Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
BMC Pregnancy and Childbirth
Published in: BMC Pregnancy and Childbirth 1/2024

Open Access 01-12-2024 | Research

Competent blastocyst and receptivity endometrium improved clinical pregnancy in fresh embryo transfer cycles: a retrospective cohort study

Authors: Longmei Wang, Pingping Qiu, Lizhi Jiang, Ping Li, Yufei Jiang

Published in: BMC Pregnancy and Childbirth | Issue 1/2024

Login to get access

Abstract

Background

Embryo quality is usually regarded as a key predictor of successful implantation and clinical pregnancy potential. The identification of embryos that have the capacity to implant and result in a healthy pregnancy is a crucial part of in vitro fertilization (IVF). Usually, morphologically high-quality embryos are chosen for embryo transfer in IVF treatment. The aim of this study was to assess the association between the available blastocyst formation rate and the clinical pregnancy outcome following the first fresh embryo transfer cycle and provide systematic individual treatment to adjust endometrial receptivity for the next transfer cycle.

Methods

This retrospective, single-center study included 512 fresh embryo transfers conducted between 11/2019 and 08/2021, which consisted of 385 cleavage-stage (Day 3) and 127 blastocyst-stage (Day 5) embryo transfers. The two groups were divided into a clinical pregnancy group and a nonclinical pregnancy group for comparison. The association between the available blastocyst formation rate and the clinical pregnancy rate in the Day 3 and Day 5 transfer groups were considered.

Results

In the Day 3 group, there were 275 clinical pregnancies, and the clinical pregnancy rate was 71.43%. Although the two pronuclei (2PN) oocyte rate and available embryo rate at Day 3 were significantly higher in the clinical pregnancy group than the nonclinical pregnancy group (P < 0.05), the blastocyst formation rate and the available blastocyst formation rate were not significantly different between the clinical pregnancy group and the nonclinical pregnancy group (P > 0.05). In the Day 5 group, there were 81 clinical pregnancies, and the clinical pregnancy rate was 63.78%. No baseline characteristics showed any obvious differences between the clinical pregnancy group and nonclinical pregnancy group (P > 0.05). The blastocyst formation rate in the nonclinical pregnancy group was higher than that in the clinical pregnancy group, but the difference was not statistically significant (81.06% vs. 77.03%, P = 0.083). Interestingly, the available blastocyst formation rate and the Day 5 available blastocyst formation rate were significantly higher in the nonclinical pregnancy group than the clinical pregnancy group (66.19% vs. 60.79%, P = 0.014; 54.58% vs. 46.98%, P = 0.007).

