Wenhao Shi1, Wei Zhang2, Na Li3, Xia Xue3, Chen Liu4, Pengfei Qu3, Juanzi Shi3, Chen Huang5. 1. Department of Cell Biology and Genetics, School of Basic Medical Sciences, Xi'an Jiaotong University Health Science Centre, Xi'an, China; The Assisted Reproduction Centre, Northwest women's and Children's Hospital, Xi'an, China. 2. Internal Medicine Department, Shaanxi Provincial People's Hospital, Xi'an, China. 3. The Assisted Reproduction Centre, Northwest women's and Children's Hospital, Xi'an, China. 4. Department of Obstetrics and Gynaecology, Northwest women's and Children's Hospital, Xi'an, China. 5. Department of Cell Biology and Genetics, School of Basic Medical Sciences, Xi'an Jiaotong University Health Science Centre, Xi'an, China. Electronic address: hchen123456@126.com.
Abstract
RESEARCH QUESTION: Are there greater risks of adverse perinatal outcomes, in particular of congenital malformations, after blastocyst transfer compared with cleavage-stage embryo transfer in IVF? DESIGN: This was a retrospective cohort analysis from a centre for assisted reproduction at a public hospital in China over the period 2006-2015. The analysis covered all women who conceived (15,254) and newborns (16,213) from IVF/intracytoplasmic sperm injection (ICSI) cycles with cleavage-stage embryo transfer or blastocyst transfer. The principal outcome measures were congenital malformations, preterm birth (PTB), low birthweight (LBW), small for gestational age (SGA) and large for gestational age (LGA). RESULTS: Logistic regression analysis showed that the sex ratio was imbalanced towards male neonates after blastocyst transfer (P=0.001; adjusted OR 1.17, 95%CI 1.07-1.30) but there were no differences in rates of miscarriage, ectopic pregnancy, stillbirth, very preterm birth (<32 weeks), PTB (<37 weeks), LBW, SGA or LGA between blastocyst transfer and cleavage-stage embryo transfer. A total of 176 congenital malformations (123 cleavage-stage embryos versus 53 blastocysts) were identified both in newborns and aborted fetuses, but the difference between groups was not statistically significant. CONCLUSIONS: There was no difference in the risks of adverse perinatal outcomes, and in particular of congenital malformation, after blastocyst transfer compared with cleavage-stage transfer, although there was a sex ratio imbalance towards male neonates after blastocyst transfer.
RESEARCH QUESTION: Are there greater risks of adverse perinatal outcomes, in particular of congenital malformations, after blastocyst transfer compared with cleavage-stage embryo transfer in IVF? DESIGN: This was a retrospective cohort analysis from a centre for assisted reproduction at a public hospital in China over the period 2006-2015. The analysis covered all women who conceived (15,254) and newborns (16,213) from IVF/intracytoplasmic sperm injection (ICSI) cycles with cleavage-stage embryo transfer or blastocyst transfer. The principal outcome measures were congenital malformations, preterm birth (PTB), low birthweight (LBW), small for gestational age (SGA) and large for gestational age (LGA). RESULTS: Logistic regression analysis showed that the sex ratio was imbalanced towards male neonates after blastocyst transfer (P=0.001; adjusted OR 1.17, 95%CI 1.07-1.30) but there were no differences in rates of miscarriage, ectopic pregnancy, stillbirth, very preterm birth (<32 weeks), PTB (<37 weeks), LBW, SGA or LGA between blastocyst transfer and cleavage-stage embryo transfer. A total of 176 congenital malformations (123 cleavage-stage embryos versus 53 blastocysts) were identified both in newborns and aborted fetuses, but the difference between groups was not statistically significant. CONCLUSIONS: There was no difference in the risks of adverse perinatal outcomes, and in particular of congenital malformation, after blastocyst transfer compared with cleavage-stage transfer, although there was a sex ratio imbalance towards male neonates after blastocyst transfer.
Authors: Anan Aljahdali; R K Raja Ili Airina; Miguel A Velazquez; Bhavwanti Sheth; Katrina Wallen; Clive Osmond; Adam J Watkins; Judith J Eckert; Neil R Smyth; Tom P Fleming Journal: Hum Reprod Date: 2020-11-01 Impact factor: 6.918