Hostname: page-component-5b777bbd6c-mqssf Total loading time: 0 Render date: 2025-06-21T07:22:25.477Z Has data issue: false hasContentIssue false
  • English
  • Français

The TLI system can help day-3 single cleavage embryo transfer to obtain comparative clinical outcomes to day-4 or day-5

Published online by Cambridge University Press:  18 September 2024

Yue Ji Open the ORCID record for Yue Ji [Opens in a new window] ,
Linjun Chen Open the ORCID record for Linjun Chen [Opens in a new window] ,
Fan Pan ,
Ruyu Jiang  and
Shanshan Wang
Yue Ji
Affiliation:
Center for Reproductive Medicine and Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, PR China Center for Molecular Reproductive Medicine, Nanjing University, Nanjing, PR China
Linjun Chen
Affiliation:
Center for Reproductive Medicine and Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, PR China Center for Molecular Reproductive Medicine, Nanjing University, Nanjing, PR China
Fan Pan
Affiliation:
Center for Reproductive Medicine and Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, PR China Center for Molecular Reproductive Medicine, Nanjing University, Nanjing, PR China
Ruyu Jiang
Affiliation:
Center for Reproductive Medicine and Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, PR China Center for Molecular Reproductive Medicine, Nanjing University, Nanjing, PR China
Shanshan Wang*
Affiliation:
Center for Reproductive Medicine and Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, PR China Center for Molecular Reproductive Medicine, Nanjing University, Nanjing, PR China
*
Corresponding author: Shanshan Wang; Email: wss_19860820@sina.com
Get access Rights & Permissions [Opens in a new window]

Summary

The aim was to explore whether the time-lapse imaging system can help day-3 single cleavage embryo transfer to obtain comparative clinical outcomes to day-4 or 5. The data of 1237 patients who underwent single embryo transfer from January 1, 2018, to September 30, 2020, in our reproductive medicine centre were retrospectively analysed. They were divided into the day-3 single cleavage-stage embryo transfer (SCT) group (n = 357), day-4 single morula transfer (SMT) group (n = 129) and day-5 single blastocyst transfer (SBT) group (n = 751) according to the different embryo transfer stage. The clinical and perinatal outcomes of the three groups were analysed and compared. The clinical pregnancy rates of the patients in the day-3 SCT group, day-4 SMT group and day-5 SBT group were 68.07, 70.54 and 72.04%, respectively. The live birth rates were 56.86, 61.24 and 60.99%, respectively. The monozygotic twin (MZT) rate in the day-3 SCT group was significantly lower than that in the day-5 SBT group (P = 0.049). Regarding perinatal outcomes, only the secondary sex ratio had a significant difference (P < 0.05). After age stratification, no improvement was found in the pregnancy outcomes of patients >35 years of age receiving blastocyst transfer. Our findings suggest that for patients with multiple high-quality embryos on day-3, prolonging the culture time can improve the pregnancy outcome to some extent, but it will bring risks. For centres that have established morphodynamic models, day-3 SCT can also achieve an ideal pregnancy outcome and reduce the rate of monozygotic twins and sex ratio.

Keywords

blastocystcleavagemorulapregnancy and perinatal outcomesingle embryo transfer
Type
Research Article
Information
Zygote , Volume 32 , Issue 3 , June 2024 , pp. 230 - 235
Check for updates
Copyright
© The Author(s), 2024. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

Footnotes

Yue Ji and Linjun Chen contributed equally to this work.

