Effect of laser-assisted hatching on birth weight in blastocyst cultureof low-grade cleavage embryos
LI Shishi1, ZHU Zhonglin2, SHU Chongyi1, XU Weihai3
1. Department of Reproductive Endocrinology, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang 310014, China; 2. Anhui University of Science and Technology, Huainan, Anhui 232001, China; 3. Reproductive Medicine Center,The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang 310003, China
Abstract：Objective To examine the impact of laser-assisted hatching (LAH) technique on perinatal outcomes in blastocyst culture of low-grade cleavage embryos, so as to provide insights into improving the utilization of low-grade cleavage embryos and embryo quality. Methods A total of 369 single live births after transfer of thawed blastocysts following in vitro fertilization or intracytoplasmic sperm injection at Zhejiang Provincial People's Hospital were selected as subjects, and they were divided into 51 conventional culture blastocysts and 318 LAH blastocysts based on whether LAH was performed on day 4 of blastocyst culture. Gestational age, birth weight, birth defects and maternal perinatal information were collected, and the prevalence of premature birth, birth weight and birth defects were analyzed after propensity score matching (PSM). Results After PSM, 98 matched cases were included in the study. There were no statistically significant differences in maternal age, body mass index, type of infertility and blastocyst age (P>0.05), indicating effective matching. The birth weight of offspring in the LAH group was lower than that in the conventional culture group [(3 261.08±432.24) g vs. (3 464.18±444.46) g; P<0.05]. Conclusion The birth weight of offspring can be reduced by using LAH during blastocyst culture of low-grade cleavage embryos.
[1] SALLEM A,SANTULLI P,BARRAUD-LANGE V,et al.Extended culture of poor-quality supernumerary embryos improves ART outcomes[J].J Assist Reprod Gen,2017,35(2):311-319. [2] XU W H,ZHANG L,ZHANG L,et al.Laser-assisted hatching in lower grade cleavage stage embryos improves blastocyst formation:results from a retrospective study[J].J Ovarian Res,2021,14(1):1-9. [3] HONGUNTIKAR S D,UPPANGALA S,SALIAN S R,et al.Laser-assisted hatching of cleavage-stage embryos impairs developmental potential and increases DNA damage in blastocysts[J].Lasers Med Sci,2015,30(1):95-101. [4] SHAFEI R A,SYRKASHEVA A G,ROMANOV A Y,et al.Blastocyst hatching in humans[J].Russ J Dev Biol,2017,48(1):5-15. [5] 周易尔,徐维海,李施施,等.激光辅助孵化对冻融胚胎移植子代发育的影响[J].预防医学,2020,32(12):1236-1238. [6] JI M X,JIN B H,GUO X Y,et al.It is not worth postponing frozen embryo transfers after oocyte pickup:a retrospective cohort study based on propensity score matching[J].Front Endocrinol(Lausanne),2022,13:1-10. [7] Balaban B,Brison D,Calderon G,et al.The Istanbul consensus workshop on embryo assessment:proceedings of an expert meeting[J].Hum Reprod,2011,26(6):1270-1283. [8] Gardner D K,Lane M,Stevens J,et al.Blastocyst score affects implantation and pregnancy outcome:towards a single blastocyst transfer[J].Fertil Steril,2000,73(6):1155-1158. [9] YANG J D,WEN Y X,LI D P,et al.Retrospective analysis of the endometrial preparation protocols for frozen-thawed embryo transfer cycles in women with endometriosis[J].Reprod Biol Endocrinol,2023,21(1):1-9. [10] LI M,SINGH B,BAKER V L.Association between embryo morphological quality and birth weight for singletons conceived via autologous fresh embryo transfer:an analysis using Society for Assisted Reproductive Technology Clinical Outcomes Reporting System[J].Fertil Steril,2022,118(4):715-723. [11] CAI J L,LIU L L,CHEN J H,et al.Day-3-embryo fragmentation is associated with singleton birth weight following fresh single blastocyst transfer:a retrospective study[J].Front Endocrinol,2022,13:1-11. [12] LEESE H J,DONNAY I,THOMPSON J G.Human assisted conception:a cautionary tale.Lessons from domestic animals[J].Hum Reprod,1998,13(4):184-202. [13] HARDY K,STARK J,WINSTON R M .Maintenance of the inner cell mass in human blastocysts from fragmented embryos[J].Biol Reprod,2003,68(4):1165-1169. [14] SPARANO S,AHRENS W,DE HENAUW S,et al.Being macrosomic at birth is an independent predictor of overweight in children:results from the IDEFICS Study[J].Matern Child Health J,2013,17(8):1373-1381. [15] GU S Y,AN X F,FANG L,et al.Risk factors and long-term health consequences of macrosomia:a prospective study in Jiangsu Province,China[J].J Biomed Res,2012,26(4):235-240. [16] CHI H J,KOO J J,CHOI S Y,et al.Fragmentation of embryos is associated with both necrosis and apoptosis[J].Fertil Steril,2011,96(1):187-192.
