To delay or not to delay a frozen embryo transfer after a failed fresh embryo transfer attempt? (original) (raw)
Related papers
The effect of fresh IVF cycle characteristics on frozen embryo transfer (FET) outcomes
JBRA Assisted Reproduction, 2020
Objective: To determine the effect of fresh IVF/ICSI cycles on FET cycle embryo and pregnancy outcomes. Methods: This retrospective cohort study included data from the medical records of 104 FET cycles performed from January 2014 to December 2016. Embryos were previously vitrified and then thawed for embryo transfer. Statistical significance was established at p<0.05. The main endpoints were FET cycle survival and pregnancy rates. Results: A total of 104 FET cycles were analyzed for survival; 94 showed good progression and 84 achieved embryo transfers. Patients with secondary infertility achieved significantly higher pregnancy rates-6/38 (15.8%) vs. 18/46 (39.1%) (p<0.018). Stimulation with FSH/LH resulted in more significant embryo progression, 38/48 (79.2%) vs. 28/46 (60.9%) in the FSH group (p=0.01). Patients who got pregnant from fresh cycles had the highest pregnancy rates in FET cycles (p<0.0001). Lower numbers of frozen embryos correlated with higher pregnancy rates (p=0.048). Embryos frozen on day 2 or 3 had the most significant progression (p<0.0001). Freeze-thaw intervals >12 months yielded higher pregnancy rates, 13/30 (43%), vs. 11/54 (20.4%) (p=0.025). Conclusion: Patient pregnancy in fresh cycles is a good prognostic factor for FET cycle success. Delaying FET by more than 12 months might result in higher pregnancy rates.
Reproductive Biology and Endocrinology : RB&E, 2021
Background The optimal time at which to perform a frozen-thawed embryo transfer (FET) following a failed in-vitro fertilization-embryo transfer (IVF-ET) attempt remains elusive to most reproductive experts. Physicians often delay the introduction of FET due to concerns related to potential residual effects of ovarian hyperstimulation which may interfere with the regular menstrual cycle. Moreover, given that most of the published studies on the topic are retrospective and have inconsistent findings, it is crucial to develop evidence-based randomized control guides for clinical practice. Therefore, this well-designed randomized controlled trial (RCT) was conducted to determine whether it is necessary to delay FET for at least one menstrual cycle after the failure of fresh embryo transfer. Methods Infertile women eligible for IVF-ET were invited to participate in this multicenter, randomized, non-inferiority, parallel-group, unblinded, controlled trial at the academic fertility centers...
Volume 18, Issue 4, October , 2024
Background: Frozen embryo transfer (FET) has been increasingly used due to advancements in cryopreservation techniques and the safety advantages. This study aims to determine various factors influencing the successful FET. Materials and Methods: Retrospective cohort analysis included 1112 women who underwent programmed FET between January 2012 and October 2022, at King Chulalongkorn Memorial Hospital, Thailand. Patient characteristics, embryo characteristics, endometrial preparation protocol, endometrial characteristics (thickness, pattern), embryo transfer procedure (tip and flow during transfer, embryo placement location, the difficulty of the procedure, presence of blood and mucous at catheter), and operator factor were analyzed. Multiple logistic regression analysis was used to assess the relationship between collected variables and successful embryo transfer which is defined by clinical pregnancy. Results: The overall clinical pregnancy rate was 34.2%. Women aged 35-40 years and >40 years were less likely to have a clinical pregnancy compared to those aged <35 years [adjusted odds ratio (aOR): 0.523; 95% confidence intervals (CI): 0.360-0.757, P<0.001 and aOR: 0.260; 95% CI: 0.152-0.434, P<0.001, respectively]. Obese women with body mass index (BMI) ≥25 kg/m 2 were significantly associated with decreased clinical pregnancy (aOR: 0.632; 95% CI: 0.403-0.978, P=0.042) compared to those with normal BMI. Day-3 and day-4 embryo transfer showed a significant decrease in clinical pregnancy compared to blastocyst transfer (aOR: 0.294; 95% CI: 0.173-0.485, P<0.001 and aOR: 0.497; 95% CI: 0.265-0.900, P=0.024). Double embryo transfer (DET) was 1.78 times more likely to have a clinical pregnancy than women with single embryo transfer (SET) (aOR: 1.779; 95% CI: 1.293-2.458, P<0.001). The cycles with endometrial thickness <8 mm were associated with a decrease in clinical pregnancy compared with those with a thickness ≥8 mm (aOR: 0.443; 95% CI: 0.225-0.823, P=0.013). Conclusion: Older age, obesity, non-blastocyst transfer, single embryo transfer, and endometrial thickness of <8 mm were significantly associated with a decreased clinical pregnancy in programmed FET.
Fertility and sterility, 2018
To assess in vitro fertilization (IVF) and pregnancy outcomes in patients having their first frozen embryo transfer (FET) after a freeze-all cycle versus similar patients having their first fresh embryo transfer (ET). Retrospective cohort study. None. Registry data on 82,935 patient cycles from the Society for Assisted Reproductive Technology (SART). All first fresh autologous IVF cycles were analyzed and compared to first FET cycles after a freeze-all first IVF stimulation. The cycles were subdivided into cohorts based upon the number of oocytes retrieved (OR): 1-5 (low), 6-14 (intermediate), and 15+ (high responders). Univariate analyses were performed on cycle characteristics, and multivariable regression analyses were performed on outcome data. Clinical pregnancy rate (CPR) and live-birth rate (LBR). Of the 82,935 cycles analyzed, 69,102 patients had their first fresh transfer, and 13,833 had a first FET. High responders were found to have a higher CPR and LBR in the FET cycles ...
