Abstract
The aim of the study was to compare the single pregnancy and neonate outcome after fresh and frozen-thawed embryo transfer in the in vitro fertilization programme (IVF). The study focused on clinical and laboratory factors affecting the abnormal placentation, especially placenta praevia, in patients conceiving in the IVF programme. The results confirm that neonates born after frozen-thawed embryo transfer had significantly higher mean birth weight than after fresh embryo transfer (ET). Moreover, the birth weight distribution in singletons was found to shift towards “large for gestation” (LGA) after frozen-thawed ET. On the other hand, the pregnancies after fresh ET were characterized by a higher incidence of placenta praevia and 3rd trimester bleeding. Placenta praevia was more common in IVF patients with fresh ET in a stimulated cycle than in patients with ET in a spontaneous cycle. It occurred more frequently in patients with transfer of 2 embryos. From this point of view, single ET and ET in a spontaneous cycle should be encouraged in good prognosis patients in the future with more than two good quality embryos developed. An important issue arose of how the ovarian hormonal stimulation relates to abnormal placentation and if the serum hormone levels interfere with in the IVF treatment results.
Highlights
The reduction in number of embryos transferred into the uterus is crucial in preventing multiple pregnancies, one of the major in vitro fertilization (IVF) complications, since it is known that they carry increased risk for maternal and neonatal morbidity in comparison to singleton pregnancies [1,2,3]
The results of our study revealed significantly more large for gestation” (LGA) neonates in pregnancies after frozen-thawed embryo transfer (ET) in comparison to fresh ET outcome
Does the higher birth weight indicate a more healthy pregnancy, or is this birth weight shift pathological, carrying all the risks of LGA, metabolic disorders, or even epigenetic changes? Placenta praevia seems to be a complication related to stimulated cycles with 2 fresh embryos transferred
Summary
The reduction in number of embryos transferred into the uterus is crucial in preventing multiple pregnancies, one of the major in vitro fertilization (IVF) complications, since it is known that they carry increased risk for maternal and neonatal morbidity in comparison to singleton pregnancies [1,2,3]. Frozen-thawed embryo transfer (ET) technique enabled a transfer of fewer embryos into the uterus and storage of surplus embryos by cryopreservation for future use [3, 4]. The consequence of such “preventing multiplicity” practice is a rapidly increasing number of frozen embryos, followed by an increased percentage of births and neonates following such infertility treatment [2,3,4,5]. Until now no significant differences regarding children’s outcome have been established in comparison to fresh ET since the worldwide introduction of frozen-thawed ET into the everyday clinical practice [5,6,7,8, 10, 11, 13]. There was a decline in placenta praevia and antepartum haemorrhage after frozen-thawed ET in comparison to fresh ET [5, 8,9,10,11,12,13]
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