title: Can repeated IVF-ICSI-cycles be avoided by using blastocysts developing from poor-quality cleavage stage embryos?
abstract: In many clinics, good-quality embryos are selected for embryo transfer and cryopreservation at the cleavage stage, and poor-quality embryos are discarded. The aim of this retrospective study was to examine how many repeated IVF cycles could be avoided by culturing the cleavage stage poor-quality embryos to blastocyst stage and transferring them after vitrification and warming (604 IVF and intracytoplasmic sperm injection [IVF-ICSI] cycles were included). Poor-quality cleavage stage embryos not eligible for transfer or cryopreservation were cultured until day 5 or 6, and those developing to the blastocyst stage were vitrified. The rate of vitrified blastocysts and clinical pregnancy and delivery rate of the warmed blastocysts was evaluated. The effect of the extended culture on the cumulative delivery rate, and the number of avoided new treatment cycles was calculated. The surplus blastocysts resulted in clinical pregnancy, spontaneous abortion and delivery rates of 24.6%, 27.3% and 17.2% respectively. The use of surplus blastocysts raised cumulative delivery rate from 43% to 47% and 53 repeated new cycles were avoided. This study shows that the cumulative delivery rate can be increased, and repeated IVF-ICSI treatments avoided by using blastocysts developing from poor-quality cleavage stage embryos, which otherwise would have been discarded.
authors.affiliation: Tampere University Hospital, Department of Obstetrics and Gynaecology, Tampere University, Teiskontie 35, Tampere 33521, Finland. Electronic address: noora.kaartinen@pshp.fi.
authors.forename: Noora
authors.initials: N
authors.lastname: Kaartinen
authors.affiliation: Tampere University Hospital, Department of Obstetrics and Gynaecology, Tampere University, Teiskontie 35, Tampere 33521, Finland.
authors.forename: Pia
authors.initials: P
authors.lastname: Das
authors.affiliation: Infertility Clinic Ovumia Ltd Biokatu 12, 33520 Tampere.
authors.forename: Kirsi
authors.initials: K
authors.lastname: Kananen
authors.affiliation: School of Health Sciences, Tampere University Medisiinarinkatu 3, 33520 Tampere.
authors.forename: Heini
authors.initials: H
authors.lastname: Huhtala
authors.affiliation: Tampere University Hospital, Department of Obstetrics and Gynaecology, Tampere University, Teiskontie 35, Tampere 33521, Finland.
authors.forename: Helena
authors.initials: H
authors.lastname: Tinkanen
mesh_terms: D001723:Birth Rate; D001755:Blastocyst / Q000473:pathology*; D002970:Cleavage Stage, Ovum / Q000473:pathology*; D015925:Cryopreservation; D004477:Ectogenesis; D046149:Embryo Culture Techniques; D004624:Embryo Transfer; D005191:Family Characteristics; D005260:Female; D005307:Fertilization in Vitro; D005387:Finland / Q000453:epidemiology; D006785:Hospitals, University; D006801:Humans; D007247:Infertility, Female / Q000473:pathology / Q000628:therapy*; D007248:Infertility, Male; D008297:Male; D010044:Outpatient Clinics, Hospital; D011247:Pregnancy; D018873:Pregnancy Rate; D012189:Retrospective Studies; D020554:Sperm Injections, Intracytoplasmic; D058989:Vitrification
keywords: blastocyst; cleavage stage; cryopreservation; cumulative delivery rate; embryo quality; poor quality