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Increased pregnancy outcome after day 5 versus day 6 transfers of human vitrified-warmed blastocysts

Published online by Cambridge University Press:  15 August 2019

Romualdo Sciorio*
Affiliation:
Edinburgh Assisted Conception Programme, EFREC, Royal Infirmary of Edinburgh, 51 Little France Crescent, Old Dalkeith Road, Edinburgh, Scotland, EH16 4SA, UK.
K.J. Thong
Affiliation:
Edinburgh Assisted Conception Programme, EFREC, Royal Infirmary of Edinburgh, 51 Little France Crescent, Old Dalkeith Road, Edinburgh, Scotland, EH16 4SA, UK.
Susan J. Pickering
Affiliation:
Edinburgh Assisted Conception Programme, EFREC, Royal Infirmary of Edinburgh, 51 Little France Crescent, Old Dalkeith Road, Edinburgh, Scotland, EH16 4SA, UK.
*
Address for correspondence: Romualdo Sciorio. Edinburgh Assisted Conception Programme, EFREC, Royal Infirmary of Edinburgh, 51 Little France Crescent, Old Dalkeith Road, Edinburgh, Scotland, EH16 4SA, UK. E-mail: sciorioromualdo@hotmail.com

Summary

Vitrification is a highly efficient technique for the cryopreservation of the human embryo. The effect of delayed blastulation may be responsible for implantation failures and negatively affects in vitro fertilization (IVF) outcomes. The current literature displays discordant results; some studies have announced higher pregnancy rates after day 5 (D5) transfer compared with day 6 (D6) transfer, while others have shown equivalent outcomes. In the present study an investigation into the clinical implications of delayed blastulation (D5 versus D6) was carried out. We performed a retrospective study comparing clinical pregnancies and implantation rates following warmed single blastocyst transfer (WSBT). All patients coming for a programmed warmed transfer at Edinburgh Assisted Conception Programme, EFREC, Royal Infirmary of Edinburgh, were included in this study and divided in two groups according to the day of blastocyst vitrification: D5 (n = 1563) and D6 (n = 517). The overall survival rate was 95.0% (1976/2080) with no significant difference between the D5 and D6 groups: 95.3% (1489/1563) and 94.2% (487/517) respectively. WSBT of D6 blastocysts resulted in a lower implantation and clinical pregnancy compared with D5 embryos. The implantation rate (IPR) and clinical pregnancy rate (CPR) were respectively 49.4% and 42.6% for the D5 and 37.4% and 32.2% for the D6 embryos, which was statistically significant. The multiple pregnancy rate was 1.32% (1.14% for D5 vs 1.84% for D6). Although the transfer of D6 vitrified-warmed blastocyst remains a reasonable option, priority to a D5 embryo would reduce the time to successful pregnancy.

