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Blastocyst versus cleavage transfers: who benefits?

  • Gynecologic Endocrinology and Reproductive Medicine
  • Published:
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Abstract

Purpose

This retrospective cohort study determined the relative efficacy of blastocyst and cleavage-stage transfers in patients with differing numbers of zygotes.

Methods

A total of 1116 women whose embryo transfers were planned independently of patient characteristics were included. Cleavage-stage (D3) and blastocyst-stage (D5) transfer outcomes were analyzed per number of zygotes. The D5 group included transfer cancellations as the intention-to-treat population. The effect of the embryo transfer date on the clinical outcomes (clinical pregnancy and implantation rates) was analyzed using multivariate logistic regression.

Results

Among the patients, 584 and 532 underwent D3 and D5 embryo transfers, respectively. The clinical pregnancy rates were significantly higher in D5 patients with ≥ 6 zygotes (25.7% vs 48.3%). The multivariate logistic regression analysis for clinical pregnancy did not show significant differences between the blastocyst and cleavage-stage transfers in patients with ≤ 5 zygotes (0.874 [0.635-1.204]). Compared to the cleavage-stage, blastocyst-stage transfers for patients with ≥ 6 zygotes resulted in a three-fold increase in clinical pregnancy rates (3.122 [1.797-5.425]).

Conclusion

Blastocyst transfers were not inferior to cleavage-stage embryo transfers among patients with few zygotes and were preferable for patients with several zygotes.

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Availability of data and material

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

Code availability

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This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Faculty of Medicine, Department of Obstetrics and Gynaecology, Center for Reproductive Endocrinology and Assisted Reproduction, Akdeniz University, 07100, Antalya, Turkey

    Enver Kerem Dirican, Safak Olgan, Mehmet Sakinci & Mete Caglar

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  1. Enver Kerem Dirican
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  2. Safak Olgan
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  3. Mehmet Sakinci
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  4. Mete Caglar
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Contributions

SO: Conceptualization, formal analysis, methodology, writing. MS: Formal analysis, supervision, writing. MC: Methodology, supervision, visualization.

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Correspondence to Enver Kerem Dirican.

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Approved by the Institutional Review Board of Akdeniz University, Faculty of Medicine (Approval Number: 27012021/71).

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Dirican, E.K., Olgan, S., Sakinci, M. et al. Blastocyst versus cleavage transfers: who benefits?. Arch Gynecol Obstet 305, 749–756 (2022). https://doi.org/10.1007/s00404-021-06224-2

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  • DOI: https://doi.org/10.1007/s00404-021-06224-2

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