References

Alpha Scientists in Reproductive Medicine and ESHRE Special Interest Group of Embryology. (2011). The Istanbul consensus workshop on embryo assessment: proceedings of an expert meeting. Human Reproduction 26(6), 1270–1283. https://doi.org/10.1093/humrep/der037.CrossRefGoogle Scholar
Bu, Z., Chen, Z.J., Huang, G., Zhang, H., Wu, Q., Ma, Y., Shi, J., Xu, Y., Zhang, S., Zhang, C., Zhao, X., Zhang, B., Huang, Y., Sun, Z., Kang, Y., Wu, R., Wu, X., Sun, H. and Sun, Y. (2014). Live birth sex ratio after in vitro fertilization. and embryo transfer in China--an analysis of 121,247 babies from 18 centers. PLoS One 9(11), e113522. https://doi.org/10.1371/journal.pone.0113522.CrossRefGoogle Scholar
Busnelli, A., Dallagiovanna, C., Reschini, M., Paffoni, A., Fedele, L. and Somigliana, E. (2018). Risk factors for monozygotic twinning after in vitro fertilization: a systematic review and meta-analysis. Fertility Sterility 111(2), 302–317. https://doi.org/10.1016/j.fertnstert.2018.10.025.CrossRefGoogle Scholar
Chen, P, Li, T, Jia, L, Fang, C and Liang, X. (2018). Should all embryos be cultured to blastocyst for advanced maternal age women with low ovarian reserve: a single center retrospective study. Gynecology Endocrinology 34(9), 761–765. https://doi.org/10.1080/09513590.2018.1450379.CrossRefGoogle Scholar
Cimadomo, D., Fabozzi, G., Vaiarelli, A., Ubaldi, N., Ubaldi, F.M. and Rienzi, L. (2018). Impact of maternal age on oocyte and embryo competence. Frontiers in Endocrinology (Lausanne) 9, 327. https://doi.org/10.3389/fendo.2018.00327.CrossRefGoogle Scholar
Gardner, D.K. and Schoolcraft, W.B. (1999). Culture and transfer of human blastocysts. Current Opinion in Obstetrics and Gynecology 11(3), 307–311. https://doi.org/10.1097/00001703-199906000-00013.CrossRefGoogle Scholar
Glujovsky, D., Farquhar, C., Quinteiro Retamar, A.M., Alvarez Sedo, C.R. and Blake, D. (2016). Cleavage stage versus blastocyst stage embryo transfer in assisted reproductive technology. Cochrane Database Systematic Reviews 6, CD002118. https://doi.org/10.1002/14651858.CD002118.pub5.Google Scholar
Ibiebele, I., Humphries, J.B., Torvaldsen, S., Ford, J.B., Morris, J.M., Bowen, J.R. and Randall, D.A. (2020). Gestational age, morbidity and mortality among twin births in New South Wales, Australia 2003–2014: a cohort study. Australian and New Zealand Journal of Obstetrics and Gynaecology 60(4), 541–547. https://doi.org/10.1111/ajo.13101.CrossRefGoogle Scholar
Li, R.S., Hwu, Y.M., Lee, R.K., Li, S.H. and Lin, M.H. (2018). Day 4 good morula embryo transfer provided compatible live birth rate with day 5 blastocyst embryo in fresh IVF/ET cycles. Taiwan Journal of Obstetrics and Gynecology 57(1), 52–57. https://doi.org/10.1016/j.tjog.2017.12.008.CrossRefGoogle Scholar
Li, Y., Liu, S. and Lv, Q. (2021). Single blastocyst stage versus single cleavage stage embryo transfer following fresh transfer: a systematic review and meta-analysis. European Journal of Obstetrics and Gynecology and Reproductive Biology 267, 11–17. https://doi.org/10.1016/j.ejogrb.2021.10.004.CrossRefGoogle Scholar
Lou, H., Li, N., Zhang, X., Sun, L., Wang, X., Hao, D. and Cui, S. (2020). Does the sex ratio of singleton births after frozen single blastocyst transfer differ in relation to blastocyst development? Reproductive Biology and Endocrinology 18(1), 72. https://doi.org/10.1186/s12958-020-00623-x.CrossRefGoogle Scholar
Luke, B., Brown, M.B., Grainger, D.A., Baker, V.L., Ginsburg, E. and Stern, J.E. (2009). Society for Assisted Reproductive Technology Writing Group. The sex ratio of singleton offspring in assisted-conception pregnancies. Fertility Sterility 92(5), 1579–1585. https://doi.org/10.1016/j.fertnstert.2008.08.107.CrossRefGoogle Scholar
Maalouf, W.E., Mincheva, M.N., Campbell, B.K. and Hardy, I.C. (2014). Effects of assisted reproductive technologies on human sex ratio at birth. Fertility Sterility 101(5), 1321–1325. https://doi.org/10.1016/j.fertnstert.2014.01.041.CrossRefGoogle Scholar
Mackie, F.L., Rigby, A., Morris, R.K. and Kilby, M.D. (2019). Prognosis of the co-twin following spontaneous. Single intrauterine fetal death in twin pregnancies: a systematic review and meta-analysis. BJOG 126(5), 569–578. https://doi.org/10.1111/1471-0528.15530.CrossRefGoogle Scholar
Maheshwari, A., Griffiths, S. and Bhattacharya, S. (2011). Global variations in the uptake of single embryo transfer. Human Reproduction Update. 17(1),107–120. https://doi.org/10.1093/humupd/dmq028.CrossRefGoogle Scholar
