Does the transfer of a poor quality embryo with a good quality embryo benefit poor prognosis patients?
Abstract Background While single embryo transfer (SET) is widely advocated, double embryo transfer (DET) remains preferable in clinical practice to improve IVF success rate, especially in poor prognosis patients with only poor quality embryos (PQEs) available in addition to one or no good quality em...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2020-09-01
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| Series: | Reproductive Biology and Endocrinology |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12958-020-00656-2 |
| _version_ | 1818846417213456384 |
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| author | Wenjie Wang Jiali Cai Lanlan Liu Yingpei Xu Zhenfang Liu Jinghua Chen Xiaoming Jiang Xiaohua Sun Jianzhi Ren |
| author_facet | Wenjie Wang Jiali Cai Lanlan Liu Yingpei Xu Zhenfang Liu Jinghua Chen Xiaoming Jiang Xiaohua Sun Jianzhi Ren |
| author_sort | Wenjie Wang |
| collection | DOAJ |
| description | Abstract Background While single embryo transfer (SET) is widely advocated, double embryo transfer (DET) remains preferable in clinical practice to improve IVF success rate, especially in poor prognosis patients with only poor quality embryos (PQEs) available in addition to one or no good quality embryos (GQEs). Furthermore, previous studies suggest PQE might adversely affect the implantation of a GQE when transferred together. This study aims to evaluate the effect of transferring an additional PQE with a GQE on the outcomes in poor prognosis patients. Methods A total of 5037 frozen-thawed blastocyst transfer (FBT) cycles between January 2012 and May 2019 were included. Propensity score matching was applied to control for potential confounders, and we used generalized estimating equations (GEE) models to identify the association between the effect of an additional PQE and the outcomes. Results Overall, transferring a PQE with GQE (Group GP) achieved significantly higher pregnancy rate (PR), live birth rate (LBR) and multiple pregnancy rate (MPR) than GQE only (group G). The addition of a PQE increased LBR in patients aged 35 and over and in patients who received over 3 cycles of embryo transfer (ET) (48.1% vs 27.2%, OR:2.56, 95% CI: 1.3–5.03 and 46.6% vs 35.4%, OR:1.6, 95% CI: 1.09–2.35), but not in women under 35 and in women who received less than 3 cycles of ET (48.7% vs 43.9%, OR:1.22, 95% CI: 0.93–1.59 and 48.3% vs 41.4%, OR:1.33, 95% CI: 0.96–1.85). Group GP resulted in significantly higher MPR than group G irrespective of age and the number of previous IVF cycles. Conclusions An additional PQE does not negatively affect the implantation potential of the co-transferred GQE. Nevertheless, the addition of a PQE contributes to both live birth and multiple birth in poor prognosis patients. Physicians should still balance the benefits and risks of DET. |
| first_indexed | 2024-12-19T05:45:13Z |
| format | Article |
| id | doaj.art-9dad920c8925490995b0805081a1ab2e |
| institution | Directory Open Access Journal |
| issn | 1477-7827 |
| language | English |
| last_indexed | 2024-12-19T05:45:13Z |
| publishDate | 2020-09-01 |
| publisher | BMC |
| record_format | Article |
| series | Reproductive Biology and Endocrinology |
| spelling | doaj.art-9dad920c8925490995b0805081a1ab2e2022-12-21T20:33:52ZengBMCReproductive Biology and Endocrinology1477-78272020-09-011811910.1186/s12958-020-00656-2Does the transfer of a poor quality embryo with a good quality embryo benefit poor prognosis patients?Wenjie Wang0Jiali Cai1Lanlan Liu2Yingpei Xu3Zhenfang Liu4Jinghua Chen5Xiaoming Jiang6Xiaohua Sun7Jianzhi Ren8Reproductive Medicine Center, Xiamen University Affiliated Chenggong HospitalReproductive Medicine Center, Xiamen University Affiliated Chenggong HospitalReproductive Medicine Center, Xiamen University Affiliated Chenggong HospitalReproductive Medicine Center, Xiamen University Affiliated Chenggong HospitalReproductive Medicine Center, Xiamen University Affiliated Chenggong HospitalReproductive Medicine Center, Xiamen University Affiliated Chenggong HospitalReproductive Medicine Center, Xiamen University Affiliated Chenggong HospitalReproductive Medicine Center, Xiamen University Affiliated Chenggong HospitalReproductive Medicine Center, Xiamen University Affiliated Chenggong HospitalAbstract Background While single embryo transfer (SET) is widely advocated, double embryo transfer (DET) remains preferable in clinical practice to improve IVF success rate, especially in poor prognosis patients with only poor quality embryos (PQEs) available in addition to one or no good quality embryos (GQEs). Furthermore, previous studies suggest PQE might adversely affect the implantation of a GQE when transferred together. This study aims to evaluate the effect of transferring an additional PQE with a GQE on the outcomes in poor prognosis patients. Methods A total of 5037 frozen-thawed blastocyst transfer (FBT) cycles between January 2012 and May 2019 were included. Propensity score matching was applied to control for potential confounders, and we used generalized estimating equations (GEE) models to identify the association between the effect of an additional PQE and the outcomes. Results Overall, transferring a PQE with GQE (Group GP) achieved significantly higher pregnancy rate (PR), live birth rate (LBR) and multiple pregnancy rate (MPR) than GQE only (group G). The addition of a PQE increased LBR in patients aged 35 and over and in patients who received over 3 cycles of embryo transfer (ET) (48.1% vs 27.2%, OR:2.56, 95% CI: 1.3–5.03 and 46.6% vs 35.4%, OR:1.6, 95% CI: 1.09–2.35), but not in women under 35 and in women who received less than 3 cycles of ET (48.7% vs 43.9%, OR:1.22, 95% CI: 0.93–1.59 and 48.3% vs 41.4%, OR:1.33, 95% CI: 0.96–1.85). Group GP resulted in significantly higher MPR than group G irrespective of age and the number of previous IVF cycles. Conclusions An additional PQE does not negatively affect the implantation potential of the co-transferred GQE. Nevertheless, the addition of a PQE contributes to both live birth and multiple birth in poor prognosis patients. Physicians should still balance the benefits and risks of DET.http://link.springer.com/article/10.1186/s12958-020-00656-2Poor quality embryoGood quality embryoSingle embryo transferPoor prognosis patientsPropensity score matching |
| spellingShingle | Wenjie Wang Jiali Cai Lanlan Liu Yingpei Xu Zhenfang Liu Jinghua Chen Xiaoming Jiang Xiaohua Sun Jianzhi Ren Does the transfer of a poor quality embryo with a good quality embryo benefit poor prognosis patients? Reproductive Biology and Endocrinology Poor quality embryo Good quality embryo Single embryo transfer Poor prognosis patients Propensity score matching |
| title | Does the transfer of a poor quality embryo with a good quality embryo benefit poor prognosis patients? |
| title_full | Does the transfer of a poor quality embryo with a good quality embryo benefit poor prognosis patients? |
| title_fullStr | Does the transfer of a poor quality embryo with a good quality embryo benefit poor prognosis patients? |
| title_full_unstemmed | Does the transfer of a poor quality embryo with a good quality embryo benefit poor prognosis patients? |
| title_short | Does the transfer of a poor quality embryo with a good quality embryo benefit poor prognosis patients? |
| title_sort | does the transfer of a poor quality embryo with a good quality embryo benefit poor prognosis patients |
| topic | Poor quality embryo Good quality embryo Single embryo transfer Poor prognosis patients Propensity score matching |
| url | http://link.springer.com/article/10.1186/s12958-020-00656-2 |
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