Research question

What is the reproductive potential of embryos that achieve blastulation on day 7 followed by preimplantation genetic testing for aneuploidies (PGT-A) for infertility patients with slow embryo development?

Design

This was a retrospective cohort study in a private IVF clinic of consecutive female infertility patients (n = 2966) aged 24–48 (36.3 ± 3.8) years who underwent frozen embryo transfer (FET) of a single euploid blastocyst.

Results

The women underwent single euploid FET of an embryo that achieved blastulation on day 5 (n = 1880), day 6 (n = 986) or day 7 (n = 100). Day 7 embryos resulted in lower implantation and live birth rates compared with both day 5 and day 6 embryos (P < 0.001). The day 5, day 6 and day 7 groups had 68.5%, 55.2% and 36.0% live birth rates, respectively. The day 7 group was older than the day 5 group (P < 0.001); comparing age-matched cohorts, the day 7 group still had lower implantation and live birth rates (P < 0.0001 and P < 0.001, respectively). Embryo grade was unrelated to live birth rates. Day 7 embryos of expansion grade 5 or 6 or trophectoderm grade A were more likely to be euploid compared with expansion grade 3 or trophectoderm grade B.

Conclusions

Euploid day 7 embryos represented reduced implantation potential, even when controlling for maternal age. Of all day 7 embryos that underwent PGT-A, euploidy was associated with expansion grade 5 or 6 and trophectoderm grade A. These results can help providers manage patient expectations in cases where infertile women have slow embryo development.

中文翻译：

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胚胎发育缓慢的不孕症患者的整倍体第 7 天胚泡降低了植入潜力

研究问题

对于胚胎发育缓慢的不孕症患者，在第 7 天达到囊胚形成然后进行非整倍体植入前基因检测 (PGT-A) 的胚胎的生殖潜力是多少？

设计

这是一项在私人 IVF 诊所中进行的回顾性队列研究，其中包括 接受单个整倍体囊胚冷冻胚胎移植 (FET) 的年龄在 24-48 (36.3 ± 3.8) 岁的连续女性不孕症患者 ( n = 2966)。

结果

这些女性在第 5 天 ( n  = 1880)、第 6 天 ( n  = 986) 或第 7 天 ( n  = 100)接受了胚胎的单整倍体 FET 。与第 5 天和第 6 天的胚胎相比，第 7 天的胚胎着床率和活产率均较低（P  < 0.001）。第 5 天、第 6 天和第 7 天组的活产率分别为 68.5%、55.2% 和 36.0%。第7天组年龄大于第5天组（P  <0.001）；比较年龄匹配的队列，第 7 天组的着床率和活产率仍然较低（P  < 0.0001 和P < 0.001，分别）。胚胎等级与活产率无关。与扩展等级 3 或滋养外胚层 B 级相比，扩展等级 5 或 6 或滋养外胚层等级 A 的第 7 天胚胎更可能是整倍体。

结论

即使在控制母亲年龄的情况下，整倍体第 7 天胚胎也代表着植入潜力降低。在接受 PGT-A 的第 7 天胚胎中，整倍体与 5 级或 6 级扩张和 A 级滋养外胚层相关。这些结果可以帮助提供者在不孕女性胚胎发育缓慢的情况下管理患者的期望。