ArticleBMC pregnancy and childbirth2024
Comparison of pregnancy outcomes between 4th day morula and 5th day blastocyst after embryo transfer: a retrospective cohort study.
Article in BMC pregnancy and childbirth, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Not all Day-4 embryos are equal: developmental stage predicts outcomes after single embryo transfer.Journal of assisted reproduction and genetics · 2026Article
- Clinical outcomes of co-transfer of partially and fully compacted morula versus fully compacted morula alone on day 4.Frontiers in endocrinology · 2026Article
- Development and validation of a predictive model for early blastocyst formation on day 4 post-fertilization.Frontiers in endocrinology · 2026Article
- Comparative outcomes of day 4 versus day 5 embryo transfers by fertilization method.Frontiers in endocrinology · 2026Article
- Elective single morula transfer achieved better clinical outcomes than two cleavage embryos transfer in fresh IVF-ET cycles.BMC pregnancy and childbirth · 2025Article
- Interaction between embryo transfer timing (D3/D4) and duration of progesterone exposure (P3/P4) on live birth rate in hormone replacement therapy cycles of frozen embryo transfer.Reproductive biology and endocrinology : RB&E · 2025Article
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Authors and funding
6 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundThis study was designed to evaluate pregnancy outcomes between morulae transferred on day 4 (D4) and blastocysts transferred on day 5 (D5).
methodsFrom September 2017 to September 2020, 1963 fresh transfer cycles underwent early follicular phase extra-long protocol for assisted conception in our fertility center were divided into D4 (324 cases) and D5 (1639 cases) groups, and the general situation and other differences of patients in both groups were compared. To compare the differences in pregnancy outcomes, the D4 and D5 groups were further divided into groups A and B based on single and double embryo transfers. Furthermore, the cohort was divided into two groups: those with live births (1116 cases) and those without (847 cases), enabling a deeper evaluation of the effects of D4 or D5 transplantation on assisted reproductive outcomes.
resultsIn single embryo transfer, there was no significant difference between groups D4A and D5A (P > 0.05). In double embryo transfer, group D4B had a lower newborn birthweight and a larger proportion of low birthweight infants (P < 0.05). The preterm delivery rate, twin delivery rate, cesarean delivery rate, and percentage of low birthweight infants were lower in the D5A group than in the D5B group (P < 0.05). Analysis of factors influencing live birth outcomes further confirmed the absence of a significant difference between D4 and D5 transplantation in achieving live birth (P > 0.05).
conclusionWhen factors such as working life and hospital holidays are being considered, D4 morula transfer may be a good alternative to D5 blastocyst transfer. Given the in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) success rate and risk of twin pregnancy, D4 morula transfer requires an adapted decision between single and double embryo transfer, although a single blastocyst transfer is recommended for the D5 transfer in order to decrease the twin pregnancy rate. In addition, age, endometrial thickness and other factors need to be taken into account to personalize the IVF program and optimize pregnancy outcomes.
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