Comparing Day 5 versus Day 6 euploid blastocyst in frozen embryo transfer and developing a predictive model for optimizing outcomes: a retrospective cohort study
BackgroundOptimal protocols for frozen-thawed embryo transfer (FET) after preimplantation genetic testing (PGT) remain unclear. This study compared Day 5 (D5) and Day 6 (D6) blastocysts and evaluated predictors of FET success.MethodsA total of 870 patients with genetic diseases or chromosomal transl...
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| Format: | Article |
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Frontiers Media S.A.
2024-01-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2023.1302194/full |
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| author | Beining Yin Sichen Li Lin Sun Zhiyi Yao Yueyue Cui Congli Zhang Yile Zhang Yile Zhang |
| author_facet | Beining Yin Sichen Li Lin Sun Zhiyi Yao Yueyue Cui Congli Zhang Yile Zhang Yile Zhang |
| author_sort | Beining Yin |
| collection | DOAJ |
| description | BackgroundOptimal protocols for frozen-thawed embryo transfer (FET) after preimplantation genetic testing (PGT) remain unclear. This study compared Day 5 (D5) and Day 6 (D6) blastocysts and evaluated predictors of FET success.MethodsA total of 870 patients with genetic diseases or chromosomal translocations who received PGT at the First Affiliated Hospital of Zhengzhou University from January 2015 to December 2019 were recruited. All patients underwent at least one year of follow-up. Patients were divided into groups according to the blastocyst development days and quality. Univariate and multivariate logistic regression were applied to identify risk factors that affect clinical outcomes and to construct a predictive nomogram model. Area under the curve (AUC) of the subject’s operating characteristic curve and GiViTI calibration belt were conducted to determine the discrimination and fit of the model.ResultsD5 blastocysts, especially high-quality D5, resulted in significantly higher clinical pregnancy (58.4% vs 49.2%) and live birth rates (52.5% vs 45%) compared to D6. Multivariate regression demonstrated the number of blastocysts, endometrial preparation protocol, days of embryonic development and the quality of blastocysts independently affected live birth rates (P<0.05). A nomogram integrating these factors indicated favorable predictive accuracy (AUC=0.598) and fit (GiViTI, P=0.192).ConclusionsTransferring high-quality D5 euploid blastocysts after PGT maximizes pregnancy outcomes. Blastocyst quality, blastocyst development days, endometrial preparation protocols, and number of blastocysts, independently predicted outcomes. An individualized predictive model integrating these factors displayed favorable accuracy for counseling patients and optimizing clinical management. |
| first_indexed | 2024-03-08T17:04:20Z |
| format | Article |
| id | doaj.art-e08a9b3c4cf241b3b089589e00837573 |
| institution | Directory Open Access Journal |
| issn | 1664-2392 |
| language | English |
| last_indexed | 2024-03-08T17:04:20Z |
| publishDate | 2024-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Endocrinology |
| spelling | doaj.art-e08a9b3c4cf241b3b089589e008375732024-01-04T06:10:06ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922024-01-011410.3389/fendo.2023.13021941302194Comparing Day 5 versus Day 6 euploid blastocyst in frozen embryo transfer and developing a predictive model for optimizing outcomes: a retrospective cohort studyBeining Yin0Sichen Li1Lin Sun2Zhiyi Yao3Yueyue Cui4Congli Zhang5Yile Zhang6Yile Zhang7Reproductive Medicine Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, ChinaReproductive Medicine Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, ChinaReproductive Medicine Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, ChinaReproductive Medicine Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, ChinaReproductive Medicine Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, ChinaReproductive Medicine Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, ChinaReproductive Medicine Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, ChinaHenan Key Laboratory of Reproduction and Genetics, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, ChinaBackgroundOptimal protocols for frozen-thawed embryo transfer (FET) after preimplantation genetic testing (PGT) remain unclear. This study compared Day 5 (D5) and Day 6 (D6) blastocysts and evaluated predictors of FET success.MethodsA total of 870 patients with genetic diseases or chromosomal translocations who received PGT at the First Affiliated Hospital of Zhengzhou University from January 2015 to December 2019 were recruited. All patients underwent at least one year of follow-up. Patients were divided into groups according to the blastocyst development days and quality. Univariate and multivariate logistic regression were applied to identify risk factors that affect clinical outcomes and to construct a predictive nomogram model. Area under the curve (AUC) of the subject’s operating characteristic curve and GiViTI calibration belt were conducted to determine the discrimination and fit of the model.ResultsD5 blastocysts, especially high-quality D5, resulted in significantly higher clinical pregnancy (58.4% vs 49.2%) and live birth rates (52.5% vs 45%) compared to D6. Multivariate regression demonstrated the number of blastocysts, endometrial preparation protocol, days of embryonic development and the quality of blastocysts independently affected live birth rates (P<0.05). A nomogram integrating these factors indicated favorable predictive accuracy (AUC=0.598) and fit (GiViTI, P=0.192).ConclusionsTransferring high-quality D5 euploid blastocysts after PGT maximizes pregnancy outcomes. Blastocyst quality, blastocyst development days, endometrial preparation protocols, and number of blastocysts, independently predicted outcomes. An individualized predictive model integrating these factors displayed favorable accuracy for counseling patients and optimizing clinical management.https://www.frontiersin.org/articles/10.3389/fendo.2023.1302194/fullpreimplantation genetic testingfrozen embryo transferD5/D6 euploid blastocystsblastocyst morphologypredictive model |
| spellingShingle | Beining Yin Sichen Li Lin Sun Zhiyi Yao Yueyue Cui Congli Zhang Yile Zhang Yile Zhang Comparing Day 5 versus Day 6 euploid blastocyst in frozen embryo transfer and developing a predictive model for optimizing outcomes: a retrospective cohort study Frontiers in Endocrinology preimplantation genetic testing frozen embryo transfer D5/D6 euploid blastocysts blastocyst morphology predictive model |
| title | Comparing Day 5 versus Day 6 euploid blastocyst in frozen embryo transfer and developing a predictive model for optimizing outcomes: a retrospective cohort study |
| title_full | Comparing Day 5 versus Day 6 euploid blastocyst in frozen embryo transfer and developing a predictive model for optimizing outcomes: a retrospective cohort study |
| title_fullStr | Comparing Day 5 versus Day 6 euploid blastocyst in frozen embryo transfer and developing a predictive model for optimizing outcomes: a retrospective cohort study |
| title_full_unstemmed | Comparing Day 5 versus Day 6 euploid blastocyst in frozen embryo transfer and developing a predictive model for optimizing outcomes: a retrospective cohort study |
| title_short | Comparing Day 5 versus Day 6 euploid blastocyst in frozen embryo transfer and developing a predictive model for optimizing outcomes: a retrospective cohort study |
| title_sort | comparing day 5 versus day 6 euploid blastocyst in frozen embryo transfer and developing a predictive model for optimizing outcomes a retrospective cohort study |
| topic | preimplantation genetic testing frozen embryo transfer D5/D6 euploid blastocysts blastocyst morphology predictive model |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2023.1302194/full |
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