What is the optimal number of embryos to transfer for POSEIDON group 1 and group 2? A retrospective study.

IF 3.8 3区医学 Q1 REPRODUCTIVE BIOLOGY Journal of Ovarian Research Pub Date : 2024-05-31 DOI:10.1186/s13048-024-01443-y

Rang Liu, Qiuju Zhang, Lan Geng, Huiqing He, Chang Xu, Jiali Feng, Miaoling Song, Yanpei Cao, Tianren Wang, Xi Xia

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Abstract

Background: The 2016 Patient-Oriented Strategy Encompassing IndividualizeD Oocyte Number (POSEIDON) criteria redefined the poor responders as low prognosis patients. The embryo transfer strategy for POSEIDON patients remained to be addressed. This study aimed to investigate the optimized number of embryos to transfer for unexpected low-prognosis patients (POSEIDON Group 1 and Group 2) with blastocyst transfer in their first frozen cycle.

Methods: A retrospective cohort study of 2970 patients who underwent frozen-thawed embryo transfer (FET) between January 2018 and December 2021. Patients from POSEIDON Group 1 (N = 219) and Group 2 (N = 135) who underwent blastocyst transfer in their first FET cycles were included and divided into the elective single embryo transfer (eSET) group and the double embryo transfer (DET) group.

Results: For POSEIDON Group 1, the live birth rate per embryo transfer of the DET group was slightly higher than the eSET group (52.17% vs 46.15%, OR 0.786, 95% CI 0.462-1.337, P = 0.374; adjusted OR (aOR) 0.622, 95% CI 0.340-1.140, P = 0.124), while a significant increase of 20.00% in the multiple birth rate was shown. For Group 2, higher live birth rates were observed in the DET group compared to the eSET group (38.46% vs 20.48%, OR 0.412, 95% CI 0.190-0.892, P = 0.024; aOR 0.358, 95% CI 0.155-0.828, P = 0.016). The difference in the multiple birth rate was 20.00% without statistical significance. Univariate and multivariate analyses revealed that age (OR 0.759, 95% CI .624-0.922, P = 0.006 and OR 0.751, 95% CI 0.605-0.932, P = 0.009) and the number of transferred embryos (OR 0.412, 95% CI 0.190-0.892, P = 0.024 and OR 0.367, 95% CI 0.161-0.840, P = 0.018) were significant variables for the live birth rate in POSEIDON Group 2.

Conclusions: The findings in the present study showed that eSET was preferred in the first frozen cycle for POSEIDON Group 1 to avoid unnecessary risks. Double embryo transfer strategy could be considered to improve the success rate for POSEIDON Group 2 with caution. Further stratification by age is needed for a more scientific discussion about the embryo transfer strategy for POSEIDON patients.

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POSEIDON 第 1 组和第 2 组的最佳胚胎移植数量是多少？一项回顾性研究。

背景：2016 年《以患者为导向的囊胚数量个体化策略》（Patient-Oriented Strategy Encompassing IndividualizeD Oocyte Number，POSEIDON）标准将反应差的患者重新定义为低预后患者。POSEIDON患者的胚胎移植策略仍有待解决。本研究旨在探讨意外低预后患者（POSEIDON 第 1 组和第 2 组）首次冷冻周期囊胚移植的最佳胚胎移植数量：对2018年1月至2021年12月期间接受冷冻-解冻胚胎移植（FET）的2970名患者进行回顾性队列研究。研究纳入了POSEIDON 1组（N = 219）和2组（N = 135）在首个FET周期中接受囊胚移植的患者，并将其分为选择性单胚胎移植（eSET）组和双胚胎移植（DET）组：在 POSEIDON 1 组中，DET 组每次胚胎移植的活产率略高于 eSET 组（52.17% vs 46.15%，OR 0.786，95% CI 0.462-1.337，P = 0.374；调整 OR (aOR) 0.622，95% CI 0.340-1.140，P = 0.124），而多胎率则显著增加了 20.00%。就第 2 组而言，与 eSET 组相比，DET 组的活产率更高（38.46% vs 20.48%，OR 0.412，95% CI 0.190-0.892，P = 0.024；aOR 0.358，95% CI 0.155-0.828，P = 0.016）。多胎率为 20.00%，差异无统计学意义。单变量和多变量分析显示，年龄（OR 0.759，95% CI .624-0.922，P = 0.006 和 OR 0.751，95% CI 0.605-0.932，P = 0.009）和移植胚胎数（OR 0.412，95% CI 0.190-0.892，P = 0.024和OR 0.367，95% CI 0.161-0.840，P = 0.018）是POSEIDON 2组活产率的显著变量.结论：本研究结果表明，为避免不必要的风险，POSEIDON 1 组首选在第一个冷冻周期进行 eSET。双胚胎移植策略可谨慎考虑，以提高POSEIDON 2组的成功率。要对波塞冬患者的胚胎移植策略进行更科学的讨论，还需要进一步按年龄进行分层。

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来源期刊

Journal of Ovarian Research REPRODUCTIVE BIOLOGY-

CiteScore

6.20

自引率

2.50%

发文量

125

审稿时长

>12 weeks

期刊介绍： Journal of Ovarian Research is an open access, peer reviewed, online journal that aims to provide a forum for high-quality basic and clinical research on ovarian function, abnormalities, and cancer. The journal focuses on research that provides new insights into ovarian functions as well as prevention and treatment of diseases afflicting the organ. Topical areas include, but are not restricted to: Ovary development, hormone secretion and regulation Follicle growth and ovulation Infertility and Polycystic ovarian syndrome Regulation of pituitary and other biological functions by ovarian hormones Ovarian cancer, its prevention, diagnosis and treatment Drug development and screening Role of stem cells in ovary development and function.