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Reproductive Biology and Endocrinology
Published in: Reproductive Biology and Endocrinology 1/2020

01-12-2020 | Infertility | Research

Does the sex ratio of singleton births after frozen single blastocyst transfer differ in relation to blastocyst development?

Authors: Hua Lou, Na Li, Xiaoke Zhang, Ling Sun, Xingling Wang, Dayong Hao, Shihong Cui

Published in: Reproductive Biology and Endocrinology | Issue 1/2020

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Abstract

Purpose

To investigate the associations between blastocyst development and the sex ratio (male:female) among singleton live births resulting from single-blastocyst frozen embryo transfer (FET) cycles.

Methods

Patients with singleton live births following the first autologous single FET of non- preimplantation genetic testing (PGT) blastocysts in a single reproductive medicine department between January 2015 and February 2019 were included in this retrospective study. The primary outcome measure was the singleton sex ratio. Multivariable logistic regression models were used to estimate the associations between blastocyst quality and singleton sex ratio after adjustment for some potential confounders.

Results

There were 638 high-quality and 572 poor-quality single blastocyst FETs, and the blastocysts were conceived via 855 IVF and 355 ICSI treatments. A total of 1210 singleton live births were assessed. High-quality single blastocyst FET resulted in a significantly higher sex ratio than did poor-quality single blastocyst FET (60% vs. 49.7%, P < 0.001). The infertility cause was not associated with sex ratio among singleton live births (P = 0.537). The results of a multivariate analysis revealed that a high-quality blastocyst has a 150% higher probability of being male than a poor-quality blastocyst (adjusted odds ratio (aOR) 1.57; 95% CI 1.24–2, P < 0.001). Among the three blastocyst morphological parameters, Grade B trophectoderm was significantly associated with a higher sex ratio than Grade C (aOR 1.71; 95% CI 1.33–2.21. P < 0.001). Neither expansion degree nor inner cell mass degree were significantly associated with the singleton sex ratio.

