Sequential Transfer of Blastocysts on Day 5 and Day 6 in Patients with Repeated Implantation Failure in Frozen Embryo Transfer Cycle

Overview

Journal Reprod Sci

Publisher Springer

Specialty Reproductive Medicine

Date 2024 Nov 25

PMID 39586989

Authors

Qi Jin

Xiaohua Jiang

Lu Zong

Tong Wu

Shengxia Zheng

Limin Wu

Bo Xu

Affiliations

Soon will be listed here.

Abstract

The aim of this study was to evaluate which frozen embryo transfer (FET) strategy benefits the recurrent implantation failure (RIF) population. A retrospective study of 336 women with RIF was performed from July 2020 to October 2023. The patients were divided into three groups according to the FET protocol. The three FET protocols included transferring a blastocyst on both days 5 and 6 (Group 1, n = 138); transferring a cleavage-stage embryo on day 3 and a blastocyst on day 5 (Group 2, n = 55); and transferring double blastocysts on day 5 (Group 3, n = 143).The sequential day 5 and day 6 blastocyst ET strategy significantly improved in vitro fertilization success rates compared with those of both the traditional double-blastocyst day 5 transfer strategy and the strategy involving one cleavage-stage embryo transfer on day 3 and one blastocyst transfer on day 5 in RIF patients. Compared with those observed in Day 5 double-blastocyst transfer, the rates of clinical pregnancy and implantation increased (51.75% vs. 64.49%, P < 0.001 and 37.06% vs. 41.3%, P = 0.005, respectively), while the rates of biochemical pregnancy and multiple gestation decreased (18.18% vs. 12.32%, P = 0.006 and 43.24% vs. 28.09%, P = 0.044, respectively) with the new protocol.Blastocysts from sequential embryo transfer on day 5 and day 6 were more effective than those from the traditional FET protocol at improving pregnancy outcomes and lowering the multiple pregnancy rate in RIF patients. When only one or zero good-quality blastocysts are available, sequential blastocyst ET on days 5 and 6 should be considered.

References

Das M, Holzer H . Recurrent implantation failure: gamete and embryo factors. Fertil Steril. 2012; 97(5):1021-7. DOI: 10.1016/j.fertnstert.2012.02.029. View

Gao J, Yuan Y, Li J, Tian T, Lian Y, Liu P . Sequential embryo transfer versus double cleavage-stage embryo or double blastocyst transfer in patients with recurrent implantation failure with frozen-thawed embryo transfer cycles: a cohort study. Front Endocrinol (Lausanne). 2023; 14:1238251. PMC: 10515716. DOI: 10.3389/fendo.2023.1238251. View

Machtinger R, Dor J, Margolin M, Levron J, Baum M, Ferber B . Sequential transfer of day 3 embryos and blastocysts after previous IVF failures despite adequate ovarian response. Reprod Biomed Online. 2006; 13(3):376-9. DOI: 10.1016/s1472-6483(10)61442-3. View

Yazbeck C, Ben Jamaa N, Hazout A, Cohen-Bacrie P, Junca A, Rougier N . Advantages of the two-step embryo transfer strategy in human IVF/ICSI cycles. Zygote. 2011; 21(1):77-83. DOI: 10.1017/S096719941100058X. View

Zhang J, Wang C, Zhang H, Zhou Y . Sequential cleavage and blastocyst embryo transfer and IVF outcomes: a systematic review. Reprod Biol Endocrinol. 2021; 19(1):142. PMC: 8439041. DOI: 10.1186/s12958-021-00824-y. View

Liu Z, Liu X, Wang M, Zhao H, He S, Lai S . The Clinical Efficacy of Personalized Embryo Transfer Guided by the Endometrial Receptivity Array/Analysis on IVF/ICSI Outcomes: A Systematic Review and Meta-Analysis. Front Physiol. 2022; 13:841437. PMC: 9092494. DOI: 10.3389/fphys.2022.841437. View

Jia Y, Sha Y, Qiu Z, Guo Y, Tan A, Huang Y . Comparison of the Effectiveness of Endometrial Receptivity Analysis (ERA) to Guide Personalized Embryo Transfer with Conventional Frozen Embryo Transfer in 281 Chinese Women with Recurrent Implantation Failure. Med Sci Monit. 2022; 28:e935634. PMC: 8957643. DOI: 10.12659/MSM.935634. View

