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. 2020 Jul 15;18(1):72.
doi: 10.1186/s12958-020-00623-x.

Does the sex ratio of singleton births after frozen single blastocyst transfer differ in relation to blastocyst development?

Hua Lou  1 , Na Li  1 , Xiaoke Zhang  1 , Ling Sun  1 , Xingling Wang  1 , Dayong Hao  1 , Shihong Cui  2
Affiliations

Does the sex ratio of singleton births after frozen single blastocyst transfer differ in relation to blastocyst development?

Hua Lou et al. Reprod Biol Endocrinol. .

Abstract

Purpose: To investigate the associations between blastocyst development and the sex ratio (male:female) among singleton live births resulting from single-blastocyst frozen embryo transfer (FET) cycles.

Methods: Patients with singleton live births following the first autologous single FET of non- preimplantation genetic testing (PGT) blastocysts in a single reproductive medicine department between January 2015 and February 2019 were included in this retrospective study. The primary outcome measure was the singleton sex ratio. Multivariable logistic regression models were used to estimate the associations between blastocyst quality and singleton sex ratio after adjustment for some potential confounders.

Results: There were 638 high-quality and 572 poor-quality single blastocyst FETs, and the blastocysts were conceived via 855 IVF and 355 ICSI treatments. A total of 1210 singleton live births were assessed. High-quality single blastocyst FET resulted in a significantly higher sex ratio than did poor-quality single blastocyst FET (60% vs. 49.7%, P < 0.001). The infertility cause was not associated with sex ratio among singleton live births (P = 0.537). The results of a multivariate analysis revealed that a high-quality blastocyst has a 150% higher probability of being male than a poor-quality blastocyst (adjusted odds ratio (aOR) 1.57; 95% CI 1.24-2, P < 0.001). Among the three blastocyst morphological parameters, Grade B trophectoderm was significantly associated with a higher sex ratio than Grade C (aOR 1.71; 95% CI 1.33-2.21. P < 0.001). Neither expansion degree nor inner cell mass degree were significantly associated with the singleton sex ratio.

Conclusions: A single high-quality blastocyst FET has a higher chance of resulting in a male infant than a female infant. The results demonstrate that grade B trophectoderm confers benefits in improving the implantation potential of male blastocysts.

Keywords: Blastocyst; Frozen-thawed transfer; Inner cell mass; Sex ratio; Trophectoderm.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Data selection process for analysis of perinatal outcomes in singleton live births as a result of the first single blastocyst frozen embryo transfer (FET) cycles. Note: Flow chart showing exclusions made to singleton cycles for analysis data to identify component subsets that were merged to construct the final study dataset. PGT = preimplantation genetic testing
Fig. 2
Fig. 2
Sex ratio among singleton births following single blastocyst frozen embryo transfer (FET) cycles with different blastocyst qualities
Fig. 3
Fig. 3
Sex ratio among singleton births following single blastocyst frozen embryo transfer (FET) cycles by different grades of trophectoderm (TE) and inner cell mass (ICM). Note: Sex ratio adjusted for age, BMI, type of fertilization, day of embryo transfer. P < 0.05 was considered statistically significant. CI = confidence interval; TE = trophectoderm; ICM = inner cell mass
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References

    1. Penzias A, Bendikson K, Butts S. ASRM standard embryo transfer protocol template: a committee opinion. Fertil Steril. 2017;107:897–900. doi: 10.1016/j.fertnstert.2017.02.108. - DOI - PubMed
    1. Papanikolaou EG, Kolibianakis EM, Tournaye H, Venetis CA, Fatemi H, Tarlatzis B, et al. Live birth rates after transfer of equal number of blastocysts or cleavage-stage embryos in IVF. A Syst rev meta-analysis. Hum Reprod Update. 2008;23:91–99. doi: 10.1093/humrep/dem339. - DOI - PubMed
    1. Zhu D, Zhang J, Cao S, Heng BC, Huang M, Ling X, et al. Vitrified-warmed blastocyst transfer cycles yield higher pregnancy and implantation rates compared with fresh blastocyst transfer cycles–time for a new embryo transfer strategy? Fertil Steril. 2011;95:1691–1695. doi: 10.1016/j.fertnstert.2011.01.022. - DOI - PubMed
    1. De C, Colman R, de Sutter P, Tilleman K. Blastocyst transfer for all? Higher cumulative live birth chance in a blastocyst-stage transfer policy compared to a cleavagestage transfer policy. Facts Views Vis Obgyn. 2019;11(2):169–176. - PMC - PubMed
    1. Chen H, Lv J-Q, Wu X-M, Yu X, Xi H-T, Zhu C-F, et al. Blastocyst-stage versus cleavage-stage embryo transfer in the first frozen cycles of OHSS-risk patients who deferred from fresh embryo transfer. Gynecol Endocrinol. 2015;31(0951–3590):1–4. - PubMed

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