Influencing factors of three pronuclei incidence and their impact on pregnancy outcomes in women with good prognosis undergoing conventional in vitro fertilization with donor sperm: a retrospective cohort study.

IF 2.9 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Frontiers in reproductive health Pub Date : 2025-03-13 eCollection Date: 2025-01-01 DOI:10.3389/frph.2025.1509710

Jianhua Sun, Xiang Liu, Shengjia Shi, Mingzhao Li

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Abstract

Purpose: This study aimed to investigate the influencing factors of three pronuclei (3PN) zygote incidence and their impact on pregnancy outcomes in women with good prognosis undergoing conventional in vitro fertilization with donor sperm (C-IVFD).

Methods: This retrospective study included women aged 35 years or younger who underwent the long/ultra-long follicular phase agonist protocol between January 2014 and January 2021. C-IVFD cycles were divided into the 3PN = 0% group (no 3PN zygotes) and the 3PN > 0% group (with 3PN zygotes). Multivariate logistic regression analysis was performed to identify factors influencing 3PN zygote incidence. The primary outcomes were clinical pregnancy, ongoing pregnancy, abortion and live birth rates. The secondary outcomes were cleavage, high-quality embryo, available embryo, implantation and ectopic pregnancy rates.

Results: 1,250 embryo transfer cycles were included in this study. The peak estradiol (E₂) level on the day of human chorionic gonadotrophin (hCG) administration (OR: 1.16, 95% CI 1.12-1.19, p < 0.001) and the number of retrieved oocytes (OR: 1.08, 95% CI 1.05-1.11, p < 0.001) were independently associated with 3PN incidence. Compared to the 3PN > 0% group, the 3PN = 0% group exhibited significantly higher ongoing pregnancy rates (p = 0.033) and live birth rates (p = 0.009), as well as lower abortion rate (p = 0.026). No significant differences were found between the 3PN = 0% and 3PN > 0% groups in cleavage, high-quality embryo, available embryo, implantation and ectopic pregnancy rates (p > 0.05).

Conclusions: The peak E₂ level on hCG administration day and the number of retrieved oocytes were independently associated with 3PN incidence. The incidence of 3PN zygotes has a negative impact on pregnancy outcomes in women with good prognosis undergoing C-IVFD.

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一项回顾性队列研究：使用供体精子进行常规体外受精的预后良好妇女的三代核发生率影响因素及其对妊娠结局的影响。

目的：本研究旨在探讨三原核（3PN）受精卵发生率的影响因素及其对预后良好的供精常规体外受精（C-IVFD）妇女妊娠结局的影响。方法：这项回顾性研究纳入了2014年1月至2021年1月期间接受长/超长卵泡期激动剂治疗的35岁及以下女性。C-IVFD周期分为3PN = 0%组（无3PN受精卵）和3PN > 0%组（有3PN受精卵）。多因素logistic回归分析确定影响3PN合子发生率的因素。主要结局为临床妊娠、持续妊娠、流产和活产率。次要结果为卵裂率、高质量胚胎、可用胚胎、着床率和异位妊娠率。结果：本研究共纳入1250个胚胎移植周期。人绒毛膜促性腺激素（hCG）给药当天雌二醇（E2）水平峰值（OR: 1.16, 95% CI 1.12-1.19, p = 0%）组、3PN = 0%组持续妊娠率（p = 0.033）和活产率（p = 0.009）显著高于对照组（p = 0.026），流产率显著低于对照组（p = 0.026）。3PN = 0%组和3PN > 0%组在卵裂率、优质胚率、有效胚率、着床率和异位妊娠率方面差异无统计学意义（p > 0.05）。结论：hCG给药当日E2峰值水平和取卵数与3PN发生率独立相关。在接受C-IVFD的预后良好的妇女中，3PN合子的发生率对妊娠结局有负面影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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