Optimal embryo management strategies for patients undergoing antagonist protocols in IVF treatment.

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Abstract

PurposeSelection of optimal embryo transfer strategies for IVF patients treated with antagonist protocols.MethodsA retrospective study was conducted to assess whether whole embryo culture to the blastocyst stage could enhance the cumulative live birth rate (CLBR). The study included data from the first oocyte retrieval cycle of 4131 patients who underwent IVF treatment between January 2018 and June 2022. Patients were categorized into two strategies based on whether they underwent partial blastocyst culture (PBC) or whole embryo culture (WEC), and were further subdivided into three subgroups according to the number of high-quality embryos on Day 3: 0-2 embryos (subgroup 1), 3-7 embryos (subgroup 2), and 8 or more embryos (subgroup 3). Propensity score matching was used to perform a 1:1 match for patients across the three subgroups. The primary outcome measure was the CLBR per oocyte retrieval cycle.ResultsAfter propensity score matching, there were no statistically significant differences in the baseline data among patients across the three corresponding subgroups for the PBC and WEC strategies. The analysis of CLBR in single oocyte retrieval cycles revealed that subgroup 1 had a significantly higher rate with the PBC strategy compared to the WEC strategy (33.0% vs. 25.7%, P = 0.018). In subgroups 2 and 3, there were no statistically significant differences in the CLBR between patients using the two embryo management strategies.ConclusionsWhen patients have 0-2 high-quality embryos on Day 3, opting for Day 3 embryo transfer rather than blastocyst culture can increase the chances of embryo transfer and improve the CLBR.
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Abstract

Purpose Selection of optimal embryo transfer strategies for IVF patients treated with antagonist protocols.

Methods

A retrospective study was conducted to assess whether whole embryo culture to the blastocyst stage could enhance the cumulative live birth rate (CLBR). The study included data from the first oocyte retrieval cycle of 4131 patients who underwent IVF treatment between January 2018 and June 2022. Patients were categorized into two strategies based on whether they underwent partial blastocyst culture (PBC) or whole embryo culture (WEC), and were further subdivided into three subgroups according to the number of high-quality embryos on Day 3: 0–2 embryos (subgroup 1), 3–7 embryos (subgroup 2), and 8 or more embryos (subgroup 3). Propensity score matching was used to perform a 1:1 match for patients across the three subgroups. The primary outcome measure was the CLBR per oocyte retrieval cycle.

Results

After propensity score matching, there were no statistically significant differences in the baseline data among patients across the three corresponding subgroups for the PBC and WEC strategies. The analysis of CLBR in single oocyte retrieval cycles revealed that subgroup 1 had a significantly higher rate with the PBC strategy compared to the WEC strategy (33.0% vs. 25.7%, P = 0.018). In subgroups 2 and 3, there were no statistically significant differences in the CLBR between patients using the two embryo management strategies.

Conclusions

When patients have 0–2 high-quality embryos on Day 3, opting for Day 3 embryo transfer rather than blastocyst culture can increase the chances of embryo transfer and improve the CLBR. Similar content being viewed by others Data Availability Requests for access to the data that support the findings of this study should be directed to the corresponding author at [email protected].

References

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BMC Pregnancy Childbirth 2023;23(1):254. https://doi.org/10.1186/s12884-023-05563-z Author information Authors and Affiliations Contributions Hao Wei: project development, data collection, and manuscript writing. BaoPing Zhu: data collection. LeiYu Deng: data collection. MeiFang Zeng: data collection. JinLiang Duan: project development. Corresponding author Ethics declarations Consent for publication All authors agreed to the publication of this study. Competing interests The authors declare no competing interests. Additional information Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Rights and permissions Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. About this article Cite this article Wei, H., Zhu, B., Deng, L. et al. Optimal embryo management strategies for patients undergoing antagonist protocols in IVF treatment. J Assist Reprod Genet 42, 827–838 (2025). https://doi.org/10.1007/s10815-024-03365-6 Received: Accepted: Published: Version of record: Issue date: DOI: https://doi.org/10.1007/s10815-024-03365-6

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