Comparing the pregnancy outcomes of cleavage and blastocyst stage in frozen embryo transfer cycles: A cross-sectional study.

Parsafar Z, Razieh Dehghani Firouzabadi
International journal of reproductive biomedicine · 2023 · doi:10.18502/ijrm.v21i11.14656 · PMID:38292510 · PMC10823116
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Blastocyst stage frozen embryo transfer is associated with higher chemical and clinical pregnancy rates compared to cleavage stage transfer, with no significant differences in other pregnancy outcomes.

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This cross-sectional study compared pregnancy outcomes between cleavage and blastocyst stage frozen embryo transfers in 194 women undergoing assisted reproductive technology. The researchers excluded patients with specific chronic conditions and endometriosis, focusing on comparing clinical pregnancy rates, miscarriage, preterm birth, and other obstetric complications between the two embryonic stages. Results indicated that the blastocyst transfer group had significantly higher rates of both chemical and clinical pregnancy compared to the cleavage stage group, while also showing differences in various pregnancy outcomes such as ectopic pregnancy and multiple births. Relevance to endometriosis: The paper explicitly excludes women with a history of endometriosis from its study population, thereby limiting its direct applicability to this condition despite discussing general infertility treatments.

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Abstract

Background: In vitro fertilization has advanced in many ways, and new techniques are challenging. Blastocyst transfer is an alternative method for embryo transfer (ET) to improve in vitro fertilization outcomes. Objective: The present study was performed to determine the effect of pregnancies resulting from ET in the blastocyst stage compared to the cleavage stage in frozen cycles to select a better method of assisted reproduction. Materials and Methods: This cross-sectional study was conducted on 194 women who referred to the Yazd Reproductive Sciences Institute, Yazd, Iran, between April 2019 and December 2020. They had a frozen ET as either cleavage or blastocyst (n = 97/each group). The study compared the pregnancy and fetal outcomes in the 2 groups of ET at the cleavage and blastocyst stages. Results: The results showed that the blastocyst stage group had higher levels of anti-Mullerian hormone, ovule number, 2 pronuclear number, and embryo number than the cleavage stage group. The frequency of chemical pregnancies was 52.6% and 36.1% in blastocyst and cleavage group respectively (p = 0.02). Also, the frequency of clinical pregnancies was 41.2% and 22.7% in blastocyst and cleavage group respectively (p < 0.001). No statistically significant difference was observed between 2 groups in abortion, preterm delivery, multiple births, preterm premature rupture of membranes, gestational diabetes and preeclampsia, ectopic pregnancy, neonatal hospitalization in Neonatal Intensive Care Unit, and fetal abnormalities (p > 0.05). Conclusion: The results showed that transmission in the blastocyst stage compared to the cleavage stage is associated with an increase in chemical and clinical pregnancy, while other pregnancy outcomes are the same in both groups.
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In general, considering that the probability of clinical pregnancy in the blastocyst stage was significantly higher than the cleavage stage and no statistically significant differences were observed between the 2 stages of pregnancy, it can be concluded that the transfer in the blastocyst stage leads to better results.

Coi Statement

The authors declare that there is no conflict of interest.

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