Abstract
This was a retrospective analysis of a total of 625 r-ICSI cycles using freeze-all-embryos and embryo transfers (ET) in subsequent cryopreservation-warming cycles to determine the effect of the ET method for day 1 rescue intracytoplasmic sperm injection cycles (r-ICSI). Two methods were used: in method 1, cleavage-stage embryos were frozen and were directly transferred in a subsequent cryopreservation-warming cycle (r-ICSI frozen cleavage), and 144 cleavage-stage ETs occurred. Similarly, in method 2, there were 188 blastocyst-stage ETs (r-ICSI frozen blast) performed. The live birth rate (LBR) for r-ICSI frozen blast was better than that for r-ICSI frozen cleavage in calculation of ET cycles (19.44% vs. 37.77%) and also remained better after the use of logistic regression analysis (OR = 2.721, 95% CI 1.604–4.616). Conservative cumulative LBR were compared between r-ICSI frozen cleavage and r-ICSI frozen blast with regard to oocyte retrieval cycles (17.39% vs. 15.30%). The same results were obtained for conservative cumulative LBR after logistic regression analysis (OR = 0.925, 95% CI 0.557–1.535). The results of this study confirmed that it was valuable to perform r-ICSI if using freeze-all-embryos. Further, r-ICSI embryos were cultured to blastocyst stage, cryopreserved, and used in subsequent cryopreservation-warming cycles, which was an effective embryo transfer strategy and obtained satisfactory results.
Highlights
This was a retrospective analysis of a total of 625 r-ICSI cycles using freeze-all-embryos and embryo transfers (ET) in subsequent cryopreservation-warming cycles to determine the effect of the ET method for day 1 rescue intracytoplasmic sperm injection cycles (r-ICSI)
Many embryologists believe that that r-ICSI has no clinical application because some studies have confirmed that the outcome of r-ICSI was poor on account of low clinical pregnancy rates, but it is worth noting that those studies were based only on cleavage embryo transfer (ET) in the fresh cycle[1,2]
For r-ICSI frozen cleavage, 502 available embryos were cryopreserved in the 132 cycles and 345 embryos were used for transfer in 144 subsequent cryopreservation-warming cycles, resulting in 24.31% pregnancy rate (PR), 11.59% implantation rate (IR), 19.44% live birth rate (LBR) and 31 newborns
Summary
This was a retrospective analysis of a total of 625 r-ICSI cycles using freeze-all-embryos and embryo transfers (ET) in subsequent cryopreservation-warming cycles to determine the effect of the ET method for day 1 rescue intracytoplasmic sperm injection cycles (r-ICSI). R-ICSI embryos were cultured to blastocyst stage, cryopreserved, and used in subsequent cryopreservation-warming cycles, which was an effective embryo transfer strategy and obtained satisfactory results. As reported in a previous study[9], the approximately 25–30% PR achieved in cryopreservation-warming cycles using r-ICSI is not a satisfactory clinical outcome This may be due to the transfer of cleavage embryos, which cannot guarantee good development potential, and are affected by the aging of eggs in particular. Blastocyst culture results in a decrease in the number of embryo transfer cycles, which may affect the final cumulative pregnancy rate To address these issues, the current study involved a retrospective analysis of a total of 625 r-ICSI cycles performed using freeze-all-embryos (from January 2013 to December 2016) and 144 cleavage-stage embryo transfers and 188 blastocyst-stage transfers in subsequent cryopreservation-warming cycles (from March 2013 to December 2018) in a single infertility center
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