Resumption of mitosis during post-thaw culture: a key parameter in selecting the right embryos for transfer |
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Authors: | Ziebe S; Bech B; Petersen K; Mikkelsen AL; Gabrielsen A; Andersen AN |
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Institution: | The Fertility Clinic, The Juliane Marie Center, Rigshospitalet, University of Copenhagen, Denmark. |
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Abstract: | This retrospective study of 701 thaw cycles analysed the clinical
importance of whether or not embryos resumed mitosis during 24 h of
post-thaw culture. A total of 3360 frozen embryos were thawed; 1922 embryos
survived the freeze-thaw procedure with at least one intact blastomere and
were then cultured for 24 h before transfer. All transfers were registered
into either the 'cleaved embryo group' (n = 459), which was defined as
transfers where at least one of the transferred embryos cleaved during the
post-thaw culture period, or the 'non-cleaved embryo group' (n = 153),
where none of the transferred embryos cleaved during the post-thaw culture
period. A total of 1408 thawed embryos were transferred in 612 cycles; 459
embryo transfers were in the cleaved embryo group, resulting in an
implantation rate of 10%, significantly higher than the 4% in the
non-cleaved embryo group (P = 0.0003). A total of 130 pregnancies (28% per
transfer) were obtained in the cleaved embryo group which was significantly
higher than the 17 pregnancies (11% per transfer) obtained in the
non-cleaved embryo group (P = 0.0001). However, the average number of
transferred embryos was significantly higher in the cleaved embryo group
(2.46 +/- 0.03) compared to the non-cleaved embryo group (1.82 +/- 0.07).
No difference was found in the age of the women between the two groups.
When analysing transfers where all transferred embryos had cleaved during
the post-thaw culture period the clinical pregnancy rate increased
significantly from 13% transferring two embryos to 36% transferring three
embryos (P = 0.0136). In this latter subgroup an implantation rate as high
as 17% was obtained. The overall multiple pregnancy rate was 16%. The
multiple pregnancy rate was 19% in the cleaved embryo group. In conclusion,
24 h post-thaw culture may allow a better selection of the embryos and
thereby we may be able to increase the implantation and pregnancy rates.
This may enable us further to reduce the number of embryos transferred.
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