The clinical outcomes of day 3 4-cell embryos after extended in vitro culture

Springer Science and Business Media LLC - Tập 32 - Trang 55-60 - 2014
Ping Zhao1,2,3, Ming Li1,2,3, Ying Lian1,2,3, Xiaoying Zheng1,2,3, Ping Liu1,2,3, Jie Qiao1,2,3
1Reproductive Medical Center, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, People’s Republic of China
2Key Laboratory of Assisted Reproduction, Ministry of Education, Beijing, People’s Republic of China
3Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproduction, Beijing, People's Republic of China

Tóm tắt

To evaluate the development potential and clinical significance of day 3 4-cell embryos after extended in vitro culture. This study was a retrospective cohort study for patients with infertility treatment between January 2011 and July 2013. Patients undergoing blastocyst culture in controlled ovarian hyperstimulation cycles using surplus embryos were analyzed in the study. A total of 764 women undergoing blastocyst culture with 1,522 surplus 4-cell embryos on day 3 were analyzed. An additional 2,391 patients with embryos undergoing blastocyst culture during the same period with embryos having more blastomeres were chosen as control. After extended culture, 253 embryos from 183 cycles in the study group which developed to blastocysts were frozen, and 118 embryos were warmed in subsequent frozen embryo transfer cycles. Implantation rates, clinical pregnancy rates (PRs) and ongoing PRs were 33.3 %, 38.4 % and 31.4 %, respectively, which were similar to those of the control group. The singleton birth weights of newborns using these blastocysts showed no significant difference to that seen in the control group. Surplus 4-cell embryos on day 3 displayed lower blastulation rates. However, once a blastocyst is obtained, it has equivalent clinical outcomes. Embryos that are developmentally lagging on day 3 can be observed in extended culture to increase the cumulative chances of a successful pregnancy.

