Supplementary file 1_Sequential blastocyst transfer improved pregnancy outcomes in patients undergoing frozen-thawed embryo transfer cycles: who will be the ultimate beneficiary.docx

Stratified analyses revealed that, compared with the conventional group, the sequential group achieved a higher CPR (57.7% vs. 31.7%, p = 0.036) and implantation rate (36.5% vs. 20.7%, p = 0.044) among patients aged ≥ 40 years (exploratory analysis) and a lower multiple pregnancy rate (31.9% vs. 51.0%, p = 0.004) in patients aged < 35 years. Sequential blastocyst transfer was associated with a lower multiple pregnancy rate (27.8% vs. 48.8%, p = 0.036) and a higher LBR (58.4% vs. 41.7%, p = 0.041) in patients with 3 previous failed cycles, and a higher CPR (63.3% vs. 40.9%, p = 0.031) in patients with > 3 previous failed cycles.

Additionally, for patients with 0 high-quality blastocysts, the sequential group yielded a higher CPR (54.5% vs. 39.8%, p = 0.032) and implantation rate (34.7% vs. 25.2%, p = 0.033) than the conventional group. All subgroup analyses are exploratory due to limited statistical power and multiple comparisons.</p>Conclusions<p>Patients with ≥ 3 previous failed cycles or 0 high-quality blastocysts, or patients aged ≥ 40 years, may benefit from the sequential blastocyst transfer strategy.</p>