Archives of Gynecology and Obstetrics

, Volume 298, Issue 4, pp 833–840 | Cite as

The risk of birth defects among children born after vitrified blastocyst transfers and those born after fresh and vitrified cleavage-stage embryo transfers

  • Qianqian Zhu
  • Ningling Wang
  • Bian Wang
  • Yun WangEmail author
  • Yanping KuangEmail author
Gynecologic Endocrinology and Reproductive Medicine



To explore the risk of birth defects among children born after vitrified blastocyst transfers and those born after fresh and vitrified cleavage-stage embryo transfers.


A retrospective cohort study was conducted including infants born after fresh and vitrified day 3 embryo transfers and those born after vitrified day 5 or 6 blastocyst transfers from January 2005 through December 2016. The outcome measures included any birth defect, multiple birth defects and 13 individual categories of birth defects.


Any birth defect occurred in 1.15% of infants born after fresh day 3 embryo transfers, 1.75% of infants born after vitrified day 3 embryo transfers, 1.60% of infants born after vitrified day 5 blastocyst transfers and 1.10% of infants born after vitrified day 6 blastocyst transfers. There was no difference in the risk of birth defects between vitrified blastocyst-stage transfers and vitrified cleavage-stage transfers (including day 5 vs. day 3 and day 6 vs. day 3) among all births or in only singletons or twins. For infants born after cleavage-stage embryo transfers at day 3, there was no difference in the risk of birth defects between fresh embryo transfers and vitrified embryo transfers among all births or in only singletons or twins.


Transfer of vitrified day 5 or 6 blastocysts does not increase the risk of birth defects compared with vitrified day 3 embryos. However, randomized control trials and follow-up studies of the long-term outcome of children born after blastocyst-stage transfers are needed to confirm the clinical safety of extending embryo culture to the blastocyst stage.


Birth defects In vitro fertilization Blastocyst transfer Cleavage-stage embryo transfer Frozen-thawed embryo transfer 



We gratefully acknowledge the staff of the Department of Assisted Reproduction in the Shanghai Ninth People’s Hospital for their contribution.

Author contributions

QQZ: Manuscript writing, data analysis; NLW: Data analysis; BW: Data collection; YW: Data collection; YPK: Project development.


This work was supported by the National Nature Science Foundation of China (Grant nos. 81571397, 31770989), the Shanghai Ninth People’s Hospital Foundation of China (Grant no. JYLJ030), the Nature Science Foundation of Shanghai (Grant no. 16ZR1419500).

Compliance with ethical standards

Conflict of interest

The authors declare that there are no conflicts of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

All participants gave written informed consent for this research.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Assisted ReproductionShanghai Ninth People’s Hospital Affiliated to Jiaotong University, School of MedicineShanghaiChina

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