The impact of blastomere loss on pregnancy and neonatal outcomes of vitrified-warmed Day3 embryos in single embryo transfer cycles

Abstract Background Blastomere loss is a common phenomenon that occurs following cryopreservation. To date, studies have drawn conflicting conclusions regarding the impact of blastomere loss on pregnancy outcomes. Besides, limited information is available concerning the neonatal safety of embryos wi...

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Main Authors: Shutian Jiang, Wei Jin, Xinxi Zhao, Qianwen Xi, Li Chen, Yining Gao, Wenzhi Li, Yanping Kuang
Format: Article
Language:English
Published: BMC 2022-05-01
Series:Journal of Ovarian Research
Subjects:
Online Access:https://doi.org/10.1186/s13048-022-00997-z
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author Shutian Jiang
Wei Jin
Xinxi Zhao
Qianwen Xi
Li Chen
Yining Gao
Wenzhi Li
Yanping Kuang
author_facet Shutian Jiang
Wei Jin
Xinxi Zhao
Qianwen Xi
Li Chen
Yining Gao
Wenzhi Li
Yanping Kuang
author_sort Shutian Jiang
collection DOAJ
description Abstract Background Blastomere loss is a common phenomenon that occurs following cryopreservation. To date, studies have drawn conflicting conclusions regarding the impact of blastomere loss on pregnancy outcomes. Besides, limited information is available concerning the neonatal safety of embryos with blastomere loss. In the present study, we aimed to investigate the impact of blastomere loss on pregnancy and neonatal outcomes of vitrified/warmed Day3 cleavage-stage embryos in single embryo transfer cycles. Methods This retrospective cohort study included all vitrified/warmed D3 cleavage-stage single frozen-thawed embryo transfer (FET) cycles between April 2015 and February 2021. We compared pregnancy and subsequent neonatal outcomes between the intact embryos group and the blastomere loss group in single FET cycles. Results A total of 6287 single FET cycles were included in the study, in which 5873 cycles were classified into the intact embryo group and 414 cycles were classified into the blastomere loss group. The outcomes of the blastomere loss group were significantly inferior to those of the intact embryo group, in terms of implantation/biochemical pregnancy/clinical pregnancy/ongoing pregnancy rate and live birth rate per embryo transfer cycle/per clinical pregnancy. Further binary logistic regression confirmed that blastomere loss was negatively associated with live birth. Moreover, the blastomere loss group presented with an elevated early miscarriage rate. The neonatal conditions were broadly similar between the two groups. Additionally, multiple binary logistic regression analysis demonstrated that primary infertility and intracytoplasmic sperm injection (ICSI) were common influencing factors of blastomere loss (aOR 1.447, 95% CI 1.038–2.019, P = 0.029; aOR: 1.388, 95% CI: 1.044–51.846, P = 0.024). Conclusions The transfer of vitrified/warmed D3 embryos with blastomere loss is related to impaired embryo developmental potentials and reduced probabilities of conception. Moreover, even if the embryos with blastomere loss have implanted and reached clinical pregnancies, they present with a lower possibility of developing to live birth owing to a higher early miscarriage rate. However, once the embryos with blastomere loss result in a live birth, no adverse neonatal outcomes are observed. Primary infertility and ICSI were found to be risk factors for blastomere loss.
