Does the transfer of a poor-quality embryo along with a good-quality embryo influence the intracytoplasmic sperm injectionembryo transfer outcomes? A cross-sectional study

Background: Embryo quality is one of the most important factors influencing the success of assisted reproductive treatments. Objective: This study aimed to evaluate the effect of transferring poor-quality embryos along with good-quality embryos on intracytoplasmic sperm injection outcomes. Materials and Methods: In this cross-sectional study, data of ۱۲۴ women who underwent intracytoplasmic sperm injection and embryo transfer from January to December ۲۰۲۳ at Kamali hospital, Karaj, Iran were extracted from their medical records. Participants were classified into ۳ groups: group ۱ (n = ۳۲) received only high-quality embryos (grades ۱-۲; A), group ۲ (n = ۳۴) received only poor-quality embryos (grades ۳-۴; B), and group ۳ (n = ۵۸) received a combination of both (A+B). Chemical pregnancy, clinical pregnancy, and miscarriage rates were measured. Results: Chemical pregnancy rates were ۵۳.۱%, ۳۲.۴%, and ۴۴.۸% in groups ۱, ۲, and ۳, respectively (p = ۰.۲۲۷). Clinical pregnancy rates were significantly higher in group ۱ (۸۲.۴%) compared with group ۲ (۵۴.۵%) and group ۳ (۷۶.۹%) (p = ۰.۰۰۱). Miscarriage rates were ۱۷.۶%, ۲۷.۳%, and ۲۶.۹%, respectively, with no significant difference (p = ۰.۸۱). Multivariate logistic regression adjusting for female age and body mass index confirmed that the embryo quality group was a significant independent predictor of clinical pregnancy. Compared to group ۲ (only poor-quality embryos), the adjusted odds ratio for achieving a clinical pregnancy was ۴.۱۲ (۹۵% confidence interval: ۱.۱۵-۱۴.۷۸, p = ۰.۰۳۰) for group ۱ and ۳.۰۵ (۹۵% confidence interval: ۱.۰۱-۹.۲۲, p = ۰.۰۴۸) for group ۳. Conclusion: Transfer of high-quality embryos (grade A) yielded the best pregnancy outcomes. However, when high-quality embryos are limited, transferring a combination of good- and poor-quality embryos may improve outcomes compared with transferring only poor-quality embryos.

کلیدواژه ها:

Infertility ، Embryo quality ، Intracytoplasmic sperm injection ، Embryo transfer ، Pregnancy outcome. ، ناباروری ، کیفیت جنین ، تزریق داخل سیتوپلاسمی اسپرم ، انتقال جنین ، پیامدهای بارداری.