Dataset Information

Perinatal outcomes of singletons following double vitrification-warming procedures: a retrospective study using propensity score analysis.

ABSTRACT:

Background

Although repeated cryopreservation is an occasional occurrence, the effect on perinatal outcomes is unclear. Therefore, the aim of this study was to evaluate the perinatal outcomes of singletons after embryo re-cryopreservation.

Methods

In this retrospective study, a total of 647 singleton live births after blastocyst freeze-thaw embryo transfer cycles were investigated. They were divided into two groups: vitrified-warmed blastocysts (once-vitrified group) and vitrified-warmed blastocysts derived from thawed cleaved embryos (re-vitrified group). Propensity score matching (PSM) was used to control for potential confounding factors.

Results

A total of 592 infants were included in the once-vitrified group, and 55 infants were included in the re-vitrified group. After PSM, 108 cases were generated for comparison. The median gestational age was 38 weeks for both groups, and the birthweights were comparable (3390.6 ± 601.5 g vs. 3412.8 ± 672.6 g, P > 0.05). The incidence of preterm birth (PTB) (20.4% vs. 16.7%), low birthweight (LBW) (3.7% vs. 7.4%), macrosomia (11.1% vs. 16.7%) and large for gestational age (LGA) (29.6% vs. 22.2%) were not significantly different between the two groups. Logistic regression analysis indicated that double vitrification-warming procedures did not affect the occurrence of PTB (OR, 2.58 [95% CI, 0.77, 8.63]), LBW (OR, 0.83 [95% CI, 0.08, 8.29]), macrosomia (OR, 0.60 [95% CI, 0.13, 2.69]), or LGA (OR, 1.51 [95% CI, 0.53, 4.27]) (P > 0.05, for all).

Conclusion

Our findings demonstrate that double vitrification-warming procedures do not increase the risk of adverse neonatal outcomes compared with those of once-vitrified embryos.

SUBMITTER: Shen X

PROVIDER: S-EPMC9840308 | biostudies-literature | 2023 Jan

REPOSITORIES: biostudies-literature

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Publications

Perinatal outcomes of singletons following double vitrification-warming procedures: a retrospective study using propensity score analysis.

Shen Xiaoyue X Ding Min M Yan Yuan Y Huang Chenyang C Wang Shanshan S Zhou Jianjun J Xing Jun J

BMC pregnancy and childbirth 20230114 1

<h4>Background</h4>Although repeated cryopreservation is an occasional occurrence, the effect on perinatal outcomes is unclear. Therefore, the aim of this study was to evaluate the perinatal outcomes of singletons after embryo re-cryopreservation.<h4>Methods</h4>In this retrospective study, a total of 647 singleton live births after blastocyst freeze-thaw embryo transfer cycles were investigated. They were divided into two groups: vitrified-warmed blastocysts (once-vitrified group) and vitrified ...[more]

PMID: 36641430

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Project description:BackgroundIn previous studies, the incidences of premature births and large for newborn gestational age (LGA ) infants were higher with blastocyst transfer than with cleavage-stage embryo transfer in infants conceived via frozen embryo transfer (FET) cycles. However, those previous studies reported unbalanced baseline characteristics between the blastocyst transfer group and the cleavage embryo transfer group. Therefore, in this study, we used propensity score matching to compare the birth weight and newborn gestational age of live-born singletons between blastocyst and cleavage-stage embryo transfer in FET cycles.MethodsFrom January 2018 to April 2023, 706 cases of singleton delivery resulting from FET cycles that met the inclusion and exclusion criteria were included in this study, of which 180 cases resulted from cleavage embryo transfer and 526 cases resulted from blastocyst transfer. Using propensity score matching, we obtained a well-balanced cohort with 173 pairs of cases. We compared the neonatal perinatal outcomes of this cohort, including birth weight and newborn gestational age, which are the primary outcomes. Moreover, we used multivariate linear regression to analyze whether the type of embryo transferred in a FET cycle was correlated with neonatal birth weight or newborn gestational age.ResultsAfter propensity score matching, there were no significant differences in any of the baseline characteristics between the blastocyst transfer group and cleavage-stage embryo transfer group. There were also no differences between the two groups in terms of the mean birth weight (g) (3380 [3050,3665] vs. 3380 [3002.5,3650], p = 0.941), newborn gestational age (days) (275 [269,280] vs. 275 [270,281], p = 0.282) or other perinatal outcomes. Multiple linear regression analysis revealed that the type of embryo transferred in a FET cycle was not correlated with neonatal birth weight or gestational age.ConclusionsBlastocyst transfer had perinatal outcomes similar to those of cleavage-stage embryo transfer for live-born singletons in FET cycles and did not influence the mean birth weight or gestational age of the neonates.Clinical trial numberNot applicable.

