Abstract
ObjectiveTo investigate whether patients with a history of recurrent implantation failure (RIF) are associated with adverse perinatal outcomes in singleton live births following frozen-thawed embryo transfer (FET) cycles.DesignRetrospective cohort study.MethodsThis study analyzed the obstetric and neonatal outcomes of patients with and without a history of RIF who underwent FET cycles in a single reproductive center between January 2017 and October 2020. A total of 1,100 women with singleton live births beyond 28 weeks of gestation were included. The primary outcome measures were perinatal outcomes, especially gestational age, birthweight, preterm birth (PTB), large for gestational age (LGA), small for gestational age (SGA), congenital malformation rates, and premature rupture of the membranes (PROM). Multiple logistic regression was used to establish relationships between RIF and adverse perinatal outcomes after adjusting for relevant baseline demographics and cycle characteristics.Result(s)The RIF group showed a preferred transfer of two embryos and cleavage embryos compared with the control group (P <0.05). Regarding perinatal outcomes in singleton deliveries, women with RIF had increased rates of LBW (adjusted odds ratio [aOR] 2.027; 95% confidence interval [CI], 1.025–4.009), PTB (aOR 1.785; 95% CI, 1.050–3.036), and PROM (aOR 2.259; 95% CI, 1.142–4.467). The incidence of congenital malformations was similar between the two groups (4.1% vs. 2.4%; P = 0.759). Furthermore, multiple intrauterine procedures were associated with a statistically significant increased risk of PROM in RIF patients (aOR 1.537; 95% CI, 1.105–2.137).ConclusionsWomen with a history of RIF were associated with an increased risk of LBW, PTB, and PROM in singleton live births after FET cycles. In addition, multiple intrauterine procedures were independent risk factors for PROM.
Highlights
Assisted reproductive technology (ART) has improved substantially over the past four decades and has brought hope to thousands of infertile families [1]
The proportion of secondary infertility (66.30% vs. 50.36%; P
The results of this retrospective cohort analysis indicated that patients with a history of RIF are associated with adverse perinatal outcomes in singleton live births following frozen-thawed embryo transfer (FET) cycles
Summary
Assisted reproductive technology (ART) has improved substantially over the past four decades and has brought hope to thousands of infertile families [1]. Many couples still fail to become pregnant for unexplained reasons, even after multiple attempts at embryo transfer, which undoubtedly places tremendous mental pressure and economic burden on the patients and their families. This is often described as recurrent implantation failure (RIF); so far, there is no universally accepted consensus on the definition of RIF. A number of procedures, namely, the administration of endometrial scraping and perfusion of granulocyte colony-stimulating factor (G-CSF) before embryo transfer have been developed to improve endometrial receptivity and decrease the incidence of implantation failure in in vitro fertilization (IVF) cycles [4–6]
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