Cimadomo D, de Los Santos M, Griesinger G, Lainas G, Le Clef N, McLernon D . ESHRE good practice recommendations on recurrent implantation failure. Hum Reprod Open. 2023; 2023(3):hoad023. PMC: 10270320. DOI: 10.1093/hropen/hoad023. View

Kaur P, Swarankar M, Maheshwari M, Acharya V . A comparative study between cleavage stage embryo transfer at day 3 and blastocyst stage transfer at day 5 in in-vitro fertilization/intra-cytoplasmic sperm injection on clinical pregnancy rates. J Hum Reprod Sci. 2014; 7(3):194-7. PMC: 4229795. DOI: 10.4103/0974-1208.142481. View

10.

Cimadomo D, Craciunas L, Vermeulen N, Vomstein K, Toth B . Definition, diagnostic and therapeutic options in recurrent implantation failure: an international survey of clinicians and embryologists. Hum Reprod. 2020; 36(2):305-317. DOI: 10.1093/humrep/deaa317. View

11.

Gardner D, Lane M, Stevens J, Schlenker T, Schoolcraft W . Blastocyst score affects implantation and pregnancy outcome: towards a single blastocyst transfer. Fertil Steril. 2000; 73(6):1155-8. DOI: 10.1016/s0015-0282(00)00518-5. View

12.

Hill M, Eubanks A, Csokmay J, Christy A, Jahandideh S, DeCherney A . Is transferring a lower-quality embryo with a good-quality blastocyst detrimental to the likelihood of live birth?. Fertil Steril. 2020; 114(2):338-345. DOI: 10.1016/j.fertnstert.2020.03.027. View

13.

Enciso M, Aizpurua J, Rodriguez-Estrada B, Jurado I, Ferrandez-Rives M, Rodriguez E . The precise determination of the window of implantation significantly improves ART outcomes. Sci Rep. 2021; 11(1):13420. PMC: 8238935. DOI: 10.1038/s41598-021-92955-w. View

14.

Stamenov G, Parvanov D, Chaushev T . Successful Pregnancy following Mixed Double Embryo Transfer in a Patient with Variable Window of Implantation. Case Rep Obstet Gynecol. 2018; 2018:1687583. PMC: 5960520. DOI: 10.1155/2018/1687583. View

15.

Ruiz-Alonso M, Valbuena D, Gomez C, Cuzzi J, Simon C . Endometrial Receptivity Analysis (ERA): data versus opinions. Hum Reprod Open. 2021; 2021(2):hoab011. PMC: 8045472. DOI: 10.1093/hropen/hoab011. View

16.

Liu C, Yao W, Yao J, Li L, Yang L, Zhang H . Endometrial extracellular vesicles from women with recurrent implantation failure attenuate the growth and invasion of embryos. Fertil Steril. 2020; 114(2):416-425. DOI: 10.1016/j.fertnstert.2020.04.005. View

17.

Bartels C, Ditrio L, Grow D, OSullivan D, Benadiva C, Engmann L . The window is wide: flexible timing for vitrified-warmed embryo transfer in natural cycles. Reprod Biomed Online. 2019; 39(2):241-248. DOI: 10.1016/j.rbmo.2019.04.003. View

18.

Saxtorph M, Hallager T, Persson G, Birch Petersen K, Eriksen J, Larsen L . Assessing endometrial receptivity after recurrent implantation failure: a prospective controlled cohort study. Reprod Biomed Online. 2020; 41(6):998-1006. DOI: 10.1016/j.rbmo.2020.08.015. View

19.

Ohgi S, Taga Y, Anakubo H, Kurata Y, Hatakeyama S, Yanaihara A . Morphologically poor blastocysts could affect the implantation rate of a morphologically good blastocyst during a double-blastocyst transfer for patients who have experienced repeated implantation failures. Reprod Med Biol. 2018; 17(3):249-254. PMC: 6046531. DOI: 10.1002/rmb2.12097. View

20.

Cha J, Sun X, Dey S . Mechanisms of implantation: strategies for successful pregnancy. Nat Med. 2012; 18(12):1754-67. PMC: 6322836. DOI: 10.1038/nm.3012. View