Sequential embryo transfer versus double cleavage-stage embryo or double blastocyst transfer in patients with recurrent implantation failure with frozen-thawed embryo transfer cycles: a cohort study.

blastocyst transfer cleavage-stage embryo transfer frozen-thawed embryo transfer repeated implantation failure sequential embryo transfer

Journal

Frontiers in endocrinology
ISSN: 1664-2392
Titre abrégé: Front Endocrinol (Lausanne)
Pays: Switzerland
ID NLM: 101555782

Informations de publication

Date de publication:
2023
Historique:
received: 11 06 2023
accepted: 21 08 2023
medline: 26 9 2023
pubmed: 25 9 2023
entrez: 25 9 2023
Statut: epublish

Résumé

Recurrent implantation failure (RIF) is more common among patients receiving assisted reproductive treatment. Many efforts have been made to increase the incidence of clinical pregnancy among patients with RIF. The effect of the sequential transfer procedure, a two-step interval transfer of a cleavage-stage embryo followed by a blastocyst in one transfer cycle, on the clinical outcomes of RIF patients remains controversial. In total, 1774 frozen-thawed embryo transfer (FET) cycles in RIF patients were included. Of these cycles, 302 were sequential embryo transfer (ET) cycles, 979 were double day 3 cleavage-stage ET cycles, and 493 were double blastocyst ET cycles. The primary outcomes were the rates of implantation, clinical pregnancy and multiple pregnancy, and the secondary outcomes were the rates of hCG positive, early miscarriage and ectopic pregnancy. The implantation, hCG positive, and clinical pregnancy rates in the sequential ET group (32.1%, 58.9%, 50.7%) were significantly higher than those in the day 3 cleavage-stage ET group (24.9%, 46.5%, 40.4%) and were similar to those in the blastocyst transfer group (30.1%, 56.4%, 47.1%). The early miscarriage rate in the blastocyst transfer group was significantly higher than that in the cleavage-stage ET group (17.2% vs. 8.1%, Sequential embryo transfer in FET cycles could improve the clinical outcomes of patients with RIF.

Sections du résumé

Background
Recurrent implantation failure (RIF) is more common among patients receiving assisted reproductive treatment. Many efforts have been made to increase the incidence of clinical pregnancy among patients with RIF. The effect of the sequential transfer procedure, a two-step interval transfer of a cleavage-stage embryo followed by a blastocyst in one transfer cycle, on the clinical outcomes of RIF patients remains controversial.
Methods
In total, 1774 frozen-thawed embryo transfer (FET) cycles in RIF patients were included. Of these cycles, 302 were sequential embryo transfer (ET) cycles, 979 were double day 3 cleavage-stage ET cycles, and 493 were double blastocyst ET cycles. The primary outcomes were the rates of implantation, clinical pregnancy and multiple pregnancy, and the secondary outcomes were the rates of hCG positive, early miscarriage and ectopic pregnancy.
Results
The implantation, hCG positive, and clinical pregnancy rates in the sequential ET group (32.1%, 58.9%, 50.7%) were significantly higher than those in the day 3 cleavage-stage ET group (24.9%, 46.5%, 40.4%) and were similar to those in the blastocyst transfer group (30.1%, 56.4%, 47.1%). The early miscarriage rate in the blastocyst transfer group was significantly higher than that in the cleavage-stage ET group (17.2% vs. 8.1%,
Conclusions
Sequential embryo transfer in FET cycles could improve the clinical outcomes of patients with RIF.

Identifiants

pubmed: 37745696
doi: 10.3389/fendo.2023.1238251
pmc: PMC10515716
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1238251

Informations de copyright

Copyright © 2023 Gao, Yuan, Li, Tian, Lian, Liu, Li, Qiao, Long and Wang.

Déclaration de conflit d'intérêts

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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Auteurs

Jiangman Gao (J)

State Key Laboratory of Female Fertility Promotion, Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.
National Clinical Research Center for Obstetrics and Gynecology Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.
Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.
Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.

Yifeng Yuan (Y)

State Key Laboratory of Female Fertility Promotion, Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.
National Clinical Research Center for Obstetrics and Gynecology Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.
Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.
Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.

Jia Li (J)

State Key Laboratory of Female Fertility Promotion, Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.
National Clinical Research Center for Obstetrics and Gynecology Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.
Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.
Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.

Tian Tian (T)

State Key Laboratory of Female Fertility Promotion, Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.
National Clinical Research Center for Obstetrics and Gynecology Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.
Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.
Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.

Ying Lian (Y)

State Key Laboratory of Female Fertility Promotion, Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.
National Clinical Research Center for Obstetrics and Gynecology Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.
Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.
Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.

Ping Liu (P)

State Key Laboratory of Female Fertility Promotion, Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.
National Clinical Research Center for Obstetrics and Gynecology Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.
Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.
Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.

Rong Li (R)

State Key Laboratory of Female Fertility Promotion, Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.
National Clinical Research Center for Obstetrics and Gynecology Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.
Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.
Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.

Jie Qiao (J)

State Key Laboratory of Female Fertility Promotion, Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.
National Clinical Research Center for Obstetrics and Gynecology Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.
Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.
Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.

Xiaoyu Long (X)

State Key Laboratory of Female Fertility Promotion, Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.
National Clinical Research Center for Obstetrics and Gynecology Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.
Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.
Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.

Haiyan Wang (H)

State Key Laboratory of Female Fertility Promotion, Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.
National Clinical Research Center for Obstetrics and Gynecology Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.
Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.
Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.

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