{"id":125,"title":"Is blastocyst culture failure during first IVF cycle a sign of poor prognosis in subsequent cycles? A matched case-control study","title_zh":"首次IVF周期囊胚培养失败是否预示后续周期预后不良？一项匹配病例对照研究","url":"https://pubmed.ncbi.nlm.nih.gov/42966532","doi":"10.1016/j.jogoh.2026.103319","pmid":"42966532","journal":"J Gynecol Obstet Hum Reprod","kind":"paper","lang":"en","published_at":"2026-10-31T00:00:00+00:00","fetched_at":"2026-11-08T03:43:53+00:00","authors":["Boughzala I","Lammers J","Chaillot M","Freour T"],"primary_topic":"art-clinical","topics":[{"slug":"art-clinical","score":7.0,"hits":["blastocyst transfer","icsi","in vitro fertilization","ivf"]},{"slug":"early-embryo","score":6.0,"hits":["blastocyst","blastocysts","early embryo"]},{"slug":"oocyte","score":3.0,"hits":["oocyte","oocytes","ovarian reserve"]},{"slug":"repro-endo","score":3.0,"hits":["amh","diminished ovarian reserve","fsh"]},{"slug":"early-pregnancy","score":1.0,"hits":["pregnancy outcomes"]}],"topic_score":7.0,"preference_score":5.0,"preference_labels":["可转化到 ART 实验室的发现"],"llm_score":72.0,"final_score":77.0,"score_dims":{"novelty":60,"rigor":72,"impact":68,"relevance":95,"translation":80},"recommend_reason":"为临床咨询提供了直接的量化依据：首次囊胚培养全部失败后约七成患者次周期可获可移植囊胚，且基础FSH/AMH可辅助识别反复失败高风险者，对ART临床决策与患者沟通有实用价值；但为单中心回顾性设计，样本量中等，机制层面有限。","keywords":["囊胚培养失败","IVF预后","卵巢储备","AMH","基础FSH","倾向性评分匹配"],"selected":1,"story_id":254,"llm_provider":"deepseek","llm_model":"deepseek-flash","llm_effort":"low","source_key":"pubmed-art","source_name":"PubMed · 辅助生殖临床","source_tier":1,"mention_count":2,"has_interpretation":false,"journal_key":null,"journal_tier":"unknown","journal_if":null,"is_mock":false,"summary_zh":"该单中心回顾性匹配病例对照研究（2020–2023年，共1126个IVF/ICSI周期）比较了首次周期囊胚培养全部失败组（n=113）与倾向性评分匹配的对照组（n=113）。失败组获成熟卵母细胞数（6.54 vs 8.29）及第3天胚胎数（3.36 vs 5.31）均显著更低。但72.6%的首次失败患者在第二周期获得了可移植囊胚；第二周期再次失败与更高的基础FSH（8.01 vs 6.73）和更低的AMH（2.02 vs 3.79）相关。结论认为首次培养失败并非绝对成功障碍，多数患者可通过方案优化在后续周期获得囊胚，卵巢储备下降是反复失败的主要风险因素。","summary":"RESEARCH QUESTION: Embryonic development arrest in extended culture during in vitro fertilization (IVF) presents a major challenge to achieving successful pregnancy outcomes. While blastocyst transfer has become the preferred method due to improved implantation rates, a significant proportion of embryos fail to develop to the blastocyst stage, resulting in cycle cancellations and reduced chances of pregnancy. Does failure to reach the blastocyst stage in a first IVF cycle signal an inherently poor prognosis for future attempts? DESIGN: In this monocentric retrospective matched case-control study (2020-2023) analyzing 1,126 IVF/ICSI cycles, we compared outcomes of patients with total blastocyst culture failure (T1 Failure, n=113) against a propensity-score-matched control group (T1 Control, n=113). RESULTS: T1 Failure cycles were characterized by significantly fewer mature oocytes (6.54±4.78 vs. 8.29±4.5, p < 0.001) and Day 3 embryos (3.36±3.11 vs. 5.31±3.53, p < 0.001). Notably, 72.6% of patients with initial culture failure achieved transferable blastocysts in their second cycle (T2). In T2, repeat failure was specifically associated with higher basal FSH (8.01±2.85 vs. 6.73±1.87, p = 0.008) and lower AMH levels (2.02±1.48 vs. 3.79±5.43, p = 0.036). CONCLUSION: While initial failure is linked to lower oocyte yield and early embryo competence, it is not an absolute barrier to success. Most patients recover in subsequent cycles through protocol optimization, though diminished ovarian reserve remains the primary risk factor for recurrent failure. Our findings underscore the multifactorial nature of embryonic arrest and highlight potential clinical indicators for predicting and managing blastocyst development failure to optimize IVF success rates.","interpretation_basis":null,"fulltext_status":null,"interpretation":null,"fulltext":{"available":false,"status":null,"reason":"尚未抓取全文（未入选、分数未达阈值，或还没跑 fulltext 步骤）","pmcid":null,"license":null,"chars":0,"source":null,"fetched_at":null}}