Study.

Autor: Wu CQ; Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, Canada.; Ottawa Fertility Centre, Ottawa, Canada.; Ottawa Hospital Research Institute, Ottawa, Canada., Campbell M; Faculty of Medicine, University of Ottawa, Ottawa, Canada., Shmorgun D; Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, Canada.; Ottawa Fertility Centre, Ottawa, Canada., Torrance S; Ottawa Fertility Centre, Ottawa, Canada., Gale J; Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, Canada.; Ottawa Fertility Centre, Ottawa, Canada.; Ottawa Hospital Research Institute, Ottawa, Canada., Leveille MC; Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, Canada.; Ottawa Fertility Centre, Ottawa, Canada.; Ottawa Hospital Research Institute, Ottawa, Canada.
Jazyk: angličtina
Zdroj: International journal of fertility & sterility [Int J Fertil Steril] 2023 Jan 01; Vol. 17 (1), pp. 40-46. Date of Electronic Publication: 2023 Jan 01.
DOI: 10.22074/ijfs.2022.535422.1195
Abstrakt: Background: Past studies have shown that culturing slow-growing embryos from day 5 to day 6 may increase vitrification yield. This study aims to evaluate if the proportion of embryos eligible for vitrification increases by growing embryos not vitrified by day 5 to day 6.
Materials and Methods: In this retrospective cohort study, a Canadian tertiary-care clinic-based cohort was identified between August 2019 and December 2020. In vitro fertilization (IVF) cycles involving autologous oocytes with at least one viable day 5 embryo were selected for inclusion. We compared embryo developmental outcomes of IVF cycles performed before and after an embryo cryopreservation policy change. Prior to March 2020, good-quality day 5 blastocysts of any stage were eligible for vitrification, and after that date, good-quality expanded blastocysts on either day 5 or day 6 were eligible. The primary outcome is the comparative proportion of embryos eligible for vitrification. The secondary outcome is to identify embryo, maternal and cycle factors that are predictive of day 6 vitrification.
Results: A total of 3,438 viable embryos across 679 consecutive IVF cycles were included in this study. After the policy change, we found similar mean proportions of blastocysts eligible for cryopreservation (46.9% per IVF cycle in group 2 vs. 44.4% in group 1, mean difference 0.025, 95% confidence interval -0.021 to 0.071, P=0.28). The mean number of cryopreserved embryos were significantly higher in group 2 (mean 2.2 vs. 1.7 embryos, P=0.007). Factors that predicated an embryo's progression to day 6 included: younger age of egg provider, presence of an early blastocyst on day 5, and cycles involving surgically-retrieved sperm.
Conclusion: A cryopreservation policy change to include good-quality full and expanded day 6 blastocysts while avoiding to vitrify early blastocysts on day 5 yielded comparable proportions of embryos eligible for vitrification per IVF cycle.
Databáze: MEDLINE
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