Comparison of pregnancy outcomes in single vitrified-warmed blastocyst transfers on day 5 versus day 6, without preimplantation genetic testing

Authors

DOI:

https://doi.org/10.33448/rsd-v14i6.49005

Keywords:

Embryo Transfer, Vitrification, Preimplantation Diagnosis, Blastocyst, Fertilization in Vitro.

Abstract

This study aimed to evaluate whether pregnancy outcomes differ between single vitrified-warmed blastocyst transfers on days 5 and 6 in hormone replacement therapy cycles without preimplantation genetic testing (PGT). A retrospective cohort study was conducted between 2022 and 2023, involving 108 single blastocyst transfers, 64 on day 5 and 44 on day 6. Participants were women under 42 years old who underwent intracytoplasmic sperm injection (ICSI), excluding cycles involving egg donation, multiple transfers, natural endometrial preparation, or PGT. No significant differences were observed in pregnancy rates (44% vs. 45%, p = 1), clinical pregnancy rates (41% vs. 41%, p = 1), live birth rates (39% vs. 34%, p = 0.687), or miscarriage rates (11% vs. 25%, p = 0.267). The results suggest that day-6 blastocysts in cycles without PGT and with controlled endometrial preparation yield clinical outcomes similar to day-5 blastocysts, offering reassurance to clinicians and patients.

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References

Akamine, C. T. & Yamamoto, R. K. (2009). Estudo dirigido: estatística descritiva. (3ed). Editora Érica.

Behr, B., Gebhardt, J., Lyon, J., & Milki, A. A. (2002). Factors relating to a successful cryopreserved blastocyst transfer program. Fertility and Sterility, 77(4), 697–699. https://doi.org/10.1016/S0015-0282(01)03267-8

Bourdon, M., Pocate-Cheriet, K., Finet De Bantel, A., Grzegorczyk-Martin, V., Amar Hoffet, A., Arbo, E., Poulain, M., & Santulli, P. (2019). Day 5 versus Day 6 blastocyst transfers: A systematic review and meta-analysis of clinical outcomes. Human Reproduction, 34(10), 1948–1964. https://doi.org/10.1093/humrep/dez163

Chen, C. H., Lee, C. I., Huang, C. C., Chen, H. H., Chang, C. Y., Cheng, E. H., Lin, P. Y., Chen, C. I., Lee, T. H., & Lee, M. S. (2023). Increased incidence of live births in implanted day 5 versus day 6 blastocysts following single embryo transfers with PGT-A. Scientific Reports, 13(1). https://doi.org/10.1038/s41598-023-40052-5

Committee of the American Society for Reproductive Medicine, P. (2013). Definitions of infertility and recurrent pregnancy loss: A committee opinion. Fertility and Sterility, 99(1), 63. https://doi.org/10.1016/j.fertnstert.2012.09.023

El-Toukhy, T., Wharf, E., Walavalkar, R., Singh, A., Bolton, V., Khalaf, Y., & Braude, P. (2011). Delayed blastocyst development does not influence the outcome of frozen-thawed transfer cycles. BJOG : an international journal of obstetrics and gynaecology, 118(13), 1551–1556. https://doi.org/10.1111/J.1471-0528.2011.03101.X

Estrela, C. (2018). Metodologia Científica: Ciência, Ensino, Pesquisa. Editora Artes Médicas.

Fang, C., Huang, R., Wei, L. N., & Jia, L. (2015). Frozen-thawed day 5 blastocyst transfer is associated with a lower risk of ectopic pregnancy than day 3 transfer and fresh transfer. Fertility and sterility, 103(3), 655-661.e3. https://doi.org/10.1016/J.FERTNSTERT.2014.11.023

Ferreux, L., Bourdon, M., Sallem, A., Santulli, P., Barraud-Lange, V., Le Foll, N., Maignien, C., Chapron, C., De Ziegler, D., Wolf, J. P., & Pocate-Cheriet, K. (2018). Live birth rate following frozen-thawed blastocyst transfer is higher with blastocysts expanded on Day 5 than on Day 6. Human Reproduction, 33(3), 390–398. https://doi.org/10.1093/humrep/dey004

Freeman, M. R., Hinds, M. S., Howard, K. G., Howard, J. M., & Hill, G. A. (2019). Guidance for elective single-embryo transfer should be applied to frozen embryo transfer cycles. Journal of assisted reproduction and genetics, 36(5). https://doi.org/10.1007/S10815-019-01433-W

Gardner, D. K., & Schoolcraft, W. B. (1999). Culture and transfer of human blastocysts. Current opinion in obstetrics & gynecology, 11(3), 307–311. https://doi.org/10.1097/00001703-199906000-00013

Glujovsky, D., Farquhar, C., Quinteiro Retamar, A. M., Alvarez Sedo, C. R., & Blake, D. (2016). Cleavage stage versus blastocyst stage embryo transfer in assisted reproductive technology. The Cochrane database of systematic reviews, 2016(6). https://doi.org/10.1002/14651858.CD002118.PUB5

Hu, J., Zheng, J., Li, J., Shi, H., Wang, H., Zheng, B., Liang, K., Rong, C., & Zhou, L. (2023). D6 high-quality expanded blastocysts and D5 expanded blastocysts have similar pregnancy and perinatal outcomes following single frozen blastocyst transfer. Frontiers in endocrinology, 14. https://doi.org/10.3389/FENDO.2023.1216910