Tài liệu tham khảo

Scott L. The biological basis of non-invasive strategies for selection of human oocytes and embryos. Hum Reprod Update. 2003;9(3):237–49. Desai NN, Goldstein J, Rowland DY, Goldfarb JM. Morphological evaluation of human embryos and derivation of an embryo quality scoring system specific for day 3 embryos: a preliminary study. Hum Reprod. 2000;15(10):2190–6. Ertzeid G, Storeng R, Tanbo T, Dale PO, Bjercke S, Abyholm T. Cycle characteristics of day 3 embryo transfers with 4-cell embryos only. J Assist Reprod Genet. 2003;20(9):352–7. Westergaard LG, Mao Q, Krogslund M, Sandrini S, Lenz S, Grinsted J. Acupuncture on the day of embryo transfer significantly improves the reproductive outcome in infertile women: a prospective, randomized trial. Fertil Steril. 2006;85(5):1341–6. Gardner DK, Schoolcraft WB. Culture and transfer of human blastocysts. Curr Opin Obstet Gynecol. 1999;11(3):307–11. Gardner DK, Vella P, Lane M, Wagley L, Shlenker T, Schoolcraft WB. Culture and transfer of human blastocysts increases implantation rates and reduces the need for multiple embryo transfers. Fertil Steril. 1998;69(1):84–8. Glujovsky D, Blake D, Farquhar C, Bardach A. Cleavage stage versus blastocyst stage embryo transfer in assisted reproductive technology. Cochrane Database Syst Rev. 2012;7, CD002118. Bolton VN, Hawes SM, Taylor CT, Parsons JH. Development of spare human preimplantation embryos in vitro: an analysis of the correlations among gross morphology, cleavage rates, and development to the blastocyst. J In Vitro Fert Embryo Transf. 1989;6(1):30–5. Lan KC, Huang FJ, Lin YC, Kung FT, Hsieh CH, Huang HW, et al. The predictive value of using a combined Z-score and day 3 embryo morphology score in the assessment of embryo survival on day 5. Hum Reprod. 2003;18(6):1299–306. Muggleton-Harris AL, Glazier AM, Wall M. A retrospective analysis of the in-vitro development of 'spare' human in-vitro fertilization preimplantation embryos using 'in-house' prepared medium and 'Medi-Cult' commercial medium. Hum Reprod. 1995;10(11):2976–84. Neuber E, Rinaudo P, Trimarchi JR, Sakkas D. Sequential assessment of individually cultured human embryos as an indicator of subsequent good quality blastocyst development. Hum Reprod. 2003;18(6):1307–12. Liu Q, Lian Y, Huang J, Ren X, Li M, Lin S, et al. The safety of long-term cryopreservation on slow-frozen early cleavage human embryos. J Assist Reprod Genet. 2014;31(4):471–5. Lin S, Li M, Lian Y, Chen L, Liu P. No effect of embryo culture media on birthweight and length of newborns. Hum Reprod. 2013;28(7):1762–7. Gardner DK, Lane M, Stevens J, Schlenker T, Schoolcraft WB. Blastocyst score affects implantation and pregnancy outcome: towards a single blastocyst transfer. Fertil Steril. 2000;73(6):1155–8. Graham J, Han T, Porter R, Levy M, Stillman R, Tucker MJ. Day 3 morphology is a poor predictor of blastocyst quality in extended culture. Fertil Steril. 2000;74(3):495–7. Rijnders PM, Jansen CA. The predictive value of day 3 embryo morphology regarding blastocyst formation, pregnancy and implantation rate after day 5 transfer following in-vitro fertilization or intracytoplasmic sperm injection. Hum Reprod. 1998;13(10):2869–73. Sjoblom P, Menezes J, Cummins L, Mathiyalagan B, Costello MF. Prediction of embryo developmental potential and pregnancy based on early stage morphological characteristics. Fertil Steril. 2006;86(4):848–61. Hardarson T, Caisander G, Sjogren A, Hanson C, Hamberger L, Lundin K. A morphological and chromosomal study of blastocysts developing from morphologically suboptimal human pre-embryos compared with control blastocysts. Hum Reprod. 2003;18(2):399–407. Guerif F, Le Gouge A, Giraudeau B, Poindron J, Bidault R, Gasnier O, et al. Limited value of morphological assessment at days 1 and 2 to predict blastocyst development potential: a prospective study based on 4042 embryos. Hum Reprod. 2007;22(7):1973–81. Janny L, Menezo YJ. Maternal age effect on early human embryonic development and blastocyst formation. Mol Reprod Dev. 1996;45(1):31–7. Tesarik J, Mendoza C, Greco E. Paternal effects acting during the first cell cycle of human preimplantation development after ICSI. Hum Reprod. 2002;17(1):184–9. Tesarik J. Paternal effects on cell division in the human preimplantation embryo. Reprod Biomed Online. 2005;10(3):370–5. Kovalevsky G, Carney SM, Morrison LS, Boylan CF, Neithardt AB, Feinberg RF. Should embryos developing to blastocysts on day 7 be cryopreserved and transferred: an analysis of pregnancy and implantation rates. Fertil Steril. 2013;100(4):1008–12. Almeida PA, Bolton VN. The relationship between chromosomal abnormality in the human preimplantation embryo and development in vitro. Reprod Fertil Dev. 1996;8(2):235–41. Dekel-Naftali M, Aviram-Goldring A, Litmanovitch T, Shamash J, Yonath H, Hourvitz A, et al. Chromosomal integrity of human preimplantation embryos at different days post fertilization. J Assist Reprod Genet. 2013;30(5):633–48. Fragouli E, Alfarawati S, Spath K, Wells D. Morphological and cytogenetic assessment of cleavage and blastocyst stage embryos. Mol Hum Reprod. 2014;20(2):117–26. Alfarawati S, Fragouli E, Colls P, Stevens J, Gutierrez-Mateo C, Schoolcraft W, et al. The relationship between blastocyst morphology, chromosomal abnormality, and embryo gender. Fertil Steril. 2011;95:520–4.