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Impact of post-warming culture duration on clinical outcomes of vitrified good-quality blastocyst transfers: a prospective randomized study

      Objective

      To determine whether post-warming culture duration (1 hour vs. 18 hours) influences implantation rates (IRs) of good-quality blastocysts (GQB) in a good-prognosis population.

      Design

      Prospective interventional randomized study.

      Setting

      University hospital.

      Patient(s)

      One hundred sixty-two GQB transfers.

      Intervention(s)

      Patients’ vitrified blastocysts were randomly allocated to group A, warming on the day before transfer (n = 81), or B, warming on the day of transfer (n = 81).

      Main Outcome Measure(s)

      IR, live birth rate, reexpansion degree, and quality after warming and immediately before transfer.

      Result(s)

      Quality of the warmed and transferred blastocysts was similar (respectively, 39.1% and 32.7% top quality [≥B4AA/AB/BA] in group A vs. 41.7 and 42.2% in group B). In group A, 14 of 102 blastocysts (12.2%) appeared to be unsuitable for transfer, versus only 1 of 103 (0.9%) in group B, thus leading to an additional warming. As expected, reexpansion degree just before transfer was higher in group A (0.90 vs. 0.70). Likewise, the proportion of hatched blastocysts before transfer was higher after a longer culture period (38.6% in group A vs. 12.7% in group B). IRs were similar (38.0% in group A vs. 36% in group B), as were live birth rates (35.8% in group A vs. 34.6% in group B).

      Conclusion(s)

      IRs were not different, whatever the duration of post-warming culture of GQB. Both warming strategies could be applied to good-prognosis patients to optimize the laboratory workflow without any detrimental effect.
      Impacto de la duración del cultivo posterior a la desvitrificación en los resultados clínicos tras la transferencia de blastocistos vitrificados de buena calidad: un estudio prospectivo aleatorizado

      Objetivo

      Determinar si la duración del cultivo posterior a la desvitrificación (1 hora vs. 18 horas) influye en la tasa de implantación (IRs) de los blastocistos de buena calidad (GQB) en una población de buen pronóstico.

      Diseño

      Estudio prospectivo aleatorizado intervencionista.

      Escenario

      Hospital Universitario.

      Paciente(s)

      Ciento sesenta y dos (162) GQB transferencias.

      Intervención(es)

      Los blastocistos vitrificados de los pacientes fueron asignados de manera aleatoria al grupo A, desvitrificación el día anterior a la transferencia embrionaria (n = 81), o B, desvitrificación en el día de la transferencia (n= 81).

      Variable principal de resultados(s)

      tasa de implantación (IR), tasa de recién nacido vivo, el grado de re expansión, y la calidad después de la desvitrificación e inmediatamente antes de la transferencia embrionaria.

      Resultado

      La calidad de los embriones desvitrificados y transferidos fue similar (respectivamente, 39,1% y 32,7% en los de calidad máxima [RB4AA/AB/BA] en el grupo A vs. 41,7 y 42,2% en el grupo B). En el grupo A, 14 de los 102 blastocistos (12,2%) parecieron no ser adecuados para la transferencia, versus 1 de los 103 (0.9%) del grupo B, con lo que conllevaba una desvitrificación adicional. Como era de esperar el grado de re expansión justo antes de la transferencia ha sido más alto en el grupo A (0,90 vs. 0,70). Así mismo, la proporción de los blastocistos con hatching antes de la transferencia ha sido mayor después del cultivo largo (38,6% en el grupo A vs. 12,7% en el grupo B). La tasa de implantación fue similar (38,0% en el grupo A vs. 36% en el grupo B), así como la tasa de recién nacido vivo (35,8% en el grupo A vs. 34,6% en el grupo B).

      Conclusiones(s)

      La IRs no fue diferente, independientemente de la duración del tiempo de cultivo posterior a la desvitrificación en embriones de buena calidad. Ambas estrategias de desvitrificación se podrían aplicar para los pacientes de buen pronostico para optimizar la marcha fluida del laboratorio sin ningún efecto perjudicial.

      Palabras clave

      Blastocisto, vitrificación, duración cultivo tras la desvitrificación, tasa de implantación.

      Key Words

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