Conclusions

In fresh cycles, the available blastocyst formation rate was not associated with the clinical pregnancy outcome for Day 3 embryo transfers, and the available blastocyst formation rate was not positively correlated with the clinical pregnancy outcome for Day 5 embryo transfers.
Appendix
Available only for authorised users
Literature
1.
Wirleitner B, Schuff M, Stecher A, Murtinger M, Vanderzwalmen P. Pregnancy and birth outcomes following fresh or vitrified embryo transfer according to blastocyst morphology and expansion stage, and culturing strategy for delayed development. Hum Reprod. 2016;31(8):1685–95.CrossRefPubMed
2.
Neuhausser WM, Vaughan DA, Sakkas D, Hacker MR, Toth T, Penzias A. 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. 2020;17(1):16.CrossRefPubMedPubMedCentral
3.
Bolton VN, Leary C, Harbottle S, Cutting R, Harper JC. How should we choose the ‘best’ embryo? A commentary on behalf of the British Fertility Society and the Association of Clinical Embryologists. Hum Fertility. 2015;18(3):156–64.CrossRef
4.
Glujovsky D, Farquhar C, Quinteiro Retamar AM, Alvarez Sedo CR, Blake D. Cleavage stage versus blastocyst stage embryo transfer in assisted reproductive technology. Cochrane Database Syst Rev. 2016(6):CD002118.
5.
Ubaldi FM, Capalbo A, Colamaria S, Ferrero S, Maggiulli R, Vajta G, Sapienza F, Cimadomo D, Giuliani M, Gravotta E, et al. Reduction of multiple pregnancies in the advanced maternal age population after implementation of an elective single embryo transfer policy coupled with enhanced embryo selection: pre- and post-intervention study. Hum Reprod. 2015;30(9):2097–106.CrossRefPubMedPubMedCentral
6.
Kamath MS, Mascarenhas M, Kirubakaran R, Bhattacharya S. Number of embryos for transfer following in vitro fertilisation or intra-cytoplasmic sperm injection. Cochrane Database Syst Rev. 2020;8:CD003416.PubMed
7.
Bortoletto P, Willson S, Romanski PA, Davis OK, Rosenwaks Z. Reproductive outcomes of women aged 40 and older undergoing IVF with donor sperm. Hum Reprod. 2021;36(1):229–35.PubMed
8.
De Croo I, Colman R, De Sutter P, Stoop D, Tilleman K. No difference in cumulative live birth rates between cleavage versus blastocyst transfer in patients with four or fewer zygotes: results from a retrospective study. Hum Reprod open. 2022;2022(3):hoac031.CrossRefPubMedPubMedCentral
9.
Franasiak JM, Alecsandru D, Forman EJ, Gemmell LC, Goldberg JM, Llarena N, Margolis C, Laven J, Schoenmakers S, Seli E. A review of the pathophysiology of recurrent implantation failure. Fertil Steril. 2021;116(6):1436–48.CrossRefPubMed
10.
Massimiani M, Lacconi V, La Civita F, Ticconi C, Rago R, Campagnolo L. Molecular signaling regulating endometrium-blastocyst crosstalk. Int J Mol Sci. 2019;21(1).
11.
Zhang S, Lin H, Kong S, Wang S, Wang H, Wang H, Armant DR. Physiological and molecular determinants of embryo implantation. Mol Aspects Med. 2013;34(5):939–80.CrossRefPubMedPubMedCentral
12.
Navot D, Scott RT, Droesch K, Veeck LL, Liu HC, Rosenwaks Z. The window of embryo transfer and the efficiency of human conception in vitro. Fertil Steril. 1991;55(1):114–8.CrossRefPubMed
13.
Wang S, Ding L, Zhao X, Zhang N, Hu Y, Sun H. Embryo selection for single embryo transfer on day 3 based on combination of cleavage patterns and timing parameters in in vitro fertilization patients. J Reprod Med. 2016;61(5–6):254–62.PubMed
14.
Hsu MI, Mayer J, Aronshon M, Lanzendorf S, Muasher S, Kolm P, Oehninger S. Embryo implantation in in vitro fertilization and intracytoplasmic sperm injection: impact of cleavage status, morphology grade, and number of embryos transferred. Fertil Steril. 1999;72(4):679–85.CrossRefPubMed
15.
Baczkowski T, Kurzawa R, Glabowski W. Methods of embryo scoring in in vitro fertilization. Reprod Biol. 2004;4(1):5–22.PubMed
16.
Alpha Scientists in Reproductive M, Embryology ESIGo: The Istanbul consensus workshop on embryo assessment: proceedings of an expert meeting. Human reproduction. 2011;26(6):1270–1283.
17.
Gardner DK, Lane M, Stevens J, Schlenker T, Schoolcraft WB. Reprint of: blastocyst score affects implantation and pregnancy outcome: towards a single blastocyst transfer. Fertil Steril. 2019;112(4 Suppl1):e81–4.CrossRefPubMed
18.
Gardner DK, Surrey E, Minjarez D, Leitz A, Stevens J, Schoolcraft WB. Single blastocyst transfer: a prospective randomized trial. Fertil Steril. 2004;81(3):551–5.CrossRefPubMed
19.
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.CrossRefPubMed
20.
Nguyen EB, Jacobs EA, Summers KM, Sparks AE, Van Voorhis BJ, Klenov VE, Duran EH. Embryo blastulation and quality between days 5 and 6 of extended embryo culture. J Assist Reprod Genet. 2021;38(8):2193–8.CrossRefPubMedPubMedCentral
