Huijun Chen, Jian Li, Sufen Cai, Sha Tang, Suimin Zeng, Chang Chu, Carl-Friedrich Hocher, Benjamin Rösing, Bernhard K Krämer, Liang Hu, Ge Lin, Fei Gong, Berthold Hocher
The Journal of Clinical Endocrinology & Metabolism, Volume 107, Issue 1, January 2022, Pages e143–e152
https://doi.org/10.1210/clinem/dgab594
The risk of developing gestational diabetes mellitus (GDM) is higher in women undergoing assisted reproductive treatment than in women conceiving spontaneously.
To determine whether the GDM risk after day-3 embryo transfer differs from the GDM risk after day-5 blastocyst transfer.
Prospective observational study in women becoming pregnant after first fresh embryo or blastocyst transfer.
A total of 1579 women got pregnant and had live birth; 1300 women got day-3 embryo transfer only, whereas 279 women received at least 1 blastocyst. Of 1579 women, 252 developed GDM. Age, body mass index, baseline estradiol, baseline high-density lipoprotein, and progesterone on the day of human chorionic gonadotropin injection were not different in women receiving day-3 embryos only vs women receiving at least 1 blastocyst. The number and quality of retrieved oocytes were not different in women receiving day-3 embryo transfer from those receiving blastocysts. Our study confirmed already established GDM risk factors such as age and body mass index, baseline estradiol, and high-density lipoprotein, as well as progesterone after ovarian stimulation. We furthermore demonstrate that the GDM incidence in women receiving day-5 blastocyst transfer was significantly higher than those who received day-3 embryo transfer (21.15% vs 14.85%; P = 0.009). Considering confounding factors, we likewise saw that blastocyst transfer was an independent procedure-related GDM risk factor [P = 0.009, Exp (B): 1.56, 95% CI: 1.12–2.18].
Blastocyst transfer after in vitro fertilization/intracytoplasmic sperm injection increases the risk of developing GDM.
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