ORİJİNAL ARAŞTIRMALAR
Tekrarlayan İmplantasyon Başarısızlığı Olan Hastalarda Euploid Embriyolarin Transfer Zamanlamasının Değerlendirilmesi
The Effect of Immediate Transfer of Euploid Embryos on Outcome in Patients with Recurrent Implantation Failure
Received Date : 17 Apr 2024
Accepted Date : 08 Oct 2024
Available Online : 18 Oct 2024
Alper ŞİŞMANOĞLUa, Ulun ULUĞb
aİstanbul Altınbaş University, Faculty of Medicine, Department of Obstetrics and Gynecology, İstanbul, Türkiye
bİstanbul Haliç University, Faculty of Medicine, Department of Obstetrics and Gynecology, İstanbul, Türkiye
Doi: 10.24074/tjrms.2024-103497 - Makale Dili: EN
Turkish Journal of Reproductive Medicine and Surgery. 2024;8(3):75-82
ÖZET
Amaç: Tekrarlayan implantasyon başarısızlığı olan kadınların PGT-A uygulanan embriyoların hemen transfer edilmesi ile klinik gebelik oranları
arasındaki ilişkiyi araştırmayı amaçladık. Gereç ve Yöntem: Bu retrospektif çalışmaya öploid blastokist transferi yapılan toplam 502 hasta
dahil edildi. Her kadın için PGT-A'dan sonra bir dondurulmuş-çözülmüş embriyo transfer siklüsü analiz edildi. Klinik gebelik sonuçlarını pozitif
veya negatif olarak sınıflandırarak değerlendirildi. Hastaları kriyo-saklama süresine göre gruplandırdık: 90 günden daha az süre saklanan kriyo
grubu Grup A, 90 gün ve daha fazla süre saklanan embriyolar Grup B olarak tanımlandı. Bulgular: İki grup arasında alınan toplam oosit sayısı,
metafaz II oositlerin, döllenmiş oositlerin, vitrifiye edilmiş veya transfer edilmiş aşamadaki blastokistlerin sayısı iki grup arasında eşitti. Genel
klinik gebelik oranı %77,1 idi ve bu oran her iki grupta da istatistik olarak benzerdi (p=0,747). Grup A içerisinde gebelik sonucu pozitif olan alt
grupta 5. gün blastokist oranı daha yüksekti (p=0,001). Grup B için, gebelik sonucu pozitif olan alt grupta daha fazla transfer edilen embriyo sayısı
vardı ancak bu grup içindeki hastalar karşılaştırıldığında kriyo-saklama süresi daha kısa olma eğlimindeydi. (sırasıyla p=0,049 ve p=0,040).
Sonuç: 90 günden kısa süren öploid embriyo transferi daha geç yapılan öploid embryo transferlerine göre daha iyi bir klinik gebelik oranını vermemiştir.
Yumurta toplama gününden transfere kadar geçen süre 90 günü aşan grupta (GrupB) klinik gebelik pozitif olanlarda transfer edilen
embriyo sayısı daha fazla olduğu görülmüş ve grup içindeki saklama süresi daha kısa olma eğiliminde olduğu izlenmiştir. Bu bulgular Grup A
ve Grup B arasındaki genel sonucu etkilememiştir. Transferin yumurta toplama işleminden sonraki 90 günden daha kısa sürede yapılması durumunda,
6. Gün yerine 5. Gün blastokist transferi daha yüksek gebelik oranı ile ilişkili görünmektedir (p=0,001).
Anahtar Kelimeler: Blastokist transferi; gebelik; öploid embriyolar; implantasyon öncesi genetik tanı; kriyo-depolama süresi
ABSTRACT
Objective: We aimed to investigate the association of immediate transfer of embryos undergoing PGT-A with the clinical pregnancy rates of
women with recurrent implantation failure. Materials and Methods: In total 502 patients with euploid blastocyst transfer were included in this
retrospective study. For each woman, one vitrified-warmed embryo transfer cycle after PGT-A was analyzed. We assessed clinical pregnancy outcomes,
categorizing them as either positive or negative. We grouped the patients according to cryo-storage duration: patients with cryo-storage
duration of less than 90-days were grouped as Group A; and the ones with more than 90-days, were included in Group B. Results: The quantities
of retrieved, metaphase II or fertilized oocytes, vitrified or transferred embryos, and blastocysts at the stage were comparable between the
two groups. The overall clinical pregnancy rate was 77.1%, and this rate was statistically similar between the Grup A and Group B groups
(p=0.747). For Group B, the subgroup with a positive pregnancy outcome had a greater number of transferred embryos but a shorter cryo-storage
duration and this features did not change the general outcome between the two groups (p=0.049 and p=0.040, respectively). Within Group
A, the subgroup with a positive pregnancy outcome had a higher proportion of Day 5 blastocysts (p=0.001). Conclusion: Immediate euploid embryo
transfer of less than 90 days do not effect the pregnancy rate. A higher number of transferred embryos and a shorter storage duration may
increase the possibility of pregnancy, if cryo-storage exceeds 90 days. Day 5 blastocyst transfer rather than Day 6 seems to be associated with a
higher pregnancy rate when the transfer is done in less than 90 days period after the ovum pick up procedure.
Keywords: Blastocyst transfer; pregnancy; euploid embryos; preimplantation genetic diagnosis; cryo-storage duration
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