Premature ovarian insufficiency patients with viable embryos derived from autologous oocytes through repeated oocyte retrievals could obtain reasonable cumulative pregnancy outcomes following frozen-embryo transfer.

Abstract

Women with premature ovarian insufficiency (POI) are often discouraged from using autologous oocytes; however, some patients have a strong desire to be genetically linked to their offspring. In the present study, we aimed to estimate cumulative pregnancy outcomes following frozen-embryo transfer (FET) in POI patients who could obtain viable embryos with their eggs during in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) treatments. In this matched-retrospective cohort study, only patients undergoing IVF/ICSI treatments with a freeze-all strategy were screened, and 103 POI patients were matched with 515 normal controls in terms of the same number of viable embryos obtained at the same age. The primary outcome was the cumulative clinical pregnancy rate (CCPR) following FET per patient. Patients with POI and normal ovarian reserve had comparable CCPRs of 62.14% (64/103) and 65.24% (336/515), respectively (P=0.547), and no statistical difference was found in the cumulative live-birth rate (CLBR) between the study group (43.69%) and the control group (53.01%). Based on binary logistic regression, the CCPR and CLBR showed no association with the type of ovarian function (POI or normal ovarian reserve). The number of embryos per transfer and the sum of all viable embryos per patient were positively associated with the CCPR and CLBR. The clinical pregnancy rate (CPR) per FET cycle was 38.17% for the study group and 52.1% for the control group, while the CPRs per oocyte retrieval cycle in the 2 groups were 11.25% and 69.9%, respectively, and both were statistically different (P<0.05). Moreover, POI patients had a lower implantation rate (27.8% vs. 37.94%) and a higher early miscarriage rate per transfer (26.76% vs. 15%) than patients in the control group (P<0.05). Cumulative pregnancy outcomes following FET were reasonable for POI patients using viable embryos derived from autologous oocytes through repeated oocyte retrievals.