21.
Jones GM, Trounson AO, Gardner DK, Kausche A, Lolatgis N, Wood C. Evolution of a culture protocol for successful blastocyst development and pregnancy. Hum Reprod. 1998;13(1):169–77.CrossRefPubMed
22.
23.
Simon C, Gomez C, Cabanillas S, Vladimirov I, Castillon G, Giles J, Boynukalin K, Findikli N, Bahceci M, Ortega I, et al. A 5-year multicentre randomized controlled trial comparing personalized, frozen and fresh blastocyst transfer in IVF. Reprod Biomed Online. 2020;41(3):402–15.CrossRefPubMed
24.
Gardner DK, Schoolcraft WB, Wagley L, Schlenker T, Stevens J, Hesla J. A prospective randomized trial of blastocyst culture and transfer in in-vitro fertilization. Hum Reprod. 1998;13(12):3434–40.CrossRefPubMed
25.
Kim HH, Matevossian K. It’s all about timing: is the window of implantation different for day 5 and 6 blastocysts? Fertil Steril. 2020;114(1):69–70.CrossRefPubMed
26.
Roelens C, Santos-Ribeiro S, Becu L, Mackens S, Van Landuyt L, Racca A, De Vos M, van de Vijver A, Tournaye H, Blockeel C. Frozen-warmed blastocyst transfer after 6 or 7 days of progesterone administration: impact on live birth rate in hormone replacement therapy cycles. Fertil Steril. 2020;114(1):125–32.CrossRefPubMed
27.
Rubio C, Bellver J, Rodrigo L, Castillon G, Guillen A, Vidal C, Giles J, Ferrando M, Cabanillas S, Remohi J, et al. In vitro fertilization with preimplantation genetic diagnosis for aneuploidies in advanced maternal age: a randomized, controlled study. Fertil Steril. 2017;107(5):1122–9.CrossRefPubMed
28.
Irani M, Reichman D, Robles A, Melnick A, Davis O, Zaninovic N, Xu K, Rosenwaks Z. Morphologic grading of euploid blastocysts influences implantation and ongoing pregnancy rates. Fertil Steril. 2017;107(3):664–70.CrossRefPubMed
29.
Dimitriadis E, Menkhorst E, Saito S, Kutteh WH, Brosens JJ. Recurrent pregnancy loss. Nat Reviews Disease Primers. 2020;6(1):98.CrossRefPubMed
30.
Li L, Kou Z, Fu Y, Liang L, Liu L, Zhang X. Clinical outcomes of personalized frozen-thawed embryo transfer timing for patients with recurrent implantation failure. Annals Translational Med. 2022;10(3):131.CrossRef
31.
Riestenberg C, Kroener L, Quinn M, Ching K, Ambartsumyan G. Routine endometrial receptivity array in first embryo transfer cycles does not improve live birth rate. Fertil Steril. 2021;115(4):1001–6.CrossRefPubMed
32.
Bergenheim SJ, Saupstad M, Pistoljevic N, Andersen AN, Forman JL, Lossl K, Pinborg A. Immediate versus postponed frozen embryo transfer after IVF/ICSI: a systematic review and meta-analysis. Hum Reprod Update. 2021;27(4):623–42.CrossRefPubMed
33.
Blesa D, Ruiz-Alonso M, Simon C. Clinical management of endometrial receptivity. Semin Reprod Med. 2014;32(5):410–3.CrossRefPubMed
34.
Kalakota NR, George LC, Morelli SS, Douglas NC, Babwah AV. Towards an improved understanding of the effects of elevated progesterone levels on human endometrial receptivity and oocyte/embryo quality during assisted reproductive technologies. Cells. 2022;11(9).
35.
Cimadomo D, Rienzi L, Conforti A, Forman E, Canosa S, Innocenti F, Poli M, Hynes J, Gemmell L, Vaiarelli A, et al. Opening the black box: why do euploid blastocysts fail to implant? A systematic review and meta-analysis. Hum Reprod Update. 2023;29(5):570–633.CrossRefPubMed
Metadata
Title
Competent blastocyst and receptivity endometrium improved clinical pregnancy in fresh embryo transfer cycles: a retrospective cohort study
Authors
Longmei Wang
Pingping Qiu
Lizhi Jiang
Ping Li
Yufei Jiang
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2024
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-024-06399-x

Other articles of this Issue 1/2024

BMC Pregnancy and Childbirth 1/2024 Go to the issue

Research

Association between single nucleotide polymorphisms, TGF-β1 promoter methylation, and polycystic ovary syndrome

Research

Continued versus discontinued oxytocin stimulation in the active phase of labour (CONDISOX): individual management based on artificial intelligence - a secondary analysis

Research

Socioeconomic and geographical inequalities in delivery by cesarean section among women in Bangladesh, 2004–2017

Research

A first trimester prediction model and nomogram for gestational diabetes mellitus based on maternal clinical risk factors in a resource-poor setting

Research

Prevalence and adverse outcomes of twin pregnancy in Eastern Africa: a systematic review and meta-analysis

Research

Evaluation of extravascular lung water and cardiac function in normal vaginal delivery by intrapartum bedside ultrasound