Project description:BackgroundAlthough acetaminophen is widely used in women during pregnancy, its safety has not been clearly stated. The study aimed to investigate the association between acetaminophen use and adverse pregnancy outcomes in pregnant women in China.MethodsWe conducted a retrospective cohort study by collecting data on pregnant women who delivered in the Beijing Obstetrics and Gynecology Hospital from January 2018 to September 2023. An acetaminophen use group and a control group were formed based on prenatal exposure to acetaminophen. The pregnancy outcomes that we focused on were stillbirth, miscarriage, preterm birth, APGAR score, birth weight, and congenital disabilities. Pregnant women exposed to acetaminophen were matched to unexposed in a 1:1 ratio with propensity score matching, using the greedy matching macro. SPSS software was used for statistical analysis. Multivariable logistics regression was used to assess the association between acetaminophen use during pregnancy and adverse pregnancy outcomes.ResultsA total of 41,440 pregnant women were included, of whom 501 were exposed to acetaminophen during pregnancy, and 40,939 were not exposed. After the propensity score matching, the acetaminophen use and control groups consisted of 501 pregnant women each. The primary analysis showed that acetaminophen exposure during pregnancy was associated with an increased risk of stillbirth (adjusted OR (aOR) = 2.29, 95% CI, 1.19-4.43), APGAR score < 7 at 1 min (aOR = 3.28, 95% CI, 1.73-6.21), APGAR score < 7 at 5 min (aOR = 3.54, 95% CI, 1.74-7.20), APGAR score < 7 at 10 min (aOR = 3.18, 95% CI, 1.58-6.41), and high birth weight (HBW) (aOR = 1.75, 95% CI, 1.05-2.92). Drug exposure during the first and second trimesters increased the odds of stillbirth, miscarriage, APGAR < 7, and the occurrence of at least one adverse pregnancy outcome. In addition, the frequency of drug use more than two times was associated with a higher risk of preterm birth and APGAR score < 7.ConclusionsExposure to acetaminophen during pregnancy was significantly associated with the occurrence of adverse pregnancy outcomes, particularly exposure in the first and second trimesters and frequency of use more than twice. It is suggested that acetaminophen should be prescribed with caution in pregnant women.