European Journal of Obstetrics & Gynecology and Reproductive Biology, 2019
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Embryo transfer duration and IVF success
2007
To study the influence of time taken for embryo transfer on the success rates of IVF. METHOD(S): A prospective study was done on 103 women recruited IVF at our unit in whom fresh embryo transfer was done. These cases were thoroughly studied as regards their age, duration of infertility, ease of transfer, and duration between loading and discharge of embryo and its statistical relationship with pregnancy and implantation rates. RESULTS: Pregnancy rate and implantation rate were found to be more among the women having less than 60 seconds duration between loading and discharge of embryo than in women where this duration was more. This difernce was found to be statistically significant (p<0.05). Furthermore, a significantly higher pregnancy and implantation rates were seen with easy embryo transfers. CONCLUSION : The time taken for loading and discharge of embryo could be an important prognostic factor for implantation and pregnancy rates in invitro fertilization programmes as the shorter the time higher the pregnancy rate.
The Egyptian Journal of Fertility of Sterility
Frozen embryo transfer (FET) is an important part of present-day IVF/ ICSI treatment. There is limited understanding of the factors affecting success rates after FET. The aim of this work to study the Clinical and laboratory factors which affect clinical pregnancy rate after frozen-thawed embryo transfer. Study design: This is three-center prospective study. Analysis was carried out on 150 consecutive FET cycles during the period from 2011-2015. The primary outcome was clinical pregnancy per cycle. We assessed the independent effect on clinical pregnancy of the following variables: female age, female age at embryo freezing, BMI, primary versus secondary infertility, cause & duration of infertility, LH/FSH ratio, protocol of fresh cycle, serum estradiol level before Human Chronic Gonadotropin (HCG) at fresh cycle, sperm source (testicular or ejaculated), day of freezing, pregnancy in the fresh cycle, storage duration of embryos, cause of, thawing method as well as number of thawed transferred embryo (s). Main results: Pregnancy rate in FET was 31%. Pregnancy rate was 21.6% in patient younger than 30 years old at fresh cycle with RR 2.31 with CI (1.72-7.37). Patients of age at FET more than 35 years to have positive outcome 9.4% of FET with 95% CI= (1.72-7.37).There was absolute risk increase of 2.91 between the two BMI groups (>=30 & <30) with 95% CI: (1.13-7.50) %. patients having explained cause of infertility would be 0.26 times as likely as patients having unexplained infertility to have positive outcome of FET with 95% CI= (0.12-0.55). Patients having abnormal semen analysis would be 1.44 times as likely as patients having normal analysis to have positive outcome of FET with 95% CI= (0.20-0.99). Patients having Negative Pregnancy outcome at fresh cycle would be 0.9 times as likely as patients having Positive Pregnancy outcome at fresh cycle but this is not significant 95% CI= (0.38-2.66). Patients with excess number of embryos as a cause of freezing would be 0.38 times as likely as patients of unusual Cause of freezing to have positive outcome of FET16.2% with 95% CI=(0.14-0.99). The chance of pregnancy increases significantly if >3 thawed embryos was transferred (odds ratio (OR) 0.34 95% confidence interval (CI) (0.12-0.97). Conclusion: Increased number of transferred thawed embryos is associated with increased clinical pregnancy; Age, BMI, cause of infertility, semen parameters, pregnancy at fresh cycle, endometrial thickness on the thawed embryo transfer day and cause of freezing. Number of transferred thawed embryos affected independently the clinical pregnancy rate in FET.
Fertility and Sterility, 2006
To compare the outcome of day 2 and day 3 embryo transfers in women demonstrating poor ovarian response. Prospective randomized clinical trial. Private assisted reproductive technology center. Two hundred eighty-one women demonstrating poor ovarian response to controlled ovarian hyperstimulation. Women who were poor responders were randomly allocated to day 2 or day 3 embryo transfer following oocyte retrieval. Implantation rates and pregnancy rates per oocyte retrieval and embryo transfer. The clinical pregnancy rates per oocyte retrieval (37.2% vs. 21.4%, respectively; P&amp;amp;amp;amp;amp;amp;amp;lt;.05) and per embryo transfer (38.9% vs. 24.1%, respectively; P&amp;amp;amp;amp;amp;amp;amp;lt;.05) were significantly higher in the day 2 embryo transfer group compared with day 3. On the other hand, implantation rates were not different between groups (23.9% vs. 17.2%, respectively; P=.08). Our results demonstrated that transfering embryos on day 2 could provide an alternative to the management of poor responder patients.
2021
Never investigated before in poor prognosis patients, we here determined how in vitro fertilization (IVF) outcomes after fresh embryo transfers compare to frozen-thawed transfers after embryo banking. Using data from our center’s anonymized electronic research data bank, we in a retrospective controlled observational study investigated IVF cycle outcomes of poor-prognosis infertility patients, utilizing autologous eggs, while utilizing donor-egg recipient cycles as controls for covariables. To accomplish statistically valid comparisons, 4 different pairings of 1st IVF cycles were utilized: (i) 127 fresh vs. 193 frozen donor recipient cycles; (ii) 741 autologous fresh unselected non-donor IVF cycles vs. 217 autologous frozen non-donor IVF cycles; (iii) 143 favorably selected autologous non-donor IVF cycles vs. the same 217 frozen autologous cycles non-donor; and (iv) 598 selected average and poor-prognosis autologous non-donor cycles vs. the same 217 frozen autologous non-donor cycle...