Blastocyst-stage embryos provide better frozen-thawed embryo transfer outcomes for young patients with previous fresh embryo transfer failure.

Lanlan Fang,Jingyan He,Yang Yan,Qiongqiong Jia,Jung-Chien Cheng,Ruizhe Zhang,Yiping Yu,Ying-Pu Sun

doi:10.18632/aging.103055

Lanlan Fang, Jingyan He + Show 6 more

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https://doi.org/10.18632/aging.103055

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Abstract

Older patients or patients with a reduced ovarian response have a low number of embryos, which limits the opportunity for embryo selection. However, for young patients undergoing frozen-thawed embryo transfer (ET), it remains unclear whether embryo stage affects pregnancy outcomes. In the present study, a total of 2952 patients undergoing their first frozen-thawed ET were divided into two groups: patients who had experienced one failed fresh ET (Group A) and patients who had not received fresh ET because of the high risk of ovarian hyperstimulation syndrome (OHSS) (Group B). Our results show that Group B patients had a significantly higher clinical pregnancy rate (CPR) and live birth rate (LBR) than Group A patients. However, Group A patients who underwent blastocyst-stage frozen-thawed ET had a significantly higher CPR and LBR and a lower ectopic pregnancy rate (ePR) than did those who underwent cleavage-stage frozen-thawed ET. In Group B, CPR, ePR, LBR and spontaneous abortion rate (sAR) were similar with blastocyst-stage and cleavage-stage frozen-thawed ET. These results suggest that blastocyst-stage frozen-thawed ET is more appropriate for young patients who had previously undergone one failed fresh ET cycle.

Highlights

Frozen-thawed embryo transfer (ET) has been an essential part of assisted reproductive therapies (ART) since the first successful frozen-thawed ET was reported [1]
No significant differences in ectopic pregnancy rate or spontaneous abortion rate were found between the two groups
We observed that young patients undergoing frozen-thawed ET who had one previous failed fresh ET (Group A) had lower clinical pregnancy rate (CPR) and live birth rate (LBR) than those who had not experienced one failed fresh ET because of the high risk of ovarian hyperstimulation syndrome (OHSS) (Group B)

Summary

Introduction

Frozen-thawed embryo transfer (ET) has been an essential part of assisted reproductive therapies (ART) since the first successful frozen-thawed ET was reported [1]. Frozen-thawed ET enables the redundant embryos generated by in vitro fertilization/intra-cytoplasmic sperm injection (IVF/ICSI) to be stored and utilized after one cycle of ovarian stimulation and increases cumulative pregnancy rates and reduces the economic burden and physical injury to ART patients. Compared with fresh ET, frozenthawed ET provides better interaction between embryo/blastocyst and endometrium which leads to a higher clinical pregnancy rate (CPR) [3,4,5,6]. For frozen-thawed ET, the selection of cleavage-stage embryo versus blastocyst-stage embryo remains controversial. Live birth rate (LBR) has been reported to be significantly higher for patients undergoing fresh www.aging-us.com blastocyst-stage ET than for those undergoing fresh cleavage-stage ET [10].

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