Conclusions

A single high-quality blastocyst FET has a higher chance of resulting in a male infant than a female infant. The results demonstrate that grade B trophectoderm confers benefits in improving the implantation potential of male blastocysts.
Literature
1.
Penzias A, Bendikson K, Butts S. ASRM standard embryo transfer protocol template: a committee opinion. Fertil Steril. 2017;107:897–900.CrossRef
2.
Papanikolaou EG, Kolibianakis EM, Tournaye H, Venetis CA, Fatemi H, Tarlatzis B, et al. Live birth rates after transfer of equal number of blastocysts or cleavage-stage embryos in IVF. A Syst rev meta-analysis. Hum Reprod Update. 2008;23:91–9.CrossRef
3.
Zhu D, Zhang J, Cao S, Heng BC, Huang M, Ling X, et al. Vitrified-warmed blastocyst transfer cycles yield higher pregnancy and implantation rates compared with fresh blastocyst transfer cycles–time for a new embryo transfer strategy? Fertil Steril. 2011;95:1691–5.CrossRef
4.
De C, Colman R, de Sutter P, Tilleman K. Blastocyst transfer for all? Higher cumulative live birth chance in a blastocyst-stage transfer policy compared to a cleavagestage transfer policy. Facts Views Vis Obgyn. 2019;11(2):169–76.
5.
Chen H, Lv J-Q, Wu X-M, Yu X, Xi H-T, Zhu C-F, et al. Blastocyst-stage versus cleavage-stage embryo transfer in the first frozen cycles of OHSS-risk patients who deferred from fresh embryo transfer. Gynecol Endocrinol. 2015;31(0951–3590):1–4.
6.
Zhu L, Xi Q, Zhang H, Li Y, Ai J, Jin L. Blastocyst culture and cryopreservation to optimize clinical outcomes of warming cycles. Reprod Biomed Online. 2013;27:154–60.CrossRef
7.
Yong H, Ryu S, Kyung E, Seung S, Yoon H, et al. A retrospective study of single frozen-thawed blastocyst transfer. Clin Exp Reprod Med. 2016;432:106–11.
8.
Marissa S, Boulet L, Kissin S, Warner D, Jamieson L, Denise J. Elective single embryo transfer trends and predictors of a good perinatal outcome--United States,1999 to 2010. Fertil Steril. 2013;997:1937–43.
9.
Maheshwari A, Hamilton M, Bhattachry S. Should we be promoting embryo transfer at blastocyst stage? Reprod Biomed Online. 2016;32:142–6.CrossRef
10.
Pedro M, Ptersen A, Gf P, FM PP. Should single embryo transfer be used in patients with any kind of infertility factor? Preliminary outcomes. JBRA Assisted reprod. 2019;233:200–4.
11.
Supramaniam PR, Mittal M, Ohuma EO, Lim LN, McVeigh E, Granne I, et al. Secondary sex ratio in assisted reproduction:an analysis of 1376454 treatment cycles performed in the UK. Human Reproduction Open. 2019;4:1–9.
12.
Pin-Yao L, Fu-Jen H, Fu-Tsai K, Li-Jung W, Young CS, Kuo-Chung L. Comparison of the offspring sex ratio between cleavage stage embryo transfer and blastocyst transfer. Taiwan J Obstet Gynecol. 2010;491:323–6.
13.
Hattori H, Kitamura A, Takahashi. The risk of secondary sex ratio imbalance and increased monozygotic twinning after blastocyst transfer: data from the Japan environment and Children's study. Reprod Biol Endocrinol RB&E. 2019;171:1–8.
14.
Jacobsen R, Møller H, Mouritsen A. Natural variation in the human sex ratio. Hum Reprod Update. 1999;14:3120–5.CrossRef
15.
Dean JH, Chapman MG, Sullivan EA. The effect on human sex ratio at birth by assisted reproductive technology (ART) procedures - an assessment of babies born following single embryo transfers, Australia and New Zealand,2002–2006. BJOG. 2010;117:1628–34.CrossRef
16.
Fernando D, Halliday JL, Breheny S, Healy DL. Outcomes of singleton births after blastocyst versus nonblastocyst transfer in assisted reproductive technology. Fertil Steril. 2012;97:579–84.CrossRef
17.
Gardner DK, Lane M. Stevens Jea. Blastocyst score affects implantation and pregnancy outcome: towards a single blastocyst transfer. Fertil Steril. 2000;73(6):1155–8.CrossRef
18.
Chen X, Zhang J, Wu X, Cao S, et al. Trophectoderm morphology predicts outcomes of pregnancy in vitrified-warmed single-blastocyst transfer cycle in a Chinese population. J Assist Reprod Genet. 2014;31:1475–81.CrossRef
19.
Thomas E, Katja T, Mayer Richard B, Peter O. Quantitative and qualitative trophectoderm grading allows for prediction of live birth and gender. J Assist Reprod Genet. 2016;331:49–57.
20.
Papanikolaou EG. Live birth rate is significantly higher after blastocyst transfer than after cleavage-stage embryo transfer when at least four embryos are available on day 3 of embryo culture. A randomized prospective study. Hum Reprod. 2005;20(11):3198–203.CrossRef
21.
