Improvement of clinical outcomes by frozen-thawed embryo transfer in aged patients

Abstract

ObjectiveFemale age is one of the important factors for successful outcome and old age is closely associated with lower pregnancy rate in human assisted reproduction program. Controlled ovarian hyperstimulation (COH) significantly affects uterine environments essential for embryo implantation in fresh IVF-ET. Frozen-thawed embryo transfer (F-ET) overcomes potential adverse effects of supraphysiological hormonal conditions by COH in fresh IVF-ET. The aim of this study was to compare the efficacy of fresh IVF-ET and F-ET in aged groups.DesignRetrospective analysis of clinical outcome.Materials and methodsLaboratory and clinical data of fresh IVF-ET cycles (n = 1,292) and F-ET cycles with embryos thawed at pronucleus (PN) stage (n = 443) were collected from 2004 to 2005. Cases of poor responders (less than 6 of retrieved oocytes) and preimplantation genetic diagnosis were excluded in this study. The data were divided into four groups according to the age of the female partner: <30 years, 30 to 34, 35 to 39, and >39. Supernumerary PN zygotes were frozen with a slow freezing method and thawed with a rapid thawing method. Clinical outcomes of different age groups were statistically analyzed by Student t-test and chi square test.ResultsTabled 1Table 1.< 3030∼3435∼39> 39Female age (years)IVF-ETF-ETIVF-ETF-ETIVF-ETF-ETIVF-ETF-ETNo. of cycles2097463922833411511026Mean age27.927.632.032.136.636.541.741.6Mean ET embryos3.43.53.53.43.63.53.73.3∗CPR52.2%a45.9%47.9%49.1%39.5%b42.6%10.0%b30.8%∗IR26.4%a24.1%c22.3%20.4%16.4%18.9%2.7%b12.8%∗∗d∗Significant difference between IVF-ET and F-ET in above than 39 years group (P<0.05).∗∗Significant difference between IVF-ET and F-ET in above than 39 years group (P<0.01).a,bSignificant difference between IVF-ET cycles (P<0.01).c,dSignificant difference between F-ET cycles (P<0.05). Open table in a new tab ConclusionsImproved clinical outcomes were achieved with F-ET in aged patients. We suggest that F-ET may be a reasonable choice to improve the clinical outcome for aged female in human ART program. ObjectiveFemale age is one of the important factors for successful outcome and old age is closely associated with lower pregnancy rate in human assisted reproduction program. Controlled ovarian hyperstimulation (COH) significantly affects uterine environments essential for embryo implantation in fresh IVF-ET. Frozen-thawed embryo transfer (F-ET) overcomes potential adverse effects of supraphysiological hormonal conditions by COH in fresh IVF-ET. The aim of this study was to compare the efficacy of fresh IVF-ET and F-ET in aged groups. Female age is one of the important factors for successful outcome and old age is closely associated with lower pregnancy rate in human assisted reproduction program. Controlled ovarian hyperstimulation (COH) significantly affects uterine environments essential for embryo implantation in fresh IVF-ET. Frozen-thawed embryo transfer (F-ET) overcomes potential adverse effects of supraphysiological hormonal conditions by COH in fresh IVF-ET. The aim of this study was to compare the efficacy of fresh IVF-ET and F-ET in aged groups. DesignRetrospective analysis of clinical outcome. Retrospective analysis of clinical outcome. Materials and methodsLaboratory and clinical data of fresh IVF-ET cycles (n = 1,292) and F-ET cycles with embryos thawed at pronucleus (PN) stage (n = 443) were collected from 2004 to 2005. Cases of poor responders (less than 6 of retrieved oocytes) and preimplantation genetic diagnosis were excluded in this study. The data were divided into four groups according to the age of the female partner: <30 years, 30 to 34, 35 to 39, and >39. Supernumerary PN zygotes were frozen with a slow freezing method and thawed with a rapid thawing method. Clinical outcomes of different age groups were statistically analyzed by Student t-test and chi square test. Laboratory and clinical data of fresh IVF-ET cycles (n = 1,292) and F-ET cycles with embryos thawed at pronucleus (PN) stage (n = 443) were collected from 2004 to 2005. Cases of poor responders (less than 6 of retrieved oocytes) and preimplantation genetic diagnosis were excluded in this study. The data were divided into four groups according to the age of the female partner: <30 years, 30 to 34, 35 to 39, and >39. Supernumerary PN zygotes were frozen with a slow freezing method and thawed with a rapid thawing method. Clinical outcomes of different age groups were statistically analyzed by Student t-test and chi square test. ResultsTabled 1Table 1.< 3030∼3435∼39> 39Female age (years)IVF-ETF-ETIVF-ETF-ETIVF-ETF-ETIVF-ETF-ETNo. of cycles2097463922833411511026Mean age27.927.632.032.136.636.541.741.6Mean ET embryos3.43.53.53.43.63.53.73.3∗CPR52.2%a45.9%47.9%49.1%39.5%b42.6%10.0%b30.8%∗IR26.4%a24.1%c22.3%20.4%16.4%18.9%2.7%b12.8%∗∗d∗Significant difference between IVF-ET and F-ET in above than 39 years group (P<0.05).∗∗Significant difference between IVF-ET and F-ET in above than 39 years group (P<0.01).a,bSignificant difference between IVF-ET cycles (P<0.01).c,dSignificant difference between F-ET cycles (P<0.05). Open table in a new tab ∗Significant difference between IVF-ET and F-ET in above than 39 years group (P<0.05). ∗∗Significant difference between IVF-ET and F-ET in above than 39 years group (P<0.01). a,bSignificant difference between IVF-ET cycles (P<0.01). c,dSignificant difference between F-ET cycles (P<0.05). ConclusionsImproved clinical outcomes were achieved with F-ET in aged patients. We suggest that F-ET may be a reasonable choice to improve the clinical outcome for aged female in human ART program. Improved clinical outcomes were achieved with F-ET in aged patients. We suggest that F-ET may be a reasonable choice to improve the clinical outcome for aged female in human ART program.