The impact of embryo quality on pregnancy outcomes in single day 5 versus day 6 euploid blastocyst transfer: a retrospective cohort study

Articles in Press

Document Type : Original Article

Authors

1 Tam Anh General Hospital, Hanoi, Vietnam

2 Department of Obstetrics, Gynecology and Reproductive Medecine, Hôpitaux Universitaires Paris Seine Saint-Denis, Assistance Publique-Hôpitaux de Paris, Bondy, France; Université Paris 13, UFR SMBH, Bobigny, France

10.22074/ijfs.2023.2006100.1488

Abstract

Background: Selecting embryos with the highest implantation potential is crucial for in vitro fertilization (IVF) success. Both the timing of blastulation, day 5 (D5) or day 6 (D6), and the embryo quality have been suggested as influential factors in determining the clinical outcome of single euploid blastocyst transfers. However, evidence supporting the superiority of D5 over D6 blastocysts remains inconclusive. The aim of this study was to compare clinical outcomes following transfer of euploid blastocysts with different quality and timing of blastulation.

Methods: A retrospective cohort study was conducted at our Assisted Reproductive Center, analyzing the outcome of 774 transfers with D5 euploids and 155 transfers with D6 euploids performed between January 2019 and February 2022.

Results: The live birth rate was significantly lower in the euploid D6 group compared to the euploid D5 group (38.71% versus 55.04%, p=0.001). The outcome was significantly influenced by the quality of the embryos. Live birth rates were 62.14% and 53.61% following transfers of D5 and D6 excellent embryos respectively, 45.18% and 32.21% following transfer of D5 and D6 good embryos but only 28.64% and 19.32% following transfer of D5 and D6 fair embryos. The outcome difference was statistically significant across embryo quality categories (p<0.05). The adjusted risk ratios of clinical outcome indicated that excellent euploid D5 embryos consistently outperformed other types of embryo quality.

Conclusions: Timing of blastulation and embryo quality are crucial factors in determining the success of single euploid blastocyst transfers. Excellent euploid D5 transfers yielded superior clinical outcomes, providing valuable insights for IVF teams and patients when selecting embryos to be transferred.

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International Journal of Fertility and Sterility

Articles in Press, Accepted Manuscript
Available Online from 30 December 2023

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