Better perinatal outcomes following transfer of fresh blastocysts and blastocysts cultured from thawed cleavage embryos: a population-based study

Authors: Wang, Yueping Alex; Chapman, Michael; Costello, Michael; Sullivan, Elizabeth Anne

Source: Human Reproduction, Volume 25, Number 6, 8 June 2010 , pp. 1536-1542(7)

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Abstract:

BACKGROUND

Fresh embryo transfer results in higher live birth rates, while thawed embryo transfer appears to result in healthier babies. This study aims to investigate the association between the transfer of fresh or thawed embryos at the cleavage or blastocyst stage and the perinatal outcomes.

METHODS

This analysis is a retrospective population-based study of 150 376 autologous embryo transfer cycles in Australia during 20022006. The rates of pregnancy, live delivery and healthy baby delivery (a single baby born live at term, weighing 2500 g, surviving for at least 28 days post birth and not having congenital anomalies) were compared after transfer of fresh cleavage embryos, fresh blastocysts, thawed cleavage embryos, blastocysts from thawed cleavage embryos and thawed blastocysts.

RESULTS

The live delivery rate was significantly higher for transfer of fresh blastocysts (27.9) than for blastocysts cultured from thawed cleavage embryos (22.0), fresh cleavage embryos (21.7), thawed blastocysts (16.3) and thawed cleavage embryos (15.2). Compared with the transfer of fresh blastocysts, the likelihood of a healthy baby was significantly lower for blastocysts from thawed cleavage embryos [adjusted odds ratios (AOR) 0.73, 95 confidence intervals (CI) 0.650.82], fresh cleavage embryos (AOR 0.67, 95 CI 0.640.69), thawed blastocysts (AOR 0.57, 95 CI 0.530.62) and thawed cleavage embryos (AOR 0.53, 95 CI 0.510.56). Of thaw cycles, transfers of thawed blastocysts (AOR 0.79, 95 CI 0.700.89) and thawed cleavage embryos (AOR 0.71, 95 CI 0.630.79) had significantly lower odds of healthy baby than transfer of blastocysts from thawed cleavage embryos.

CONCLUSIONS

These data suggest that an optimum practice model to maximize the outcomes of the birth of a healthy baby is the transfer of blastocysts and the freezing of cleavage embryos in fresh cycles and subsequent transfer of blastocysts cultured from these thawed cleavage embryos.

Keywords: embryo development; fresh/thawed embryo; pregnancy; live delivery; perinatal outcome

Document Type: Research article

DOI: http://dx.doi.org/10.1093/humrep/deq067

Publication date: 2010-06-08

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Human Reproduction features full-length, peer-reviewed papers reporting original research, clinical case histories, as well as opinions and debates on topical issues. Papers published cover the scientific and medical aspects of reproductive physiology and pathology, endocrinology, andrology, gonad function, gametogenesis, fertilization, embryo development, implantation, pregnancy, genetics, genetic diagnosis, oncology, infectious disease, surgery, contraception, infertility treatment, psychology, ethics and social issues. The highest scientific and editorial standard is maintained throughout the journal along with a rapid rate of publication.

Better perinatal outcomes following transfer of fresh blastocysts and blastocysts cultured from thawed cleavage embryos: a population-based study

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