J Korean Med Sci.  2022 Mar;37(12):e96. 10.3346/jkms.2022.37.e96.

Does Post-Warming Extended Culture Duration Affect the Clinical and Obstetric Outcomes of Patients of Advanced Maternal Age? A SingleCenter Study

• Park JK
• Ahn SY
• Seok SH
• Chang EM
• Kim JW
• Kwak IP
• Lee WS

• KMID: 2527637
• DOI: http://doi.org/10.3346/jkms.2022.37.e96

Abstract

Background
The single vitrified-warmed blastocyst transfer (SVBT) cycle has been increasingly utilized for assisted reproductive technology. Women of advanced maternal age (AMA) comprise a significant portion of patients who have undergone ‘freeze-all’ cycles. This study investigated the association between the post-warming extended culture duration and pregnancy outcomes in patients of AMA.
Methods
This retrospective cohort study analyzed the outcomes of 697 SVBT cycles between January 2016 and December 2017. The cycles were divided into 3 groups based on the age of the female partners: group I: < 35 years (n = 407), group II: 35–37 years (n = 176); and group III, 38–40 years (n = 114). Data are shown as the mean ± standard error of the mean. Data were analyzed using one-way ANOVA followed by Duncan’s multiple range test. Statistical significance was set at P < 0.001.
Results
The blastocyst rate, clinical pregnancy rate, and live birth rate (LBR) was significantly lower in the AMA groups. However, there were no significant differences in LBR in the transfer between the AMA and younger groups according to blastocyst morphology and post-warming extended culture duration.
Conclusion
Post-warming extended culture of blastocysts is not harmful to patients of AMA. It could be a useful parameter in clinical counseling and decision making for fertility treatments.

Keyword

Maternal Age; Single Blastocyst Transfer; Blastocyst Culture Techniques; Morphological Grade

Figure

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  Fig. 1 Relationship between live birth rate (LBR) and morphological grades and groups. (A) The morphological grades have been sorted into three categories (good: excellent & good quality, average: fair quality, poor: poor quality). The good group had a significantly higher birth rate than average and poor groups (P < 0.001). However, the difference between the average and poor groups was not statistically significant. There was also no statistically significant difference when comparing individual groups within the same morphological grade. (B) LBR by transfer according to blastocyst culture duration and the woman’s age group. (C) Morphological grades by transfer according to blastocyst culture duration and the woman’s age group. The characteristics of the three groups are as follows: (Good + Average)/Total. Competency value, group I: age < 35 years, group II: age 35–37 years, group III: age 38–40 years.a,bDifferent letters within a column indicate significant differences at P < 0.05.

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