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Polumiskova A.O.

LLC «Institute of reproductive medicine»

Tevkin S.I.

LLC «Institute of reproductive medicine»

Shishimorova M.S.

LLC «Institute of reproductive medicine»

Jussubaliyeva T.M.

LLC «Institute of reproductive medicine»

Transfers of slow-growing embryos: «fresh» day 5 morulas/early blastocysts or frozen-thawed day 6 blastocysts?

Authors:

Polumiskova A.O., Tevkin S.I., Shishimorova M.S., Jussubaliyeva T.M.

More about the authors

Journal: Russian Journal of Human Reproduction. 2022;28(5): 46‑54

DOI: 10.17116/repro20222805146

Read: 24964 times

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TRANSFERS OF SLOW-GROWING EMBRYOS: «FRESH» DAY 5 MORULAS/EARLY BLASTOCYSTS OR FROZEN-THAWED DAY 6 BLASTOCYSTS?
TRANSFERS OF SLOW-GROWING EMBRYOS: «FRESH» DAY 5 MORULAS/EARLY BLASTOCYSTS OR FROZEN-THAWED DAY 6 BLASTOCYSTS?

To cite this article:

Polumiskova AO, Tevkin SI, Shishimorova MS, Jussubaliyeva TM. Transfers of slow-growing embryos: «fresh» day 5 morulas/early blastocysts or frozen-thawed day 6 blastocysts? Russian Journal of Human Reproduction. 2022;28(5):46‑54. (In Russ.)
https://doi.org/10.17116/repro20222805146

Подписка 2026 Проблемы репродукции (Russian Journal of Human Reproduction)
МСФ на ЯМ
Использование инфографики авторами научных работ
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Abstract:

INTRODUCTION

In clinical practice of assisted reproductive technologies (ART) there are cases of the entire cohort of embryos developing slowly and resulting in morulas or early blastocysts on day 5. It can be assumed that the effectiveness of slow-growing embryos transfers would be low, due to asynchrony between the development stage of an embryo and the receptivity of the endometrium. While in frozen-thawed embryo transfers with fully expanded blastocyst, the stage of embryo development and endometrium are synchronized. However, there are contradictory results reported by several studies, that compared clinical pregnancy rates (CPR) between day 5 or day 6 frozen embryo transfers (FET).

OBJECTIVE

Is to determine the best strategy of embryo transfer for patients with slow-growing embryos, to compare outcomes of day 5 morula/early blastocyst transfers in «fresh» cycles and expanded frozen-thawed blastocysts transfers on day 6.

MATERIALS AND METHODS

The study included data of patients under 40 years old who underwent the IVF/ICSI cycles with the transfer of «fresh» embryos between 2013 and 2019, and FET between 2015 and 2019, in the Institute of Reproductive Medicine (IRM) in Almaty. The number of «fresh» cycles with the transfer of day 5 morula/early blastocyst was 436 (group A). The number of FET cycles with expanded blastocysts of day 6 (group B) and day 5 (group C, control) were 211 and 2747, respectively.

RESULTS

The CPR, the implantation rate (IR), the ongoing pregnancy rate (OPR) and the live birth rate (LBR) were significantly increased in the group B compared to the group A (CPR — 17.7 (110/619) vs 47.8% (101/211) p<0.001, IR — 12.6 (119/946) vs 35.7% (111/311) p<0.001, ORP — 11.9 (74/619) vs 37.4% (79/211) p<0.001, LBR — 10.5 (65/619) vs 35.5% (75/211) p<0.001). The miscarriage rate (MR) was significantly higher in group A than in group B: 35.3 (42/119) vs 18.9% (21/111) p=0.003. Moreover, the CPR, the OPR, the LBR and the IR were as following: 47.8 (101/211) vs 51.4% (1412/2724), 37.4 (79/211) vs 38.2% (1052/2757), 35.5 (75/211) vs 37.3% (1027/2747), and 35.7 (111/311) vs 36.5% (1586/4345), between day 6 (group B) and day 5 (group C, control) respectively. Statistical difference was not observed (p>0.05) in any indicators. Moreover, there was no significant difference in the MR between group B — 18.9 (21/111) and group C — 22.5% (358/1586).

CONCLUSION

In ART cycles with scheduled «fresh» embryo transfer, the preference should be given to the day 5 expanded blastocysts of good/excellent quality. If the entire cohort of embryos has been developing slowly, the culture of embryos should be extended until day 6 with subsequent cryopreservation of blastocysts. All good/excellent quality frozen blastocyst should be transferred in the cryo cycles regardless of the day of cryopreservation.

Keywords:

infertility
vitrification
frozen-thawed embryo transfer
slow-growing embryos
morula
early blastocyst
blastocysts
pregnancy rate

Authors:

Polumiskova A.O.

LLC «Institute of reproductive medicine»

Tevkin S.I.

LLC «Institute of reproductive medicine»

Shishimorova M.S.

LLC «Institute of reproductive medicine»

Jussubaliyeva T.M.

LLC «Institute of reproductive medicine»

Received:

06.04.2022

Accepted:

04.05.2022

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