Project description:ObjectiveTo quantify severe perinatal and maternal morbidity/mortality associated with midcavity operative vaginal delivery compared with caesarean delivery.DesignPopulation-based, retrospective cohort study.SettingBritish Columbia, Canada.PopulationTerm, singleton deliveries (2004-2014) by attempted midcavity operative vaginal delivery or caesarean delivery in the second stage of labour, stratified by indication for operative delivery (n = 10 901 deliveries; 5057 indicated for dystocia, 5844 for fetal distress).MethodsMultinomial propensity scores and mulitvariable log-binomial regression models were used to estimate adjusted rate ratios (ARR) and 95% confidence intervals (95% CI).Main outcome measuresComposite severe perinatal morbidity/mortality (e.g. convulsions, severe birth trauma and perinatal death) and severe maternal morbidity (e.g. severe postpartum haemorrhage, shock, sepsis and cardiac complications).ResultsAmong deliveries with dystocia, attempted midcavity operative vaginal delivery was associated with higher rates of severe perinatal morbidity/mortality compared with caesarean delivery (forceps ARR 2.11, 95% CI 1.46-3.07; vacuum ARR 2.71, 95% CI 1.49-3.15; sequential ARR 4.68, 95% CI 3.33-6.58). Rates of severe maternal morbidity/mortality were also higher following midcavity operative vaginal delivery (forceps ARR 1.57, 95% CI 1.05-2.36; vacuum ARR 2.29, 95% CI 1.57-3.36). Among deliveries with fetal distress, there were significant increases in severe perinatal morbidity/mortality following attempted midcavity vacuum (ARR 1.28, 95% CI 1.04-1.61) and in severe maternal morbidity following attempted midcavity forceps delivery (ARR 2.34, 95% CI 1.54-3.56).ConclusionAttempted midcavity operative vaginal delivery is associated with higher rates of severe perinatal morbidity/mortality and severe maternal morbidity, though these effects differ by indication and instrument.Tweetable abstractPerinatal and maternal morbidity is increased following midcavity operative vaginal delivery.

Project description:Study questionDoes double vitrification and thawing of an embryo compromise the chance of live birth after a single blastocyst transfer?Summary answerThe live birth rate (LBR) obtained after double vitrification was comparable to that obtained after single vitrification.What is known alreadyDouble vitrification-warming (DVW) is commonly practiced to accommodate surplus viable embryos suitable for transfer, to allow retesting of inconclusively diagnosed blastocysts in preimplantation genetic testing (PGT), and to circumvent limitations associated with national policies on embryo culture in certain countries. Despite its popularity, the evidence concerning the impact of DVW practice on ART outcomes is limited and lacking credibility. This is the first thorough investigation of clinical pregnancy and LBR following DVW in the case where the first round of vitrification occurred at the zygote stage and the second round occurred at the blastocyst stage in the absence of biopsy.Study design size durationThis is a retrospective observational analysis of n = 407 single blastocyst transfers whereby embryos created by IVF/ICSI were vitrified-warmed once (single vitrification-warming (SVW) n = 310) or twice (DVW, n = 97) between January 2017 and December 2021.Participants/materials setting methodsIn the SVW group, blastocysts were vitrified on Day 5/6 and warmed on the day of embryo transfer (ET). In the DVW group, two pronuclear (2PN) zygotes were first vitrified-warmed and then re-vitrified on Day 5/6 and warmed on the day of ET. Exclusion criteria were ETs from PGT and vitrified-warmed oocyte cycles. All of the ETs were single blastocyst transfers performed at the University Hospital Zurich in Switzerland following natural or artificial endometrial preparation.Main results and the role of chanceThe biochemical pregnancy rate, clinical pregnancy rate (CPR), and LBR were all comparable between the DVW and SVW groups. The CPR for DVW was 44.3% and for SVW it was 42.3% (P = 0.719). The LBR for DVW was 30.9% and for SVW it was 28.7% (P = 0.675). The miscarriage rate was additionally similar between the groups: 27.9% for DVW and 32.1% for SVW groups (P = 0.765).Limitations reasons for cautionThe study is limited by its retrospective nature. Caution should be taken concerning interpretation of these findings in cases where DVW occurs at different stages of embryo development.Wider implications of the findingsThe result of the present study on DVW procedure provides a framework for counselling couples on their chance of clinical pregnancy per warming cycle. It additionally provides confidence and reassurance to laboratory professionals in certain countries where national policies limit embryo culture strategies making DVW inevitable.Study funding/competing interestsThis work was supported by the University Research Priority Program 'Human Reproduction Reloaded' of the University of Zurich. The authors have no conflict of interest related to this study to declare.Trial registration numberN/A.

Dataset Information

Perinatal outcomes of singletons following double vitrification-warming procedures: a retrospective study using propensity score analysis.

Background

Methods

Results

Conclusion

Publications

Perinatal outcomes of singletons following double vitrification-warming procedures: a retrospective study using propensity score analysis.

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