Clinical and Experimental Reproductive Medicine

The Korean Society for Reproductive Medicine (대한생식의학회)
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The Optimal Time for Embryo Transfer in Fresh IVF: Comparison between Day 3 and Day 5 on Pregnancy Outcomes

체외수정술 후 난할단계 배아와 포배기단계 배아를 이식했을 때의 임신예후의 비교

  • Lyu, Sang-Woo (Fertility Center of CHA Gangnam Medical Center, Department of Obstetrics and Gynecology, CHA University College of Medicine) ;
  • Kim, A-Ri (Fertility Center of CHA Gangnam Medical Center, Department of Obstetrics and Gynecology, CHA University College of Medicine) ;
  • Seok, Hyun-Ha (Fertility Center of CHA Gangnam Medical Center, Department of Obstetrics and Gynecology, CHA University College of Medicine) ;
  • Kim, You-Shin (Fertility Center of CHA Gangnam Medical Center, Department of Obstetrics and Gynecology, CHA University College of Medicine) ;
  • Lee, Woo-Sik (Fertility Center of CHA Gangnam Medical Center, Department of Obstetrics and Gynecology, CHA University College of Medicine) ;
  • Yoon, Tae-Ki (Fertility Center of CHA Gangnam Medical Center, Department of Obstetrics and Gynecology, CHA University College of Medicine) ;
  • Won, Hyung-Jae (Fertility Center of CHA Gangnam Medical Center, Department of Obstetrics and Gynecology, CHA University College of Medicine)
  • 유상우 (차의과학대학교 차병원 여성의학연구소) ;
  • 김아리 (차의과학대학교 차병원 여성의학연구소) ;
  • 석현하 (차의과학대학교 차병원 여성의학연구소) ;
  • 김유신 (차의과학대학교 차병원 여성의학연구소) ;
  • 이우식 (차의과학대학교 차병원 여성의학연구소) ;
  • 윤태기 (차의과학대학교 차병원 여성의학연구소) ;
  • 원형재 (차의과학대학교 차병원 여성의학연구소)
  • Received : 2010.01.26
  • Accepted : 2010.03.12
  • Published : 2010.06.30
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Abstract

Objective: The aim of this study was to compare day 3 embryo transfer (D3ET) with day 5 ET (D5ET) in fresh in vitro fertilization (IVF) cycle on pregnancy outcomes. Methods: We conducted a retrospective matched case control study that included 90 women with D3ET and 90 women with D5ET from January 2007 to June 2009. Subjects were matched for reproductive profiles and IVF cycle characteristics. Two good quality embryos were transferred in both groups. Pregnancy rates (PR), implantation rate, and multiple PR were compared. Results: Demographics, stimulation parameters and embryological data were comparable in both groups. Main pregnancy outcomes with D3ET and D5ET groups were not statistically different: implantation rate (39.4% vs. 32.8%), positive PR (57.8% vs. 46.7%), clinical PR (53.3% vs. 45.6%), ongoing PR (50.0% vs. 42.2%), respectively. Both groups showed high multiple PR (37.5% vs. 34.1). Conclusion: D5ET may not be beneficial and necessary in comparison with D3ET on pregnancy outcomes, and elective single ET should be considered to decrease multiple pregnancies in women with favorable conditions and good quality embryos undergoing IVF.

목 적: 본 연구는 체외수정술 후 배양 3일째 2개의 난할단계 배아 (D3ET)와 배양 5일째 2개의 포배기단계 배아(D5ET)를 이식했을 때 각각의 임신예후를 비교하기 위하여 시행하였다. 연구방법: 2007년 1월부터 2009년 6월까지 강남차병원 여성의학연구소에서 체외수정술 후 D3ET을 시행한 90명의 환자를 나이와 체외수정 주기의 특성을 고려하여 D5ET군 90명과 비교한 후향적 환자군-대조군 연구를 시행하였으며, 두 군 모두 2개씩의 양질의 배아를 이식하였다. 각각의 임신율, 착상률, 다태임신율을 비교하였다. 결 과: 환자의 특성, 체외수정주기 및 배아의 특징은 두 군 간에 차이를 보이지 않았다. 임신예후를 비교했을 때, D3ET군과 D5ET군 모두 유의한 차이를 보이지 않았다: 착상률 (39.4% vs. 32.8%), 임신율 (57.8% vs. 46.7%), 임상적임신율 (53.3% vs. 45.6%), 진행임신율 (50.0% vs. 42.2%), 유산율 (13.5% vs. 9.5%). 두 군 모두 높은 다태임신율을 보여주었다 (37.5% vs. 34.1%). 결 론: 체외수정술 후 배양 5일째 포배기단계 배아이식이 배양 3일째 난할단계 이식보다 더 좋은 임신예후를 보여주지 못한다. 또한 나이가 젊고, 양질의 배아를 가진 좋은 예후를 예측할 수 있는 여성에서는 다태임신율을 줄이기 위해 단일배아이식을 고려해야 한다.

Keywords

References

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