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Association between women’s age and stage, morphology, and implantation of the competent blastocyst: a multicenter cohort study

      Objective

      To study if the age of women undergoing assisted reproductive technology treatment associates with stage, morphology, and implantation of the competent blastocyst.

      Design

      Multicenter historical cohort study based on exposure (age) and outcome data (blastocyst stage and morphology and initial human chorionic gonadotrophin [hCG] rise) from women undergoing single blastocyst transfer resulting in singleton pregnancy/birth.

      Setting

      Sixteen private and university-based facilities.

      Patient(s)

      In this study, 7,246 women who, between 2014 and 2018, underwent controlled ovarian stimulation (COS) or frozen-thawed embryo transfer (FET) with a single blastocyst transfer resulting in singleton pregnancy were identified. Linking data to the Danish Medical Birth Registry resulted in a total of 4,842 women with a live birth being included.

      Intervention(s)

      None.

      Main Outcome Measure(s)

      The competent blastocyst development stage (1–6), inner cell mass (A, B, C), trophectoderm (A, B, C), and initial serum hCG value.

      Result(s)

      Adjusted analysis of age and stage in COS treatments showed that for every 1-year increase in age there was a 5% reduced probability of the competent blastocyst assessed as being in a high stage at transfer. Comparison between hCG values in women 18–24 years and 25–29 years in both COS and FET showed significantly lower levels in the youngest women.

      Conclusion(s)

      The initial hCG rise was influenced by the age of the woman, with an identical pattern for hCG values in COS and FET treatments. In COS, the competent blastocyst had a reduced stage with increasing women’s age.
      Título: Asociación entre la edad de la mujer y el estadio, la morfología y la implantación del blastocisto competente: un estudio de cohorte multicéntrico.

      Objetivo

      Estudiar si la edad de las mujeres que se realizan tratamientos de reproducción asistida se asocia con el estadio, morfología e implantación del blastocisto competente.

      Diseño

      Estudio de cohorte histórico multicéntrico basado en la exposición (edad) y los datos de resultados (estadio y morfología del blastocisto e incremento inicial de la gonadotropina coriónica humana [hCG]) en mujeres que se sometieron a transferencia de un solo blastocito que resultó en un embarazo/nacimiento único.

      Entorno

      Dieciséis centros privados y universitarios.

      Paciente(s)

      En este estudio, se identificaron 7.246 mujeres que, entre 2014 y 2018, se sometieron a estimulación ovárica controlada (COS) o a transferencia de embriones congelados (FET) con transferencia de un solo blastocisto que resultó en un embarazo único. Mediante la relación de los datos con el Danish Medical Birht Registry se consiguió incluir a un total de 4.842 mujeres con un nacido vivo.

      Intervención(es)

      Ninguna.

      Medida(s) de resultado principal

      etapa de desarrollo del blastocisto competente (1—6), masa celular interna (A, B, C), trofectodermo (A, B, C) y valor inicial de hCG sérica.

      Resultado(s)

      El análisis ajustado de la edad y el estadio de desarrollo en los tratamientos de COS mostró que por cada aumento de 1 año en la edad había una 5% menos de probabilidad de que, en la transferencia, el blastocisto competente evaluado se encontrara en un estadio avanzado. La comparación entre los valores de hCG en mujeres de 18 a 24 años y de 25 a 29 años, tanto en COS como en FET, mostró niveles significativamente más bajos en las mujeres más jóvenes.

      Conclusión(es)

      El aumento inicial de hCG se vio influenciado por la edad de la mujer, con un patrón idéntico para los valores de hCG en los tratamientos COS y FET. En COS, el blastocisto competente tenía un estadio menos avanzado con el aumento de la edad de la mujer.

      Key words

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