The association between blastocyst quality during a single frozen-thawed blastocyst transfer cycle and subsequent perinatal outcomes: a propensity score-matched study

Abstract

Abstract Background At present, with the increasing acceptance of blastocyst transfer, more and more attention were being paid to the selection of blastocysts during the transplant cycle. The preferred method for reducing the incidence of adverse perinatal outcomes was to select blastocysts with a low rate of adverse perinatal outcomes for transplantation. However, few studies have investigated the relationship between blastocyst quality and perinatal outcomes in single frozen-thawed blastocyst transfer (SFBT) cycles. The aim of this study was to focus solely on the blastocyst and investigate the association between embryo morphological grading and perinatal outcomes in a single frozen-thawed blastocyst transfer (SFBT) cycle. Method In a retrospective case-control study, we divided patients into the good-quality blastocysts transfer group and the poor-quality blastocyst transfer group based on the Gardner and Schoolcraft system. To control for potential confounding factors, propensity score-matching (PSM) was used to match male age, secondary infertility, primiparity, developmental day of the transferred blastocysts, endometrial thickness on transfer day, and polycystic ovary syndrome. Patients who received single vitrified-warmed high-quality blastocysts were matched with patients who received single poor-quality blastocysts at a 1:1 ratio. Result(s) Both before and after using PSM, there were no statistically significant differences in obstetric outcomes, including the incidence of gestational hypertension, gestational diabetes, or cesarean delivery, among women receiving SFBT with different blastocyst quality. There were also no significant differences in neonatal outcomes between the two groups with respect to newborn birth weight or the occurrence of birth defects. Conclusion The quality of blastocysts did not affect the perinatal outcomes of SFBT cycles. It is feasible to select a single poor-quality blastocyst for SFBT.