| Objectives:To investigate whether blastocyst transfer achieved better pregnancy outcomes than cleavage stage embryo transfer in the cycle of in vitro fertilization/intracytoplasmic sperm injection-embryo transfer(IVF/ICSI-ET)with Gonadotropin releasing hormone antagonist(GnRH-ant)protocols and to explore the optimal timing of blastocyst transfer in GnRH antagonist protocols,with a view to providing instruction for clinical practice.Methods:Retrospective analysis the medical case data of infertility patients who received IVF/ICSI-ET treatment with GnRH antagonist protocols at the Reproductive Center,the Second Hospital of Jilin University from January 2017 to January 2022.A total of1051 cycles were included in this study depending on the set inclusion and exclusion criteria.Grouping Method: Depending on the type of embryo transfer,the 1051 cycles were divided into cleavage stage embryo transfer group(group A,n=850)and blastocyst transfer group(group B,n=201).Depending on the timing of embryo transfer,the cleavage stage embryo transfer group was divided into the fresh cycle cleavage stage embryo transfer group(group A1,n=502)and the frozen-thawed cycle cleavage embryo transfer group(group A2,n=348),and the blastocyst embryo transfer group was divided into the fresh cycle blastocyst embryo transfer group(group B1,n=101)and the frozen-thawed cycle blastocyst embryo transfer group(group B2,n=100).Patients’ basal medical data,ovulation cycle characteristics and pregnancy outcomes were compared by groups.Differences were statistically significant when P < 0.05.Results:1.Group A compared with Group B,Group B had a higher embryo implantation rate than Group A(44.50% vs 26.30%,P < 0.001);Group B had a higher clinical pregnancy rate than Group A(55.20% vs 41.30%,P < 0.001);Group B had a higher live birth rate than Group A(50.20% vs 36.10%,P < 0.001);Group A had a higher multiple pregnancy rate than Group B(24.20% vs 5.4%,P < 0.001);all the above differences were statistically significant.The differences in miscarriage rate,ectopic pregnancy rate,and preterm birth rate between the two groups were not statistically different(P > 0.05).2.Group A1 compared with group B1,Group B1 had a higher embryo implantation rate than Group A1(43.00% vs 23.40%,P < 0.001);Group B1 had a higher clinical pregnancy rate than Group A1(51.50% vs 37.50%,P=0.009);Group B1 had a higher live birth rate than Group A1(46.50% vs 31.50%,P=0.004);Group A1 had a higher multiple pregnancy rate than Group B1(23.90% vs 5.8%,P=0.004);all the above differences were statistically significant.The differences in miscarriage rate,ectopic pregnancy rate,and preterm birth rate between the two groups were not statistically different(P > 0.05).3.Group A2 compared with Group B2,Group B2 had a higher embryo implantation rate than Group A2(45.90% vs 30.70%,P=0.001);Group B2 had a higher clinical pregnancy rate than Group A2(59.00% vs 46.80%,P=0.032);Group B2 had a higher live birth rate than Group A2(54.00% vs 42.8%,P=0.048);Group A2 had a higher multiple pregnancy rate than Group B2(24.50% vs 5.10%,P=0.001);all the above differences were statistically significant.The differences in miscarriage rate,ectopic pregnancy rate,and preterm birth rate between the two groups were not statistically different(P > 0.05).4.Group A1 compared with Group A2,Group A2 had a higher embryo implantation rate than Group A1(30.70% vs 23.40%,P=0.001);Group A2 had a higher clinical pregnancy rate than Group A1(46.80% vs 37.50%,P=0.006);Group A2 had a higher live birth rate than Group A1(42.80% vs 31.50%,P=0.001);all the above differences were statistically significant.The differences in miscarriage rate,ectopic pregnancy rate,preterm birth rate and multiple pregnancy rate between the two groups were not statistically different(P > 0.05).5.Group B1 compared with Group B2,Group B2 had a slightly higher embryo implantation rate than Group B1(P=0.630);Group B2 had a slightly higher clinical pregnancy rate than Group B1(P=0.284);Group B2 had a slightly higher live birth rate than Group B1(P=0.290);all of the above were not statistically different.The differences in miscarriage rate,ectopic pregnancy rate,preterm birth rate and multiple pregnancy rate between the two groups were not statistically different(P > 0.05).Conclusions:1.In IVF/ICSI cycles with GnRH antagonist protocols,compared with cleavage stage embryo transfer,blastocyst transfer can improve embryo implantation rates,clinical pregnancy rates,and live birth rates whether in fresh or frozen-thaw cycles.2.In IVF/ICSI cycles with GnRH antagonist protocols,compared with fresh cycle cleavage stage embryo transfer,freeze-thawed cycle cleavage stage embryo transfer can improve embryo implantation rate,clinical pregnancy rate,and live birth rate.3.In IVF/ICSI cycles with GnRH antagonist protocols,pregnancy outcomes were similar in both groups between fresh blastocyst transfer group and frozen-thawed blastocyst transfer group. |
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