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spelling doaj.art-9a4c2fb1a2694ab2bed1c4c941ecbe452023-01-02T16:58:37ZengBMCJournal of Ovarian Research1757-22152022-05-0115111110.1186/s13048-022-00997-zThe impact of blastomere loss on pregnancy and neonatal outcomes of vitrified-warmed Day3 embryos in single embryo transfer cyclesShutian Jiang0Wei Jin1Xinxi Zhao2Qianwen Xi3Li Chen4Yining Gao5Wenzhi Li6Yanping Kuang7Department of Assisted Reproduction, Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of MedicineDepartment of Assisted Reproduction, Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of MedicineDepartment of Assisted Reproduction, Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of MedicineDepartment of Assisted Reproduction, Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of MedicineDepartment of Assisted Reproduction, Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of MedicineDepartment of Assisted Reproduction, Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of MedicineDepartment of Assisted Reproduction, Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of MedicineDepartment of Assisted Reproduction, Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of MedicineAbstract Background Blastomere loss is a common phenomenon that occurs following cryopreservation. To date, studies have drawn conflicting conclusions regarding the impact of blastomere loss on pregnancy outcomes. Besides, limited information is available concerning the neonatal safety of embryos with blastomere loss. In the present study, we aimed to investigate the impact of blastomere loss on pregnancy and neonatal outcomes of vitrified/warmed Day3 cleavage-stage embryos in single embryo transfer cycles. Methods This retrospective cohort study included all vitrified/warmed D3 cleavage-stage single frozen-thawed embryo transfer (FET) cycles between April 2015 and February 2021. We compared pregnancy and subsequent neonatal outcomes between the intact embryos group and the blastomere loss group in single FET cycles. Results A total of 6287 single FET cycles were included in the study, in which 5873 cycles were classified into the intact embryo group and 414 cycles were classified into the blastomere loss group. The outcomes of the blastomere loss group were significantly inferior to those of the intact embryo group, in terms of implantation/biochemical pregnancy/clinical pregnancy/ongoing pregnancy rate and live birth rate per embryo transfer cycle/per clinical pregnancy. Further binary logistic regression confirmed that blastomere loss was negatively associated with live birth. Moreover, the blastomere loss group presented with an elevated early miscarriage rate. The neonatal conditions were broadly similar between the two groups. Additionally, multiple binary logistic regression analysis demonstrated that primary infertility and intracytoplasmic sperm injection (ICSI) were common influencing factors of blastomere loss (aOR 1.447, 95% CI 1.038–2.019, P = 0.029; aOR: 1.388, 95% CI: 1.044–51.846, P = 0.024). Conclusions The transfer of vitrified/warmed D3 embryos with blastomere loss is related to impaired embryo developmental potentials and reduced probabilities of conception. Moreover, even if the embryos with blastomere loss have implanted and reached clinical pregnancies, they present with a lower possibility of developing to live birth owing to a higher early miscarriage rate. However, once the embryos with blastomere loss result in a live birth, no adverse neonatal outcomes are observed. Primary infertility and ICSI were found to be risk factors for blastomere loss.https://doi.org/10.1186/s13048-022-00997-zBlastomere lossPregnancy outcomesNeonatal outcomesVitrificationSingle frozen embryo transfer
spellingShingle Shutian Jiang
Wei Jin
Xinxi Zhao
Qianwen Xi
Li Chen
Yining Gao
Wenzhi Li
Yanping Kuang
The impact of blastomere loss on pregnancy and neonatal outcomes of vitrified-warmed Day3 embryos in single embryo transfer cycles
Journal of Ovarian Research
Blastomere loss
Pregnancy outcomes
Neonatal outcomes
Vitrification
Single frozen embryo transfer
title The impact of blastomere loss on pregnancy and neonatal outcomes of vitrified-warmed Day3 embryos in single embryo transfer cycles
title_full The impact of blastomere loss on pregnancy and neonatal outcomes of vitrified-warmed Day3 embryos in single embryo transfer cycles
title_fullStr The impact of blastomere loss on pregnancy and neonatal outcomes of vitrified-warmed Day3 embryos in single embryo transfer cycles
title_full_unstemmed The impact of blastomere loss on pregnancy and neonatal outcomes of vitrified-warmed Day3 embryos in single embryo transfer cycles
title_short The impact of blastomere loss on pregnancy and neonatal outcomes of vitrified-warmed Day3 embryos in single embryo transfer cycles
title_sort impact of blastomere loss on pregnancy and neonatal outcomes of vitrified warmed day3 embryos in single embryo transfer cycles
topic Blastomere loss
Pregnancy outcomes
Neonatal outcomes
Vitrification
Single frozen embryo transfer
url https://doi.org/10.1186/s13048-022-00997-z
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