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Influences of blastocyst grade and development speed on clinical outcomes of Frozen-thawed blastocyst transfer cycles |
Shenzhen People's Hospital (The Second Clinical Medical College,Jinan University;The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen 518020 |
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Abstract To study the differences of blastocyst grade and development speed (D5 and D6)on the clinical outcomes of frozen-thawed blastocyst transfer cycles. Methods:The data of 1429 frozen-thawed blastocyst transfer cycles in Reproductive Medical Center of the Shenzhen people’s Hospital were analyzed in this retrospective cohort study. Patients were divided into four groups according to the blastocyst morphological score and development speed: D5 top-quality single blastocyst group、D6 top-quality single blastocyst group、 D5 non-top quality single blastocyst group and D6 non-top quality single blastocyst group. The pregnancy outcomes were compared among four groups when the transferred blastocysts morphological score are fit well.Results:The clinical pregnancy rate(67.0%) and live birth rate (57.3%)of D5 group were higher than that of D6 group(52.0%,40.3%) for those who transferred top-quality single blastocyst patients; the early spontaneous abortion rate (13.1%) of D5 group was lower than that of D6 group (19.1%), and all of the differences were statistically significant(P<0.05). For those who transferred non-top quality single blastocyst patients, the clinical pregnancy rate(44.7%) and live birth rate(34.3%) of D5 group were better than that of D6 group(31.1%, 20.9%), and there were significant statistically differences between groups. There was not significant difference in spontaneous abortion rate between two groups (13.7% vs 21.7%)(P>0.05). The clinical outcomes were better in D6 top-quality single blastocyst group than D5 non-top quality single blastocyst group but that didn't reach statistical significance. Logistic regression analyses of the clinical data based on single blastocyst group indicated that slow blastocyst development speed was a risk factor for clinical pregnancy (OR=0.57) and early spontaneous abortion (OR=1.76). Blastocyst morphology score is an independent influencing factor of clinical pregnancy(OR=2.45). Conclusions:It is necessary to comprehensively evaluate the blastocyst development speed and morphological score before single blastocyst transfer. The following sequence can be referred to when selecting single blastocyst for transplantation: D5 top-quality blastocysts、D6 top-quality blastocysts、D5 non-top blastocysts、D6 non-top blastocysts.
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