Incorporation of comprehensive chromosome screening (CCS) in IVF care is associated with faster resumption of care after failed embryo transfer

Abstract

Time away from fertility treatment after a pregnancy loss can have a negative impact on overall success rates. Treatment paradigms which minimize loss rates and decrease time to resumed treatment are thus optimal. This data seeks to determine if utilization of CCS impacts time to resumption of treatment after an embryo transfer fails to result in a delivery. Retrospective cohort study at a single, academic center. All first fresh or frozen embryo transfer cycles from 2010 to 2014 were evaluated. All cycles which had an embryo transfer which did not result in a delivery were included for analysis. Time away from treatment was designated by calculating the number of days between the embryo transfer and the date of next treatment cycle start. Patients were compared overall and then analyzed depending upon whether CCS was part of their treatment strategy. Student t-test and chi square were utilized where appropriate. During the study timeframe there were 1763 individual patients who met inclusion criteria. The average number of days away from treatment was 88.2 (9-700). There were 1504 patients who did not have CCS and 259 who did have CCS. Patient in the non-CCS group required a D&C in 10.8% of cases while those in the CCS group required a D&C in 7.0% of cases (p=0.106). The average time away from treatment for the group without CCS was 90.2±1.95 days and with CCS was 76.3±4.69 days (p<0.006). Time away from fertility treatment when an embryo transfer does not result in a delivery can significantly impact overall success rates. Data about time away from treatment after pregnancy loss can be helpful in patient counseling and setting expectations. The overall average time to next treatment nearly 3 months. When CCS is incorporated into the treatment paradigm, the time away from treatment after a loss is decreased. It is possible that a priori knowledge of ploidy status allows for patients and their care team to process the implications of pregnancy loss more quickly and allows swifter return to care.