Type
Research Article
Copyright
© Cambridge University Press 2019 

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References

AbdelHafez, FF, Desai, N, Abou-Setta, AM, Falcone, T and Goldfarb, J (2010) Slow-freezing, vitrification and ultra-rapid freezing of human embryos: a systematic review and meta-analysis. Reprod Biomed Online 20, 209–22.CrossRefGoogle ScholarPubMed
Adashi, EY, Barri, PN, Berkowitz, R, Braude, P, Bryan, E, Carr, J, Cohen, J, Collins, J, Devroey, P, Frydman, R, Gardner, D, Germond, M, Gerris, J, Gianaroli, L, Hamberger, L, Howles, C, Jones, H Jr, Lunenfeld, B, Pope, A, Reynolds, M, Rosenwaks, Z, Shieve, LA, Serour, GI, Shenfield, F, Templeton, A, van Steirteghem, A, Veeck, L and Wennerholm, UB (2003) Infertility therapy-associated multiple pregnancies (births): an ongoing epidemic. Reprod Biomed Online 7, 515–42.CrossRefGoogle ScholarPubMed
Alfarawati, S, Fragouli, E, Colls, P, Stevens, J, Gutierrez-Mateo, C, Schoolcraft, WB and Wells, D (2011) The relationship between blastocyst morphology, chromosomal abnormality, and embryo gender. Fertil Steril 95, 520–4.CrossRefGoogle ScholarPubMed
Barrenetxea, G, López-de Larruzea, A, Ganzabal, T, Jiménez, R, Carbonero, K and Mandiola, M (2005) Blastocyst culture after repeated failure of cleavage-stage embryo transfers: a comparison of day 5 and day 6 transfers. Fertil Steril 83, 4953.CrossRefGoogle ScholarPubMed
Behr, B, Gebhardt, J, Lyon, J and Milki, AA (2002) Factors relating to a successful cryopreserved blastocyst transfer program. Fertil Steril 77, 697–9.CrossRefGoogle ScholarPubMed
Capalbo, A, Rienzi, L, Cimadomo, D, Maggiulli, R, Elliott, T, Wright, G and Ubaldi, FM (2014) Correlation between standard blastocyst morphology, euploidy and implantation: An observational study in two centers involving 956 screened blastocysts. Hum Reprod 29, 1173–81.CrossRefGoogle ScholarPubMed
Cohen, J, Wells, D and Munne, S (2007) Removal of 2 cells from cleavage stage embryos is likely to reduce the efficacy of chromosomal tests that are used to enhance implantation rates. Fertil Steril 87, 496503.CrossRefGoogle ScholarPubMed
Cutting, R, Morroll, D, Roberts, SA, Pickering, SJ, Rutherford, A, BFS and ACE (2008) Elective single embryo transfer: guidelines for practice British Fertility Society and Association of Clinical Embryologists. Hum Fertil (Camb) 11, 131–46.CrossRefGoogle Scholar
Desai, N, Ploskonka, S, Goodman, L, Attaran, M, Goldberg, JM, Austin, C and Falcone, T (2016) Delayed blastulation, multinucleation, and expansion grade are independently associated with live-birth rates in frozen blastocyst transfer cycles. Fertil Steril 106, 1370–8.CrossRefGoogle ScholarPubMed
El-Toukhy, T, Wharf, E, Walavalkar, R, Singh, A, Bolton, V, Khalaf, Y and Braude, P (2011) Delayed blastocyst development does not influence the outcome of frozen–thawed transfer cycles. BJOG, 118, 1551–6.CrossRefGoogle Scholar
Fragouli, E, Alfarawati, S, Spath, K and Wells, D (2014) Morphological and cytogenetic assessment of cleavage and blastocyst stage embryos. Mol Hum Reprod, 20, 117–26.CrossRefGoogle ScholarPubMed
Gardner, DK and Schoolcraft, WB (1999) Culture and transfer of human blastocysts. Curr Opin Obstet Gynecol 11, 307–11.CrossRefGoogle ScholarPubMed
Gardner, DK, Schoolcraft, WB, Wagley, L, Schlenker, T, Stevens, J and Hesla, J (1998) A prospective randomized trial of blastocyst culture and transfer in in-vitro fertilization. Hum Reprod 13, 3434–40.CrossRefGoogle ScholarPubMed
Gerris, J, de Neubourg, D, Mangelschots, K, van Royen, E, Vercruyssen, M, Barudy-Vasquez, J, Valkenburg, M and Ryckaert, G (2002) Elective single day 3 embryo transfer halves the twinning rate without decrease in the ongoing pregnancy rate of an IVF/ICSI programme. Hum Reprod 17, 2626–31.CrossRefGoogle ScholarPubMed
Haas, J, Meriano, J, Laskin, C, Bentov, Y, Barzilay, E, Casper, RF and Cadesky, K (2016) Clinical pregnancy rate following frozen embryo transfer is higher with blastocysts vitrified on day 5 than on day 6. J Assist Reprod Genet 33, 1553–7.CrossRefGoogle ScholarPubMed
Hashimoto, S, Amo, A, Hama, S, Ohsumi, K, Nakaoka, Y and Morimoto, Y (2013) A closed system supports the developmental competence of human embryos after vitrification: Closed vitrification of human embryos. J Assist Reprod Genet 30, 371–6.CrossRefGoogle ScholarPubMed
Kaye, L, Will, EA, Bartolucci, A, Nulsen, J, Benadiva, C and Engmann, L (2017) Pregnancy rates for single embryo transfer (SET) of day 5 and day 6 blastocysts after cryopreservation by vitrification and slow freeze. J Assist Reprod Genet 34, 913–9.CrossRefGoogle ScholarPubMed
Khorram, O, Shapiro, SS and Jones, JM (2000) Transfer of nonassisted hatched and hatching human blastocysts after in vitro fertilization. Fertil Steril 74, 163–5.CrossRefGoogle ScholarPubMed
