最佳发育的胚胎在授精后达到胚泡期116±2小时。可用的D7胚泡占IVF胚胎的近5%,具有可接受的妊娠和活产率。然而,数据仍然有限。因此,本研究旨在分析单个整倍体冷冻胚胎移植(FET)周期中D7胚泡的持续妊娠率(OPR)。进行了一项观察性研究,包括在D5上对胚泡进行活检的1527个FET周期(N=855),D6(N=636)和D7(N=36)。囊胚分类为良好(AA/AB/BA),一般(BB)或较差(AC/BC/CC/CA/CB)(Gardner评分)。在自然周期(NC)或激素替代疗法(HRT)周期中进行FET。D5、D6和D7囊胚FET周期患者年龄差异显著(33.2±5.6,34.4±5.3和35.9±5.2,P<0.001)。与D6和D7相比,转移D5整倍体胚泡时OPR较高(56.0%vs.45.3%和11.1%,P<0.001)。在D7胚泡FET周期中,劣质胚泡占主导地位(良好质量:35.4%,27.2%,5.6%;质量一般:52.1%,38.5%,11.1%;质量差:12.5%,34.3%,83.3%,D5,D6和D7胚泡的P<0.001;分别)。D7胚泡FET显著降低OPR(OR=0.23[0.08;0.62],P=0.004),患者的BMI(OR=0.96[0.94;0.98],P<0.001),HRT周期(OR=0.70[0.56;0.88],P=0.002)和劣质胚泡(OR=0.33[0.24;0.45],P<0.001)。与FET循环中的D5/D6整倍体胚泡相比,D7的OPR显著降低。病人年龄越大,他们在D7时进行囊胚活检的FET周期的可能性越大,因此在D7之前培养胚胎可能是增加≥38岁患者OPR结局的策略.
Embryos of optimal development reach blastocyst stage 116 ± 2 h after insemination. Usable D7 blastocysts represent nearly 5% of embryos in IVF with acceptable pregnancy and live birth rates, however data are still limited. Therefore, this study aimed to analyze the ongoing pregnancy rate (OPR) of D7 blastocysts in single euploid frozen embryo transfer (FET) cycles. An observational study was performed including 1527 FET cycles with blastocysts biopsied on D5 (N = 855), D6 (N = 636) and D7 (N = 36). Blastocysts were classified as good (AA/AB/BA), fair (BB) or poor (AC/BC/CC/CA/CB) (Gardner scoring). FETs were performed in natural cycles (NC) or hormone replacement therapy (HRT) cycles. Patient\'s age differed significantly between D5, D6 and D7 blastocysts FET cycles (33.2 ± 5.6, 34.4 ± 5.3 and 35.9 ± 5.2, P < 0.001). OPRs were higher when D5 euploid blastocysts were transferred compared with D6 and D7 (56.0% vs. 45.3% and 11.1%, P < 0.001). Poor quality blastocysts were predominant in D7 blastocyst FET cycles (good quality: 35.4%, 27.2%, 5.6%; fair quality: 52.1%, 38.5%, 11.1%; poor quality: 12.5%, 34.3%, 83.3%, P < 0.001 for D5, D6 and D7 blastocysts; respectively). OPR was significantly reduced by D7 blastocyst FETs (OR = 0.23 [0.08;0.62], P = 0.004), patient\'s BMI (OR = 0.96 [0.94;0.98], P < 0.001), HRT cycles (OR = 0.70 [0.56;0.88], P = 0.002) and poor quality blastocysts (OR = 0.33 [0.24;0.45], P < 0.001). OPR is significantly reduced with D7 compared with D5/D6 euploid blastocysts in FET cycles. The older the patient, the more likely they are to have an FET cycle with blastocysts biopsied on D7, therefore culturing embryos until D7 can be a strategy to increase OPR outcomes in patients ≥38 years.