Vitrification can modify embryo cleavage stage after warming. Should we change endometrial preparation?

• Published in: Journal of assisted reproduction and genetics Vol. 29; no. 12; pp. 1363 - 1368
• Main Authors: Cercas, R., Villas, C., Pons, I., Braña, C., Fernandez-Shaw, S.
• Format: Journal Article
• Language: English
• Published: Boston Springer US 01.12.2012; Springer Nature B.V
• Subjects: Adult; Assisted Reproduction Technologies; Blastocyst - cytology; Blastocyst - physiology; Cell division; Cleavage Stage, Ovum - cytology; Cleavage Stage, Ovum - physiology; Cryopreservation; Cryopreservation - methods; Embryo Culture Techniques; Embryo Implantation; Embryo Transfer - methods; Embryonic Development; Embryos; Endometrium; Female; Gynecology; Human Genetics; Humans; Medicine; Medicine & Public Health; Morula - cytology; Morula - physiology; Pregnancy; Pregnancy Rate; Prospective Studies; Reproductive Medicine; Vitrification; United States > US; Embryo cleavage; Progesterone; Vitrification; Endometrium; Blastocyst; Implantation window
• ISSN: 1058-0468; 1573-7330
• DOI: 10.1007/s10815-012-9881-0

Purpose Studies have shown that embryo metabolism and cell cleavage after warming vitrified embryos is faster than after thawing frozen embryos. We study vitrified embryo transfer (VET) results depending on the developmental stage of warmed embryos and the duration of progesterone treatment before embryo transfer. Methods We designed a prospective study, patients were randomized in two groups, starting progesterone three (D + 3) or four days (D + 4) before embryo transfer. We recruited 88 patients with embryos vitrified on day 3. Results We didn’t find statitistical differences in pregnancy rate when we transferred embryos in D + 3 vs D + 4 (38.2 % vs 40.5 % p  ≥ 0.05). The day after warming, 54.6 % of embryos had developed to morula or early blastocyst, 32.4 % to cleavage stage and 13 % didn’t cleave. Transfers were with morula/blastocysts stage embryos (52.1 %; n:37), cleavage stage embryos (18.3 %; n:13) or mixed (29.6 %; n:21). Implantation rate was significantly higher in morula/blastocyst stage than in cleavage stage or mixed transfers (44 %, 22 % and 16.3 %; p  = 0.011). Pregnancy and implantation rates were significantly higher in morula/blastocyst transfers on D + 4 than on D + 3 (68.7 % and 64.7 % vs 33.3 %, and 33.3 %, p  = 0.033 and p  = 0.034). Conclusions Our findings suggest that a majority of embryos will develop to morula/blastocyst stage after warming. VET results with morula/blastocysts, and after four days of progesterone supplementation, are better than with cleavage stage embryos.