Kovalevsky, G, Carney, SM, Morrison, LS, Boylan, CF, Neithardt, AB and Feinberg, RF (2013) Should embryos developing to blastocysts on day 7 be cryopreserved and transferred: an analysis of pregnancy and implantation rates. Fertil Steril 100, 1008–12CrossRefGoogle ScholarPubMed
Kroener, L, Ambartsumyan, G, Briton-Jones, C, Dumesic, D, Surrey, M, Munné, S and Hill, D (2012) The effect of timing of embryonic progress on chromosomal abnormality. Fertil Steril 98, 876–80.CrossRefGoogle ScholarPubMed
Li, Z, Wang, YA, Ledger, W, Edgar, DH and Sullivan, EA (2014) Clinical outcomes following cryopreservation of blastocysts by vitrification or slow freezing: a population-based cohort study Hum Reprod 29, 2794–801.CrossRefGoogle ScholarPubMed
Liebermann, J and Tucker, MJ (2006) Comparison of vitrification and conventional cryopreservation of day 5 and day 6 blastocysts during clinical application. Fertil Steril 86, 20–6.CrossRefGoogle ScholarPubMed
Loutradi, KE, Kolibianakis, EM, Venetis, CA, Papanikolaou, EG, Pados, G, Bontis, I and Tarlatzis, BC (2008) Cryopreservation of human embryos by vitrification or slow freezing: a systematic review and meta-analysis. Fertil Steril 90, 186–93.CrossRefGoogle ScholarPubMed
McArthur, SJ, Leigh, D, Marshall, JT, de Boer, KA and Jansen, RP (2005) Pregnancies and live births after trophectoderm biopsy and preimplantation genetic testing of human blastocysts. Fertil Steril 84, 1628–36.CrossRefGoogle ScholarPubMed
Richter, KS, Shipley, SK, McVearry, I, Tucker, MJ and Widra, EA (2006) Cryopreserved embryo transfers suggest that endometrial receptivity may contribute to reduced success rates of later developing embryos. Fertil Steril 86, 862–6.CrossRefGoogle ScholarPubMed
Rienzi, L, Gracia, C, Maggiulli, R, LaBarbera, AR, Kaser, DJ, Ubaldi, FM, Vanderpoel, S and Racowsky, C (2017) Oocyte, embryo and blastocyst cryopreservation in ART: systematic review and meta-analysis comparing slow-freezing versus vitrification to produce evidence for the development of global guidance. Hum Reprod Update 23, 139–55.Google ScholarPubMed
Roque, M, Lattes, K, Serra, S, Solà, I, Geber, S, Carreras, R and Checa, MA (2013) Fresh embryo transfer versus frozen embryo transfer in in vitro fertilization cycles: a systematic review and meta-analysis. Fertil Steril 99, 156–62.CrossRefGoogle ScholarPubMed
Sciorio, R, Thong, JK and Pickering, SJ (2018) Comparison of the development of human embryos cultured in either an EmbryoScope or benchtop incubator. J Assist Reprod Genet 35, 515–22.CrossRefGoogle ScholarPubMed
Shapiro, BS, Richter, KS, Harris, DC, and Daneshm, ST (2001) A comparison of day 5 and day 6 blastocyst transfers. Fertil Steril 75, 1126–30.CrossRefGoogle ScholarPubMed
Shapiro, BS, Daneshmand, ST, Garner, FC, Aguirre, M and Ross, R (2008) Contrasting patterns in in vitro fertilization pregnancy rates among fresh autologous, fresh oocyte donor, and cryopreserved cycles with the use of day 5 or day 6 blastocysts may reflect differences in embryo-endometrium synchrony. Fertil Steril 89, 20–6.CrossRefGoogle ScholarPubMed
Shoukir, Y, Chardonnens, D, Campana, A, Bischof, P and Sakkas, D (1998) The rate of development and time of transfer play different roles in influencing the viability of human blastocysts. Hum Reprod 13, 676–81.CrossRefGoogle Scholar
Stanger, J, Wong, J, Conceicao, J and Yovich, J (2012) Vitrification of human embryos previously cryostored by either slow freezing or vitrification results in high pregnancy rates. Reprod Biomed Online 24, 314–20.CrossRefGoogle ScholarPubMed
Sunkara, SK, Siozos, A, Bolton, VN, Khalaf, Y, Braude, PR and El-Toukhy, T (2010) The influence of delayed blastocyst formation on the outcome of frozen–thawed blastocyst transfer: a systematic review and meta-analysis. Hum Reprod 25, 1906–15.CrossRefGoogle ScholarPubMed
Taylor, TH, Patrick, JL, Gitlin, SA, Wilson, JM, Crain, JL and Griffin, DK (2014) Comparison of aneuploidy, pregnancy and live birth rates between day 5 and day 6 blastocysts. Reprod Biomed Online 29, 305–10.CrossRefGoogle ScholarPubMed
Vilska, S, Tiitinen, A, Hyden-Granskog, C and Hovatta, O (1999) Elective transfer of one embryo results in an acceptable pregnancy rate and eliminates the risk of multiple birth. Hum Reprod 14, 2392–5.CrossRefGoogle Scholar
Wang, X, Zhen, J, Sun, Z, Yu, Q, Deng, C, Zhou, Y, Wang, H and He, F (2016) Effects of fifth day (D5) or sixth day (D6) frozen–thawed blastocysts on neonatal outcomes. Zygote 24, 684–91.CrossRefGoogle ScholarPubMed
Yin, H, Jiang, H, He, R, Wang, C, Zhu, J and Luan, K (2015) The effects of fertilization mode, embryo morphology at day 3, and female age on blastocyst formation and the clinical outcomes. Syst Biol Reprod Med 61, 50–6.CrossRefGoogle ScholarPubMed
Yang, H, Yang, Q, Dai, S, Li, G, Jin, H, Yao, G and Sun, Y (2016) Comparison of differences in development potentials between frozen–thawed D5 and D6 blastocysts and their relationship with pregnancy outcomes. J Assist Reprod Genet 33, 865–72.CrossRefGoogle ScholarPubMed