Research question

To investigate whether patient factors influence the decision to freeze a blastocyst with low implantation potential.

Design

This experimental study assessed 170 practicing embryologists from a variety of countries who were recruited via an online survey. Participants were currently practicing embryologists, who grade blastocysts as part of this role. The survey presented decision-making ‘vignettes’ to participants. These included specific patient information, as well as an image of an expanded blastocyst that was of borderline quality for inner cell mass and trophectoderm, for which the embryologist selected whether or not to freeze. High/low maternal age, the presence/absence of other top quality blastocysts, and the presence/absence of previously unsuccessful IVF cycles were systematically varied within the patient information in a 2 × 2 × 2 design. Participants reported how likely they would be to freeze a particular blastocyst on a scale of 1 (Extremely Unlikely) to 7 (Extremely Likely), and whether or not they would ultimately freeze each blastocyst (Yes or No).

Results

Lower maternal age, no other high-quality blastocysts within the cohort, and multiple unsuccessful IVF cycles were associated with greater likelihood of recommending to freeze (P < .001). Furthermore, significant interactions among all three patient factors were noted.

Conclusion

This study provides evidence suggesting that when faced with an uncertain blastocyst, factors pertaining to the patient (maternal age, the presence/absence of other top quality blastocysts, and the presence/absence of previously unsuccessful IVF cycles) influence the decision to freeze.

中文翻译：

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患者因素是否会影响胚胎学家冻结临界囊胚的决定？

研究问题

研究患者因素是否影响冷冻具有低着床潜力的囊胚的决定。

设计

这项实验性研究评估了通过在线调查招募的来自不同国家的 170 名执业胚胎学家。参与者目前正在执业的胚胎学家，他们对囊胚进行分级作为此角色的一部分。该调查向参与者展示了决策“小插曲”。其中包括特定的患者信息，以及内细胞团和滋养外胚层处于临界质量的膨胀囊胚图像，胚胎学家选择是否冷冻。在 2 × 2 × 2 设计的患者信息中，高/低母亲年龄、其他优质囊胚的存在/不存在以及先前不成功的 IVF 周期的存在/不存在系统地变化。

结果

较低的产妇年龄、队列中没有其他高质量的囊胚以及多次不成功的 IVF 周期与推荐冷冻的可能性更大有关 ( P  < .001)。此外，还注意到所有三个患者因素之间的显着相互作用。

结论

这项研究提供的证据表明，当面临不确定的囊胚时，与患者有关的因素（母亲年龄、其他优质囊胚的存在/不存在以及以前不成功的试管婴儿周期的存在/不存在）会影响冷冻的决定。