Marconi, N., Allen, C.P., Bhattacharya, S. and Maheshwari, A. (2022). Obstetric and perinatal outcomes of singleton pregnancies after blastocyst-stage embryo transfer compared with those after cleavage-stage embryo transfer: a systematic review and cumulative meta-analysis. Human Reproduction Update. 28(2), 255–281. https://doi.org/10.1093/humupd/dmab042.CrossRefGoogle Scholar
Mersereau, J., Stanhiser, J., Coddington, C., Jones, T., Luke, B. and Brown, M.B. (2017). Patient and cycle. Characteristics predicting high pregnancy rates with single-embryo transfer: an analysis of the Society for Assisted Reproductive Technology outcomes between 2004 and 2013. Fertility Sterility 108(5), 750–756. https://doi.org/10.1016/j.fertnstert.2017.07.1167.CrossRefGoogle Scholar
Neuhausser, W.M., Vaughan, D.A., Sakkas, D., Hacker, M.R., Toth, T. and Penzias, A. (2020). Non-inferiority of cleavage-stage versus blastocyst-stage embryo transfer in poor prognosis IVF patients (PRECiSE trial): study protocol for a randomized controlled trial. Reproductive Health 17(1),16. https://doi.org/10.1186/s12978-020-0870-y.CrossRefGoogle Scholar
Papanikolaou, E.G., Camus, M., Kolibianakis, E.M., Van Landuyt, L., Van Steirteghem, A. and Devroey, P. (2006). In vitro fertilization with single blastocyst-stage versus single cleavage-stage embryos. New England Journal of Medicine 354(11), 1139–1146. https://doi.org/10.1056/NEJMoa0535247.CrossRefGoogle Scholar
Practice Committee of the American Society for Reproductive Medicine. Electronic address: ASRM@asrm.org; Practice Committee of the Society for Assisted Reproductive Technology. (2017). Guidance on the limits to the number of embryos to transfer: a committee opinion. Fertility Sterility 107(4), 901–903. https://doi.org/10.1016/j.fertnstert.2017.02.107.CrossRefGoogle Scholar
Racca, A., Drakopoulos, P., Van Landuyt, L., Willem, C., Santos-Ribeiro, S., Tournaye, H., Blockeel, C. and Polyzos, N.P. (2020). Single and double embryo transfer provide similar live birth rates in frozen cycles. Gynecology Endocrinology 36(9), 824–828. https://doi.org/10.1080/09513590.2020.1712697.CrossRefGoogle Scholar
Sainte-Rose, R., Petit, C., Dijols, L., Frapsauce, C. and Guerif, F. (2021). Extended embryo culture is effective for patients of an advanced maternal age. Science Reproduction 11(1), 13499. https://doi.org/10.1038/s41598-021-92902-9.Google Scholar
Spangmose, A.L., Ginström Ernstad, E., Malchau, S., Forman, J., Tiitinen, A., Gissler, M., Opdahl, S., Romundstad, L.B., Bergh, C., Wennerholm, U.B., Henningsen, A.A. and Pinborg, A. (2020). Obstetric and perinatal risks in 4601 singletons and 884 twins conceived after fresh blastocyst transfers: a Nordic study from the CoNARTaS group. Human Reproduction 35(4), 805–815. https://doi.org/10.1093/humrep/deaa032.CrossRefGoogle Scholar
Vassena, R., Boué, S., González-Roca, E., Aran, B., Auer, H., Veiga, A. and Izpisua Belmonte, J.C. (2011). Waves of early transcriptional activation and pluripotency program initiation during human preimplantation development. Development 138(17), 3699–3709. https://doi.org/10.1242/dev.064741.CrossRefGoogle Scholar
Wang, M., Liu, X., Zhang, H., Li, L., Liu, R., Zhang, H. and Yu, Y. (2020). Associated factors of secondary sex ratio of offspring in assisted reproductive technology: a cross-sectional study in Jilin Province, China. BMC Pregnancy Childbirth 20(1), 666. https://doi.org/10.1186/s12884-020-03373-1.CrossRefGoogle ScholarPubMed
Wang, S., Chen, L., Fang, J., Jiang, W. and Zhang, N. (2019). Comparison of the pregnancy and obstetric. Outcomes between single cleavage-stage embryo transfer and single blastocyst transfer by time-lapse selection of embryos. Gynecology Endocrinology 5(9), 792–795. https://doi.org/10.1080/09513590.2019.1594762.CrossRefGoogle Scholar
Yang, L., Cai, S., Zhang, S., Kong, X., Gu, Y., Lu, C., Dai, J., Gong, F., Lu, G. and Lin, G. (2018). Single embryo transfer by Day 3 time-lapse. Selection versus Day 5 conventional morphological selection: a randomized, open-label, non-inferiority trial. Human Reproduction 33(5), 869–876. https://doi.org/10.1093/humrep/dey047.CrossRefGoogle Scholar
Zeng, M., Su, S. and Li, L. (2018). Comparison of pregnancy outcomes after vitrification at the cleavage and blastocyst stage: a meta-analysis. Journal of Assisted Reproduction and Genetics 35(1), 127–134. https://doi.org/10.1007/s10815-017-1040-1.CrossRefGoogle Scholar
Zhang, X., Deng, C., Huang, X., Liu, P., Zhou, C., Feng, Y., Hao, G., Lu, W., Quan, S., Shen, H., et al. (2022). Annual report on assisted reproductive technology of Chinese Society of Reproductive Medicine in 2019. Journal of Reproductive Medicine. 31(8), 1015–1021. https://doi.org/10.3969/j.issn.1004-3845.2022.08.001.Google Scholar