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http://dx.doi.org/10.5653/cerm.2013.40.3.122

Comparison of the clinical outcomes of day 4 and 5 embryo transfer cycles  

Lee, Sun-Hee (Laboratory of Reproductive Biology and Infertility, Cheil General Hospital and Women's Healthcare Center, Kwandong University College of Medicine)
Lee, Hyoung-Song (Laboratory of Reproductive Biology and Infertility, Cheil General Hospital and Women's Healthcare Center, Kwandong University College of Medicine)
Lim, Chun Kyu (Laboratory of Reproductive Biology and Infertility, Cheil General Hospital and Women's Healthcare Center, Kwandong University College of Medicine)
Park, Yong-Seog (Laboratory of Reproductive Biology and Infertility, Cheil General Hospital and Women's Healthcare Center, Kwandong University College of Medicine)
Yang, Kwang Moon (Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, Kwandong University College of Medicine, Seoul, Korea)
Park, Dong Wook (Laboratory of Reproductive Biology and Infertility, Cheil General Hospital and Women's Healthcare Center, Kwandong University College of Medicine)
Publication Information
Clinical and Experimental Reproductive Medicine / v.40, no.3, 2013 , pp. 122-125 More about this Journal
Abstract
Objective: The majority of embryo transfers (ETs) to date have been performed on day 3 to reduce the potential risk of developmental arrest of in vitro cultured embryos before ET. Development of sequential media has significantly improved culture conditions and allowed blastocyst transfer on day 5. While day 5 ET provides higher clinical pregnancy outcomes with reduced risks of multiple pregnancies, it still has potential risks of developmental arrest of IVF embryos. The aim of this study was to evaluate the clinical outcomes of day 4 ETs and compare the efficacy of day 4 ET with day 5 ET. Methods: From 2006 to 2009, a total of 747 fresh IVF-ET cycles were retrospectively analyzed (day 4, n=440 or and day 5, n=307). The cycles with any genetic factors were excluded. The rates of matured oocytes, fertilization, good embryos, and clinical pregnancy of the two groups were compared. The chi-square test and t-test were used for statistical analysis. Results: There were no significant differences between the two groups with respect to the mean age of the females and rates of matured oocytes. The pregnancy outcomes of day 4 ET (40.7%) were similar to those of day 5 ET (44.6%). The implantation rate of day 5 ET (24.2%) was significantly higher than that of day 4 ET (18.4%) (p=0.003). Conclusion: Day 4 ET can be chosen to avoid ET cancellation in day 5 ET resulting from suboptimal circumstances in the IVF laboratory, but the decremented quality of embryos for transfer and the decreased pregnancy rate must be taken into consideration.
Keywords
Pregnancy outcome; Embryo transfer; Blastocyst; Embryo selection; Embryonic grading; Embryo culture; Embryo-uterine synchrony;
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1 Quinn P, Stone BA, Marrs RP. Suboptimal laboratory conditions can affect pregnancy outcome after embryo transfer on day 1 or 2 after insemination in vitro. Fertil Steril 1990;53:168-70.   DOI
2 Bolton VN, Wren ME, Parsons JH. Pregnancies after in vitro fertilization and transfer of human blastocysts. Fertil Steril 1991;55:830-2.   DOI
3 Feil D, Henshaw RC, Lane M. Day 4 embryo selection is equal to Day 5 using a new embryo scoring system validated in single embryo transfers. Hum Reprod 2008;23:1505-10.   DOI
4 Braude P, Bolton V, Moore S. Human gene expression first occurs between the four- and eight-cell stages of preimplantation development. Nature 1988;332:459-61.   DOI
5 Hershlag A, Floch JA, DeCherney AH, Lavy G. Comparison of singleton and multiple pregnancies in in vitro fertilization (IVF) and embryo transfer (ET). J In Vitro Fert Embryo Transf 1990;7:157-9.   DOI
6 Tan SL, Steer C, Royston P, Rizk P, Mason BA, Campbell S. Conception rates and in-vitro fertilisation. Lancet 1990;335:299.
