Fresh embryo transfer in the cleavage and blastocyst stages and pregnancy outcomes: A retrospective cross-sectional study

Mahsa Poormoosavi S, Seyedeh Mahsa Poormoosavi, Amin Behmanesh M, Mohammad Amin Behmanesh, Sara Aryannejad, Aryannejad S, Janati S
International journal of reproductive biomedicine · 2023 · vol. 21(5) , pp. 425–432 · doi:10.18502/ijrm.v21i5.13477 · PMID:37362096 · PMC10285195
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This retrospective study of 1246 IVF cases found no significant difference in clinical pregnancy, live birth, abortion, or multifetal pregnancy rates between fresh embryo transfers performed at the cleavage stage versus the blastocyst stage.

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This retrospective cross-sectional study analyzed IVF outcomes for 1246 women to compare pregnancy rates following fresh embryo transfers at cleavage stages (days 2–3) versus blastocyst stages (days 5–6). The researchers excluded patients with specific comorities, including grades III and IV endometriosis, uterine myomas, and hydrosalpinges, to isolate the effects of transfer timing on reproductive success. Statistical analysis revealed no significant differences among the groups regarding chemical pregnancy, clinical pregnancy, ongoing pregnancy, live birth rates, or miscarriage frequencies. Relevance to endometriosis: the paper explicitly excludes patients with grades III and IV endometriosis from its cohort, indicating that the findings are not applicable to this patient population and the condition is only mentioned as an exclusion criterion.

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Abstract

BACKGROUND: Advances in cell culture media have led to a trend of embryo transfer from the early cleavage stages to blastocyst stage. OBJECTIVE: The study aims to compare the effects of fresh embryo transfer in cleavage and blastocyst stage on pregnancy outcomes. MATERIALS AND METHODS: This cross-sectional study was conducted on 1422 cases referred to the Umm-al-Banin Infertility Clinic Center, Dezful, Iran, between July 2013 and December 2020 who were candidates for in vitro fertilization/intracytoplasmic sperm injection for fresh embryo transfer. A total of 1246 cases were divided into 4 categories on days 2-5 or 6. Chemical and clinical pregnancy, abortion, multifetal pregnancy, ongoing pregnancy, and live birth rates were analyzed. RESULTS: Fresh embryo transfer was performed in 28.5% of the cases on the 2nd day, 45.8% on the 3rd, 15.3% on the 4th day, and 10.4% on days 5 or 6. The overall clinical pregnancy and live birth rates were estimated at 20.6% and 17.6% in the cleavage, and 17% and 14% in the blastocyst stages, respectively. However, no significant difference was observed in either group. In addition, there was no significant difference between groups in terms of the abortion, multifetal pregnancy, and ongoing pregnancy rate (p > 0.05). CONCLUSION: According to the results, the consequences of pregnancy in fresh embryo transfer at the blastocyst stage were not superior to embryo transfer at different stages of the cleavage process.
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According to the results, the developmental stage of the fresh embryo (blastocyst or cleavage stage) for transfer had no positive or negative effect on fertility. It seems BET is not superior to cleavage embryo transfer in reproductive outcomes. However, it is suggested that similar investigations can be conducted in this regard on larger sample sizes to assess the different stages of embryo transfer, pregnancy, and perinatal outcomes.

Coi Statement

Authors declare that there is no conflict of interest.

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