IMMEDIATE START IVF STIMULATION FOLLOWING POLYPECTOMY DOES NOT IMPACT PREGNANCY OUTCOMES IN LARGE MULTICENTER COHORT OF OVER SIXTEEN HUNDRED EMBRYO TRANSFERS

Abstract

To determine if delayed IVF stimulation start after hysteroscopic polypectomy (HP) has superior pregnancy outcomes when compared to an immediate start in both fresh and frozen embryo transfers (FET). We analyzed IVF cycles following HP from 2017 - 2021 at a large multicenter private practice. Cohorts of fresh and frozen embryo transfers performed after HP were identified using standard CBT codes. These cohorts were divided into 3 groups consistent with prior studies according to time to embryo transfer at intervals of: within 28 days, 28-90 days, and 28-180 days for both fresh and FET. The interval “within 28 days” represented “immediate IVF stimulation start.” All other time intervals were compared to the “immediate start” group. To identify significant differences between groups, chi square analysis and linear regression were utilized to compare between groups with p values <0.05 for significance. Lastly, a continuous analysis of the number of days from HP to ET compared with live birth was made utilizing GEE analysis for all transfers. A total of 1619 cases were identified as undergoing frozen or fresh embryo transfers following HP, including 488 fresh and 1131 FET. Controlling for age, BMI, and PGT for aggregate FETs and fresh transfers, there was no difference in live birth when comparing the number of days from HP to ET (p= 0.984). Specifically, the time to embryo transfer was not associated with negative pregnancy outcomes from either fresh or FET, when comparing intervals of less than 28d, 28-90d and 28-180 days post HP; fresh (p= 0.14) or FET (p = 0.31). Pregnancy outcomes included not pregnant (NP), spontaneous abortion (SAB), ongoing pregnancy (ONG), stillbirth (SB), and live birth (LB). Delaying either fresh or frozen embryo transfer following HP does not significantly improve pregnancy outcomes.