Day 3胚胎植入懷孕率優於Day 1胚胎植入

Day 3胚胎植入懷孕率優於Day 1胚胎植入

Day 1胚胎挑選Z score準確度不盡理想

http://humrep.oxfordjournals.org/content/19/3/645.long

Zygote transfer on day 1 versus cleavage stage embryo transfer on day 3: a prospective randomized trial

1. Kamal Jaroudi1, 
2. Saad Al‐Hassan1, 
3. Ulla Sieck1, 
4. Hamad Al‐Sufyan1,
5. Maya Al‐Kabra2 and 
6. Serdar Coskun2,3

+Author Affiliations

1. King Faisal Specialist Hospital and Research Center, Departments of
2. ¹Obstetrics and Gynecology and
3. ²Pathology and Laboratory Medicine, P.O.Box 3354, Riyadh, 11211, Saudi Arabia

1. 3To whom correspondence should be addressed. e‐mail: serdar@kfshrc.edu.sa

• Received August 20, 2003.
• Revision received October 6, 2003.
• Accepted November 4, 2003.

 

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Abstract

BACKGROUND: It has been reported that pronuclear morphology is related to embryo quality and viability, and that zygote stage embryos might establish pregnancies after being transferred to the uterus. The objective of this study was to investigate whether transferring zygotes on day 1 would result in similar pregnancy rates compared to transferring cleavage stage embryos on day 3 in a prospective randomized trial. METHODS: Patients undergoing IVF/ICSI treatments were randomized to either day 1 or day 3 transfers by envelope withdrawal technique. Zygotes were classified as ‘pattern 0’ and ‘non‐pattern 0’ according to the size and alignment of pronuclei, the number and distribution of nucleoli. The two best zygotes or embryos were transferred on day 1 or day 3 respectively. The primary outcome measure was pregnancy rate. RESULTS: Pregnancy rates were higher in day 3 group (55/131, 42%) when compared to day 1 (34/123, 28%, P = 0.024). Similarly, implantation rates were higher in day 3 group (P = 0.03). There were more cycles with cryopreservation in the day 1 group (P < 0.001). Embryo quality on day 3 was similar between pattern 0 and non‐pattern 0 zygotes. CONCLUSIONS: Day 3 embryo transfers result in better pregnancy and implantation rates compared to day 1 zygote transfers. The present pronuclei scoring cannot reliably select zygotes for transfer on day 1.

Table III.

Pattern 0 distribution of zygotes on day 1 and 3 transfers and their use in cycles that resulted in pregnancies

	Total	Transferred	In pregnant cycles (%)
Day 1
Pattern 0	172	119	41 (34.5)
Non‐pattern 0	421	105	25 (23.8)
Day 3
Pattern 0	182	77	39 (50.7)
Non‐pattern 0	518	169	79 (46.8)

Table IV.

Distribution of embryo quality on day 3 according to the zygote classification.

Zygote	Embryo quality
	Good	Fair	Poor
Pattern 0	89 (48.9)	36 (19.8)	56 (30.8)
Non‐pattern 0	212 (40.9)	93 (17.9)	208 (40.2)

Differences were not statistically significant.