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Clinical Outcomes Deriving from Transfer of Blastocysts Developed in Day 7: a Systematic Review and Meta-Analysis of Frozen-Thawed IVF Cycles

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Abstract

This meta-analysis aimed to assess the reproductive competence of blastocysts developed on day 7 compared with blastocysts developed on day 5/6. A systematic search was carried out to select relevant studies published before January 2020. Ten retrospective observational cohort studies were included. The primary outcome was the clinical pregnancy rate (CPR). Secondary outcomes were live birth rate (LBR), euploid rate, and survival rates after thawing. Frozen-thawed day 7 blastocyst transfer was associated with a significant reduction in CPR compared to day 5/6 (OR 0.36 95% CI 0.21 to 0.62, p = 0.0002, I2 = 71% and OR 0.43, 95% CI 0.32 to 0.58, p < 0.0001, I2 = 17% respectively). A significantly lower proportion of LBR was found comparing blastocysts transfers in day 7 to those in day 5/6 (OR 0.21, 95% CI 0.16–0.27, p < 0.0001, I2 = 0% and OR 0.34, 95% CI 0.26–0.45, p < 0.0001, I2 = 0% respectively). These findings were confirmed in a subgroup of Preimplantation Genetic Testing for Aneuploidies (PGT-A)-screened blastocysts. Blastocysts biopsied in day 7 was associated with a significant decrease of euploid rate compared with day 5/6 (OR 0.47, 95% CI 0.39–0.57, p < 0.0001, I2 = 69% and OR 0.68, 95% CI 0.61–0.75, p < 0.0001, I2 = 19% respectively). The survival rate after thawing was not statistically different. Sensitivity analyses were also performed. This study shows an association between delayed blastulation and a poorer prognosis in terms of euploid rate and pregnancy outcomes following frozen-thawed transfers. On the other hand, the results do not support the discharge of slow-blastulation embryos.

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Funding

This work was sponsored by Fondazione Ricerca Donna e Feto Onlus.

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Authors and Affiliations

  1. Obstetrics and Gynaecology Unit, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, Milan, 20132, Italy

    Laura Corti, Alessandra Alteri & Enrico Papaleo

  2. Reproductive Sciences Laboratory, Obstetrics and Gynaecology Unit, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy

    Greta Chiara Cermisoni, Luca Pagliardini & Paola Viganò

  3. Department of Women’s and Children’s Health, University of Padua, Padua, Italy

    Guido Ambrosini, Alessandra Andrisani & Marco Noventa

Authors
  1. Laura Corti
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  2. Greta Chiara Cermisoni
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  3. Alessandra Alteri
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  4. Luca Pagliardini
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  5. Guido Ambrosini
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  7. Enrico Papaleo
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  8. Paola Viganò
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  9. Marco Noventa
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Contributions

All authors contributed to the conception of this study. L.C., G.C.C., and A.Al. designed the study, collected and interpreted the data, and drafted the manuscript. L.P. and M.N. analyzed and interpreted the data and revised the manuscript. E.P., G.A., A.An., and P.V revised the manuscript. All authors approved the final version of paper.

Corresponding author

Correspondence to Paola Viganò.

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Conflict of Interest

P.V. reports grants from Theramex and ESHRE and speakers’ honoraria from Merck outside the submitted work. All the other authors have no competing interests to declare.

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Corti, L., Cermisoni, G.C., Alteri, A. et al. Clinical Outcomes Deriving from Transfer of Blastocysts Developed in Day 7: a Systematic Review and Meta-Analysis of Frozen-Thawed IVF Cycles. Reprod. Sci. 29, 43–53 (2022). https://doi.org/10.1007/s43032-020-00424-y

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  • DOI: https://doi.org/10.1007/s43032-020-00424-y

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