Huang, B., Hu, D., Qian, K., Ai, J., Li, Y., Jin, L., Zhu, G., & Zhang, H. (2014). Is frozen embryo transfer cycle associated with a significantly lower incidence of ectopic pregnancy? An analysis of more than 30,000 cycles. Fertility and sterility, 102(5), 1345–1349. https://doi.org/10.1016/J.FERTNSTERT.2014.07.1245

Kaing, A., Kroener, L. L., Tassin, R., Li, M., Liu, L., Buyalos, R., Hubert, G., & Shamonki, M. (2018). Earlier day of blastocyst development is predictive of embryonic euploidy across all ages: essential data for physician decision-making and counseling patients. Journal of assisted reproduction and genetics, 35(1), 119–125. https://doi.org/10.1007/S10815-017-1038-8

Kontopoulos, G., Simopoulou, M., Zervomanolakis, I., Prokopakis, T., Dimitropoulos, K., Dedoulis, E., Grigorakis, S., Agapitou, K., Nikitos, E., Rapani, A., & Vlahos, N. (2019). Cleavage Stage versus Blastocyst Stage Embryo Transfer in Oocyte Donation Cycles. Medicina (Kaunas, Lithuania), 55(6). https://doi.org/10.3390/MEDICINA55060293

O. R. & Costa Neto, P. L. O. (2009). Análise estatística da decisão. (2ed). Ed. Edgar Blucher.

Pereira A. S. et al. (2018). Metodologia da pesquisa científica. [free e-book]. Ed.UAB/NTE/UFSM.

Shapiro, B. S., Richter, K. S., Harris, D. C., & Daneshmand, S. T. (2001). A comparison of day 5 and day 6 blastocyst transfers. Fertility and Sterility, 75(6), 1126–1130. https://doi.org/10.1016/S0015-0282(01)01771-X

Shitsuka et al. (2014). Matemática fundamental para a tecnologia. São Paulo: Ed. Érica.

Steptoe, P. C., & Edwards, R. G. (1978). Birth after the reimplantation of a human embryo. Lancet (London, England), 2(8085), 366. https://doi.org/10.1016/S0140-6736(78)92957-4

Styer, A. K., Wright, D. L., Wolkovich, A. M., Veiga, C., & Toth, T. L. (2008). Single-blastocyst transfer decreases twin gestation without affecting pregnancy outcome. Fertility and Sterility, 89(6), 1702–1708. https://doi.org/10.1016/j.fertnstert.2007.05.036

Sundhararaj, U., Madne, M., Biliangady, R., Gurunath, S., Swamy, A., & Gopal, I. (2017). Single Blastocyst Transfer: The Key to Reduce Multiple Pregnancy Rates Without Compromising the Live Birth Rate. Journal of human reproductive sciences, 10(3), 201–207. https://doi.org/10.4103/JHRS.JHRS_130_16

Toassi, R. F. C. & Petry, P. C. (2021). Metodologia científica aplicada à área da Saúde. (2ed). Editora da UFRGS.

Tubbing, A., Shaw-Jackson, C., Ameye, L., Colin, J., Rozenberg, S., & Autin, C. (2018). Increased live births after day 5 versus day 6 transfers of vitrified-warmed blastocysts. Journal of Assisted Reproduction and Genetics, 35(3), 417–424. https://doi.org/10.1007/S10815-017-1097-X

Vieira, S. (2021). Introdução à bioestatística. Ed.GEN/Guanabara Koogan. Bekman,

Yang, H., Yang, Q., Dai, S., Li, G., Jin, H., Yao, G., & Sun, Y. (2016). Comparison of differences in development potentials between frozen-thawed D5 and D6 blastocysts and their relationship with pregnancy outcomes. Journal of Assisted Reproduction and Genetics, 33(7), 865–872. https://doi.org/10.1007/s10815-016-0712-6

Yin, B., Li, S., Sun, L., Yao, Z., Cui, Y., Zhang, C., & Zhang, Y. (2024). Comparing Day 5 versus Day 6 euploid blastocyst in frozen embryo transfer and developing a predictive model for optimizing outcomes: a retrospective cohort study. Frontiers in endocrinology, 14, 1302194. https://doi.org/10.3389/fendo.2023.1302194

Yu, Q., He, H., Ren, X. ling, Hu, S. fu, & Jin, L. (2023). Pregnancy Outcomes for Day 5 Versus Day 6 Single Frozen-thawed Blastocyst Transfer with Different Qualities of Embryos: A Large Matched-cohort Study. Current Medical Science, 43(2), 297–303. https://doi.org/10.1007/s11596-023-2699-4

Published

2025-06-18

Issue

Section

Health Sciences

How to Cite

Comparison of pregnancy outcomes in single vitrified-warmed blastocyst transfers on day 5 versus day 6, without preimplantation genetic testing. Research, Society and Development, [S. l.], v. 14, n. 6, p. e6414649005, 2025. DOI: 10.33448/rsd-v14i6.49005. Disponível em: https://ojs34.rsdjournal.org/index.php/rsd/article/view/49005. Acesso em: 28 jun. 2025.