Effect of single blastocyst-stage versus single cleavage-stage embryo transfer on cumulative live births in women with good prognosis undergoing in vitro fertilization: Multicenter Randomized Controlled Trial

Xiang Ma, Jing Wang, Yuhua Shi, Jichun Tan, Yichun Guan, Yun Sun, Bo Zhang, Junli Zhao, Jianqiao Liu, Yunxia Cao, Hong Li, Cuilian Zhang, Feng Chen, Honggang Yi, Ze Wang, Xing Xin, Pingping Kong, Yao Lu, Ling Huang, Yingying Yuan, Haiying Liu, Caihua Li, Ben Willem J. Mol, Zhibin Hu, Heping Zhang, Zi-Jiang Chen () and Jiayin Liu ()
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Xiang Ma: the First Affiliated Hospital of Nanjing Medical University
Jing Wang: the First Affiliated Hospital of Nanjing Medical University
Yuhua Shi: Shandong University
Jichun Tan: Shengjing Hospital of China Medical University
Yichun Guan: the Third Affiliated Hospital of Zhengzhou University
Yun Sun: Shanghai Jiao Tong University School of Medicine
Bo Zhang: Maternal and Child Health Hospital in Guang Xi
Junli Zhao: General Hospital of Ningxia Medical University
Jianqiao Liu: the Third Affiliated Hospital of Guangzhou Medical University
Yunxia Cao: the First Affiliated Hospital of Anhui Medical University
Hong Li: the Affiliated Suzhou Hospital of Nanjing Medical University
Cuilian Zhang: Henan Provincial People’s Hospital
Feng Chen: Nanjing Medical University
Honggang Yi: Nanjing Medical University
Ze Wang: Shandong University
Xing Xin: Shengjing Hospital of China Medical University
Pingping Kong: the Third Affiliated Hospital of Zhengzhou University
Yao Lu: Shanghai Jiao Tong University School of Medicine
Ling Huang: Maternal and Child Health Hospital in Guang Xi
Yingying Yuan: General Hospital of Ningxia Medical University
Haiying Liu: the Third Affiliated Hospital of Guangzhou Medical University
Caihua Li: the First Affiliated Hospital of Anhui Medical University
Ben Willem J. Mol: Monash University
Zhibin Hu: the First Affiliated Hospital of Nanjing Medical University
Heping Zhang: Yale University School of Public Health
Zi-Jiang Chen: Shandong University
Jiayin Liu: the First Affiliated Hospital of Nanjing Medical University

Nature Communications, 2024, vol. 15, issue 1, 1-13

Abstract: Abstract In this multicenter, non-inferiority, randomized trial, we randomly assigned 992 women undergoing in-vitro fertilization (IVF) with a good prognosis (aged 20-40, ≥3 transferrable cleavage-stage embryos) to strategies of blastocyst-stage (n = 497) or cleavage-stage (n = 495) single embryo transfer. Primary outcome was cumulative live-birth rate after up to three transfers. Secondary outcomes were cumulative live-births after all embryo transfers within 1 year of randomization, pregnancy outcomes, obstetric-perinatal complications, and livebirths outcomes. Live-birth rates were 74.8% in blastocyst-stage group versus 66.3% in cleavage-stage group (relative risk 1.13, 95%CI:1.04-1.22; Pnon-inferiority 3 days. Among good prognosis women, a strategy of single blastocyst transfer increases cumulative live-birth rates over single cleavage-stage transfer. Blastocyst transfer resulted in higher preterm birth rates. This information should be used to counsel patients on their choice between cleavage-stage and blastocyst-stage transfer (NCT03152643, https://clinicaltrials.gov/study/NCT03152643 ).

Date: 2024
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DOI: 10.1038/s41467-024-52008-y

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