7 Glujovsky D, Blake D, Farquhar C, Bardach A. Cleavage stage versus blastocyst stage embryo transfer in assisted reproductive technology. Cochrane Database Syst Rev 2012;7:CD002118.
8 Gardner DK, Schoolcraft WB, Wagley L, Schlenker T, Stevens J, Hesla J. A prospective randomized trial of blastocyst culture and transfer in in-vitro fertilization. Hum Reprod 1998;13:3434-40.   DOI
9 Skorupski JC, Stein DE, Acholonu U, Field H, Keltz M. Successful pregnancy rates achieved with day 4 embryo transfers. Fertil Steril 2007;87:788-91.   DOI
10 Phillips SJ, Dean NL, Buckett WM, Tan SL. Consecutive transfer of day 3 embryos and of day 5-6 blastocysts increases overall pregnancy rates associated with blastocyst culture. J Assist Reprod Genet 2003;20:461-4.   DOI
11 Lim CK, Cho JW, Kim JY, Kang IS, Shim SH, Jun JH. A healthy live birth after successful preimplantation genetic diagnosis for carriers of complex chromosome rearrangements. Fertil Steril 2008;90:1680-4.   DOI
12 Lim CK, Cho JW, Song IO, Kang IS, Yoon YD, Jun JH. Estimation of chromosomal imbalances in preimplantation embryos from preimplantation genetic diagnosis cycles of reciprocal translocations with or without acrocentric chromosomes. Fertil Steril 2008;90:2144-51.   DOI
13 Schoolcraft WB, Gardner DK, Lane M, Schlenker T, Hamilton F, Meldrum DR. Blastocyst culture and transfer: analysis of results and parameters affecting outcome in two in vitro fertilization programs. Fertil Steril 1999;72:604-9.   DOI
14 Ko DS, Cho JW, Park SY, Kim JY, Koong MK, Song IO, et al. Clinical outcomes of preimplantation genetic diagnosis (PGD) and analysis of meiotic segregation modes in reciprocal translocation carriers. Am J Med Genet A 2010;152:1428-33.
15 Lee HS, Kim MJ, Lim CK, Cho JW, Song IO, Kang IS. Multiple displacement amplification for preimplantation genetic diagnosis of fragile X syndrome. Genet Mol Res 2011;10:2851-9.   DOI
16 Tao J, Tamis R, Fink K, Williams B, Nelson-White T, Craig R. The neglected morula/compact stage embryo transfer. Hum Reprod 2001;17:1513-8.
17 Jones GM, Trounson AO, Gardner DK, Kausche A, Lolatgis N, Wood C. Evolution of a culture protocol for successful blastocyst development and pregnancy. Hum Reprod 1998;13:169-77.   DOI
18 Milki AA, Hinckley MD, Fisch JD, Dasig D, Behr B. Comparison of blastocyst transfer with day 3 embryo transfer in similar patient populations. Fertil Steril 2000;73:126-9.   DOI
19 Montag M, van der Ven K, Dorn C, van der Ven H. Extended embryo culture reduces the implantation rate on day 4 and day 5 when only a maximum of three embryos are cultured beyond the pronuclear stage. Eur J Obstet Gynecol Reprod Biol 2006;124:65-9.   DOI
20 Pantos K, Makrakis E, Chronopoulou M, Biba M, Perdikaris A, Dafereras A. Day 4 versus day 3 embryo transfer: a prospective study of clinical outcomes. Fertil Steril 2008;89:573-7.   DOI
21 Zhang JQ, Li XL, Peng Y, Guo X, Heng BC, Tong GQ. Reduction in exposure of human embryos outside the incubator enhances embryo quality and blastulation rate. Reprod Biomed Online 2010;20:510-5.   DOI
22 Lesny P, Killick SR, Tetlow RL, Robinson J, Maguiness SD. Uterine junctional zone contractions during assisted reproduction cycles. Hum Reprod Update 1998;4:440-5.   DOI