Outcomes of neonates born following transfers of frozen-thawed cleavage-stage embryos with blastomere loss: a prospective, multicenter, cohort study

BMC Medicine

William D. Fraser¹  Jian-Zhong Sheng²  Yi-Min Zhu³  Rong Yin³  Yan Wu³  Qiong-Fang Wu⁴  Li-Ping Wang⁵  Shu-Hua Zou⁶  Yan-Ting Wu⁷  Yi-Jing Xu⁷  Yun-Fei Su⁷  Chao-Yi Shi⁷  Cheng Li⁷  Zhi-Wei Liu⁷  He-Feng Huang⁷  Jian Zhang⁷  Jing Lin⁷  Zi-Ru Jiang⁷ 

[1] Centre de recherche du Centre Hospitalier Universitaire de Sherbrooke (CRCHUS) and Department of Obstetrics and Gynecology, University of Sherbrooke;Department of Pathology and Pathophysiology, School of Medicine, Zhejiang University;Department of Reproductive Endocrinology, Women’s Hospital, School of Medicine, Zhejiang University;Department of Reproductive Medicine, Jiangxi Maternal and Child Health Hospital;Department of Reproductive Medicine, Jiaxing Maternity and Child Health Care Hospital;Department of Reproductive Medicine, Qingdao Women and Children’s Hospital;International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University;

关键词: Frozen embryo transfer;    Blastomere loss;    Pregnancy outcomes;    Small for gestational age;    Transient tachypnea of the newborn;    Cohort study;   

DOI  :  10.1186/s12916-018-1077-8

来源: DOAJ

【 摘 要 】

Abstract Background Despite limited information on neonatal safety, the transfer of frozen-thawed cleavage-stage embryos with blastomere loss is common in women undergoing in vitro fertilization. We aimed to evaluate the pregnancy outcomes and safety of frozen-thawed cleavage-stage embryos with blastomere loss. Methods This prospective, multicenter, cohort study included all frozen-thawed cleavage-stage embryo transfer (FET) cycles between 2002 and 2012. Pregnancy outcomes and subsequent neonatal outcomes were compared between FET cycles with intact embryos and those with blastomere loss. Results A total of 12,105 FET cycles were included in the analysis (2259 cycles in the blastomere loss group and 9846 cycles in the intact embryo group). The blastomere loss group showed significantly poorer outcomes with respect to implantation, pregnancy, and live birth rates than the intact embryo group. However, following embryo implantation, the two groups were similar with respect to live birth rates per clinical pregnancy. Among multiple pregnancies (4229 neonates), neonates from the blastomere loss group were at an increased risk of being small for gestational age (aOR = 1.50, 95% CI 1.00–2.25) compared to those from the intact group. A similar trend was observed among singletons (aOR = 1.84, 95% CI 0.99–3.37). No associations were found between blastomere loss and the subsequent occurrence of congenital anomalies or neonatal mortality. However, neonates from the blastomere loss group were at an increased risk of transient tachypnea of the newborn (aOR = 5.21, 95% CI 2.42–11.22). Conclusions The transfer of embryos with blastomere loss is associated with reduced conception rates. Once the damaged embryos have implanted, pregnancies appear to have the same probability of progressing to live birth but with an increased risk of small for gestational age neonates and transient tachypnea of the newborn. Study registration This study was retrospectively registered at Chinese Clinical Trial Registry. Registration number: ChiCTR-OOC-16007753. Registration date: 13 January 2016.

【 授权许可】

Unknown