Schoolcraft WB, Gardner DK, Lane M, Schlenker T, Hamilton F, Meldrum DR, et al. Blastocyst culture and transfer: analysis of results and parameters affecting outcome in two in vitro fertilization programs. Fertil Steril. 1999;72:604–12.CrossRef
22.
Charlène H, Sarah C, Sarah B, Cedrin-Durnerin EA. Impact of post-warming culture duration on clinical outcomes of vitrified good-quality blastocyst transfers: a prospective randomized study. Fertil Steril. 2018;1107:1290–7.
23.
Kuwayama M. Highly efficient vitrification for cryopreservation of human oocytes and embryos: the Cryotop method2007. Theriogenology. 2007;67:73–80.CrossRef
24.
Mukaida T, Takahashi K, Kasai M. Blastocyst cryopreservation: ultrarapid vitrification using cryoloop technique. Reprod Biomed Online. 2003;6:221–5.CrossRef
25.
Mamdoh E, Abou-Setta Ahmed M, Almushait Mona A, et al. Ultrasound guidance during embryo transfer: a prospective, single-operator, randomized, controlled trial. Fertil Steril. 2008;904:1187-90.
26.
Jinli D, Tailang Y, Yi Z, Danni Z, Yang J. The effect of blastocyst transfer on newborn sex ratio and monozygotic twinning rate: an updated systematic review and meta-analysis. Reprod Biomed Online. 2018;373:1187–90.
27.
Luna M, Duke M, Copperman A, Grunfield L, Sandler B, Barritt J. Blastocyst embryo transfer is associated with a sex-ratio imbalance in favor of male offspring. Fertil Steril. 2007;87:519–23.CrossRef
28.
Hentemann MA, Briskemyr S, Bertheussen K. Blastocyst transfer and gender: IVF versus ICSI. J Assist Reprod Genet. 2009;26:433–6.CrossRef
29.
Irani M, Reichman D, Robles A, Melnick A, Davis O, Zaninovic N, et al. Morphologic grading of euploid blastocysts influences implantation and ongoing pregnancy rates. Fertil Steril. 2017;107:664–70.CrossRef
30.
Elgindy E, Elsedeek MS. Day5 expanded blastocysts transferred on same day have comparable outcome to those left for more extended culture and transferred on day 6. J Assist Reprod Genet. 2012;29:1111–5.CrossRef
31.
Desai N, Ploskonka S, Goodman L, Attaran M, Jeffrey M, Jeffrey G, et al. Delayed blastulation,multinucleation, and expansion grade are independently associated with live-birth rates in frozen blastocyst transfer cycles. Fertil Steril. 2016;106:1–9.
32.
Alfarawati S, Fragouli E, Colls P, Stevens J, Gutierrez-Mateo C, Schoolcraft WB, et al. The relationship between blastocyst morphology, chromosomal abnormality, and embryo gender. Fertil Steril. 2011;95:520–4.CrossRef
33.
Parks JC, McCallie BR, Janesch AM, Schoolcraft WB, Katz-Jaffe MG. Blastocyst gene expression correlates with implantation potential. Fertil Steril. 2011;95:1367–72.CrossRef
34.
Jing Z, Yi Y, Xi H, Lunquan S, Yanping L. Blastocoele expansion: an important parameter for predicting clinical success pregnancy after frozen-warmed blastocysts transfer. Reprod Biol Endocrinol RB&E. 2019;171:15.
35.
Du QY, Wang EY, Huang Y, Guo XY, Xiong YJ, Yu YP, et al. Blastocoele expansion degree predicts live birth after single blastocyst transfer for fresh and vitrified/warmed single blastocyst transfer cycles. Fertil Steril. 2016;105:910–9.CrossRef
36.
Subira J, Craig J, Turner K, Bevan A, Ohuma E, McVeigh E, et al. Grade of the inner cell mass, but not trophectoderm, predicts live birth in fresh blastocyst single transfers. Hum Fertil (Camb). 2016;19:254–61.CrossRef
37.
Licciardi F, McCaffrey C, Cheongeun O, et al. Birth weight is associated with inner cell mass grade of blastocysts. Fertil Steril. 2015;103(2):382–7.CrossRef
38.
Hlströ A, Westin C, Wikland M, Hardarson T. Prediction oflive birth in frozen-thawed single blastocyst transfer cycles by prefreeze and post-thaw morphology. Hum Reprod. 2013;28:1199–209.CrossRef
39.
Ahlstrom A, Westin C, Reismer E, Wikland M, Hardarson T. Trophectoderm morphology: an important parameter for predicting live birth after single blastocyst transfer. Hum Reprod Biol. 2011;26:3289–96.CrossRef
40.
Norwitz ER, Schust DJ, Fisher SJ. Implantation and the survival of early pregnancy. N Engl J Med. 2001;345:1400–8.CrossRef
Metadata
Title
Does the sex ratio of singleton births after frozen single blastocyst transfer differ in relation to blastocyst development?
Authors
Hua Lou
Na Li
Xiaoke Zhang
Ling Sun
Xingling Wang
Dayong Hao
Shihong Cui
Publication date
01-12-2020
Publisher
BioMed Central
Published in
Reproductive Biology and Endocrinology / Issue 1/2020
Electronic ISSN: 1477-7827
DOI
https://doi.org/10.1186/s12958-020-00623-x

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