Comparison of pregnancy rate between fresh embryo transfers and frozen-thawed embryo transfers following ICSI treatment (original) (raw)
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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.
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.
Evidence Based Women's Health Journal, 2017
Objective: To study pregnancy rates after vitrified-thawed embryo transfer and fresh embryo transfer. Design: Retrospective study. Setting: Infertility and IVF unit, Minia University Hospital. Patients and Methods: All women undergone ICSI program during the period from first of January 2010 to December 2014, pregnancy rate was compared between two groups, first group (Group I) had fresh embryo transfer, the second group (Group II) had vitrified-thawed embryo transfer. Main outcome: Clinical pregnancy rate. Results: There was insignificant difference between two groups regarding chemical pregnancy rate it was 228 (43%) in (Group I), 36% (186) in the second group (Group II). Clinical pregnancy rate 24.5 % (130) versus 22.1% (114). Implantation rate 28.6 % versus 24%. The rate of single pregnancy was higher in the first group 80% than in the second group 76.4%. The rate of twins was higher in the second group 23.6 %. Conclusion: A program of vitrified-thawed embryo transfer should be adopted by all IVF center especially in low-income countries to maximize the benefit of the single treatment cycle, increase cumulative pregnancy rate and decrease the cost of repeated cycle stimulation, as the pregnancy rate is almost equal in FET and fresh embryo transfer.
Fresh versus frozen embryo transfer: a retrospective cohort study
International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Background: Elective frozen embryo transfer (FET), has recently increased significantly with improvements in cryopreservation techniques. Observational studies and randomized controlled trials suggested that the endometrium in stimulated cycles is not optimally prepared for implantation; risk of ovarian hyperstimulation syndrome reduced and pregnancy rates increased following FET and perinatal outcomes are less affected after FET. However, the evidence is not unequivocal and recent randomised control trials challenge the use of elective FET for the general IVF population. Pregnancy rates were analysed in a cohort of patients undergoing embryo transfers.Methods: This was a retrospective cohort study of patients who underwent embryo transfers from April 2018 to March 2019 at study centre in Surat.175 cycles of embryo transfers (119 fresh and 56 frozen) were included in the study. Outcomes measured were positive pregnancy, clinical pregnancy and ongoing clinical pregnancy rates achieve...
The Journal of Obstetrics and Gynecology of India, 2015
Introduction Advanced fertilization techniques like frozen embryo transfer (FET) and assisted reproductive technology have become popular and commonly used methods to treat patients suffering from infertility. Incidences of infertility are on a rise due to increased representation of females in the work place, delay in marriages, stress, and ignorance. Methods We performed this prospective therapeutic study to compare FET and fresh embryo transfer in the treatment of infertility in terms of conception rate, patient acceptance, complications, and patient's compliance. A prospective screening therapeutic study on 108 patients, from September 2013 to September 2014 in Karnataka, India, randomized the patients into 2 groups (n = 54), Group-I treated with day-3 FET while Group-II was treated with fresh embryo transfer, after performing ICSI. Results In 108 patients, 45 % patients were within 35 years of age, 35 % were in the age group 35-39. Significantly, 22 (40.75 %) patients treated with FET conceived (P = 0.022), whereas 16 (29.63 %) patients treated with fresh embryo transfer conceived (P = 0.59).
Frozen embryo transfers: implications of clinical and embryological factors on the pregnancy outcome
Human Reproduction, 2006
BACKGROUND: Frozen embryo transfers are characterized by impaired pregnancy outcome and increased incidence of pregnancy loss as compared with fresh IVF/ICSI embryo transfers. In this study, we performed a retrospective analysis of clinical and embryological factors that potentially influence the outcome of frozen embryo transfer. METHODS: We reviewed the outcome of 1242 frozen embryo transfers with respect to the age of the woman, the method of fertilization, embryo quality before and after freezing and the number of embryos transferred. RESULTS AND CONCLUSIONS: The pregnancy (positive hCG) and clinical pregnancy rates were 25.8 and 21.1%, respectively. A total of 107 (33.3%) of the 321 pregnancies identified by a positive hCG test miscarried either before (18.4%) or after (15%) the clinical recognition of gestational sac(s). The delivery rate for the frozen embryo transfers analysed was 17.2%. Our data revealed that the delivery rate after frozen embryo transfer was dependent on both the woman's age and the quality of embryos transferred, at the same time being unaffected by IVF/ICSI treatment. In addition, the increased woman's age at IVF/ICSI treatment was identified as the only parameter elevating the biochemical pregnancy rate, whereas the clinical abortion rate was found to be unrelated to the clinical or embryological parameters studied.
Romanian Journal of Medical Practice
Objectives. To evaluate which type of embryo transfer (ET) has a superior pregnancy rate. Material and method. Prospective observational non-randomized study including 79 women that underwent 145 ET. Outcomes. The results show that the highest biochemical pregnancy rate (BPR) was in the fresh day 3 ET group (47.62%), but in this group there were also the highest abortion rate (80%) and the highest premature birth rate (100%), giving that, after 21 fresh day 3 ET did not result any term live birth. The frozen day 3 embryo has the lowest BPR (30%), but also the lowest abortion rate (33.33%) and the lowest premature birth rate (0%), in the present study after 13 frozen day 3 ET resulting 2 full-term births (15.38%). The results for the fresh day 5 blastocyst show a good BPR (43.48%), a low abortion rate (33.33%) and the lowest premature birth rate (0%), giving that in the study performed after 23 day 5 ET resulted 4 newborns at term (15.38%). The frozen day 5 blastocyst has a very good...
Reproductive Health, 2019
Background: Infertility affects one in seven couples; many of these need in vitro fertilisation (IVF). IVF involves external hormones to stimulate a woman's ovaries to produce eggs which are harvested surgically. Embryos, created in the laboratory by mixing eggs with sperm, are grown in culture for a few days before being replaced within the uterus (fresh embryo transfer). Spare embryos are usually frozen with a view to transfer at a later point in timeespecially if the initial fresh transfer does not result in a pregnancy. Despite improvements in technology, IVF success rates remain low with an overall live birth rate of 25-30% per treatment. Additionally, there are concerns about health outcomes for mothers and babies conceived through IVF, particularly after fresh embryo transfer, including maternal ovarian hyperstimulation syndrome (OHSS) and preterm delivery. It is believed that high levels of hormones during ovarian stimulation could create a relatively hostile environment for embryo implantation whilst increasing the risk of OHSS. It has been suggested that freezing all embryos with the intention of thawing and replacing them within the uterus at a later stage (thawed frozen embryo transfer) instead of fresh embryo transfer, may lead to improved pregnancy rates and fewer complications. We aim to compare the clinical and cost effectiveness of fresh and thawed frozen embryo transfer, with the primary aim of identifying any difference in the chance of having a healthy baby.
Fertility and Sterility, 2010
In this randomized trial study, two groups of infertile women (n ¼ 55) aged %40 years underwent in vitro fertilization or intracytoplasmic sperm injection treatment cycles with or without 0.2 mL of air pushed into the catheter after embryo transfer. The implantation and clinical pregnancy rates were statistically significantly higher in the study group than in the controls. This improvement on standard ET technique may advance clinical pregnancy rates.