Frozen Embryo Transfer Research Articles

Association between serum hormone levels in early pregnancy and risk of hypertensive diseases of pregnancy in women undergoing assisted reproduction.

We examined the association between progesterone (P4), estradiol (E2), and human chorionic gonadotropin (hCG) levels in early pregnancy and the development of hypertensive diseases of pregnancy among women undergoing assisted reproduction. Retrospective study including patients who underwent frozen embryo transfer (FET), ovarian stimulation (OS), or unassisted conception (UC) and had a live singleton birth. The primary outcome was the development of hypertensive diseases of pregnancy (gestational hypertension, preeclampsia, HELLP, or eclampsia). Secondary outcomes were the development of fetal intrauterine growth restriction (IUGR), gestational diabetes mellitus, birth weight, and pre-term birth. Hormone levels and the development of the outcomes were correlated. A total of 681 patients were included; 189 had FET, 193 had OS, and 299 had UC. Patients undergoing FET or OS were not more likely to develop hypertensive diseases of pregnancy compared with UC patients. While median levels of E2 and P4 were significantly different between P-FET and NC-FET patients (E2: 252 vs 317pg/mL, P4: 64 vs 29ng/mL, respectively; both p < 0.01), rates of hypertensive diseases of pregnancy did not significantly differ between those two groups. In the multivariate analyses, P4, E2, and hCG were not associated with the development of hypertensive diseases of pregnancy, but progesterone levels were significantly higher among those with IUGR. This remained consistent when the analysis was limited to FET patients. P4, E2, and hCG levels did not correlate with the development of hypertensive diseases of pregnancy but elevated progesterone levels did correlate with the development of IUGR.

Embryo retention and live birth in frozen embryo transfer cycles: a cohort study

To study the effect of embryo retention in the transfer catheter on pregnancy outcomes in frozen embryo transfer (FET) cycles. Retrospective cohort study. Tertiary-care academic medical center. This retrospective study involved a total of 39,118 women who underwent FET cycles at a tertiary-care academic medical from January 2016 to December 2022. Women were divided into a control group (n = 38,933) and embryo retention group (n = 185). The women in the embryo retention group had been propensity scores matched with those in the control group at a 1:4 ratio. The primary outcome was live birth (LB). The secondary outcomes were biochemical pregnancy, clinical pregnancy (CP), miscarriage, and ectopic pregnancy. The overall incidence of embryo retention in the transfer catheter was 0.47% (185/39,118). The pregnancy outcome in the embryo retention group after propensity score matching (PSM) was comparable to that before PSM, with a reduced likelihood of biochemical pregnancy (odds ratio [OR], 0.83; 95% confidence interval [CI], 0.72-0.95), CP (OR, 0.81; 95% CI, 0.69-0.96), and LB (OR, 0.80; 95% CI, 0.66-0.97). In addition, the birth weight in the embryo retention group was higher compared with the control group. However, no differences were observed in terms of miscarriage, ectopic pregnancy, cesarean delivery, as well as gestational age both before and after PSM. Embryo retention in the transfer catheter decreases the chance of biochemical pregnancy, CP, and LB in FET cycles.

Progesterone Concentrations on Blastocyst Transfer Day in Modified Natural Cycle Frozen Embryo Transfer Cycles

Progesterone Concentrations on Blastocyst Transfer Day in Modified Natural Cycle Frozen Embryo Transfer Cycles

Similar accuracy and patient experience with different one-step ovulation predictor kits

To examine the accuracy of five different at home ovulation predictor kits (OPKs), and to understand patient experience with the use of those kits. Prospective cohort study. Single academic fertility practice. Patients with regular menses undergoing monitored natural cycle frozen embryo transfer, timed intercourse, and intrauterine insemination cycles involving daily blood luteinizing hormone (LH) level monitoring between 2022 and 2024. Use of five commercially available OPKs for the first five days of blood LH monitoring with a daily experience survey. The primary outcome was accuracy of the ovulation predictor kits defined as concordance between test result (positive or negative) and blood LH level (above or below 25mIU/ml). Secondary outcomes included positive predictive value, negative predictive value, sensitivity, and specificity of OPK surge detection. We also examined patient report regarding clarity of kit instructions, confidence in kit results, and likelihood of future purchase and use. 23 patients completed 97 total days of ovulation predictor kit testing and 13 patients had a documented blood LH surge during their testing. OPK surge detection accuracy when compared to blood LH surge was similar across the five kits (Easy@Home 95.88%, Wondfo 94.85%, Pregmate 96.90%, Clearblue 91.75%, Clinical Guard 91.75%, p-value 0.06). Sensitivity was slightly better for Easy@ Home (75.00%), Wondfo (69.23%) and Pregmate (76.92%) than for Clearblue (61.54%) and Clinical Guard (38.46%). There were no clinically significant differences between the five OPKs regarding positive predictive value, negative predictive value, or specificity of surge detection. Participant experience was qualitatively similar across all five OPKs with exception of slightly fewer patients reporting that they were likely to purchase and use Clinical Guard again in the future. All five tested at home one step OPKs were highly accurate and performed similarly regarding patient experience despite variation in price.

Impact of overweight and obesity on live birth rate in single euploid frozen embryo transfers: the key is in the preparation protocol!

Research questionDoes endometrial preparation using a natural cycle (NC) lead to higher live birth rates (LBR) in single euploid frozen embryo transfers (seFET) compared to programmed cycles (PC), for women across normal, overweight, and obese body mass index (BMI) categories? DesignRetrospective study of 845 seFETs. Patients were stratified by BMI into 3 categories (Normal weight, Overweight, and Obesity Class I/II). Outcome was LBR. ResultsA total of 845 seFET cycles of 688 couples were included in the analysis. After achieving covariate (female age, AMH, embryo quality and infertility type) balance in each stratum, the effective sample size was 481 and 262 for the PC and NC, respectively. The PC approach, in which patients received vaginal luteal phase support with 3×100 mg micronized vaginal progesterone (MVP)/day, were associated with significantly lower LBR in the weighted regression analysis of the cohort (RR: 0.80, 95%CI: 0.73 – 0.88, p<0.001), compared to the NC approach. The effect was significantly modified by BMI (P=0.003). While the effect was significant for all BMI categories, the reduction in live birth was less pronounced in patients with normal or overweight BMI (RR: 0.87, 95%CI: 0.78-0.97, p=0.014) compared to patients with class I/II obesity (RR: 0.61, 95%CI: 0.49-0.75, p<0.001). ConclusionA natural cycle endometrial preparation approach leads to overall better live birth rates in single euploid FET, and the most significant difference is observed in women with higher BMI. Furthermore, overweight / obese patients in a PC may require a higher dosage of progesterone for luteal phase support.

Effect of ART treatments on maternal and neonatal outcomes in singleton live births: A large-scale retrospective cohort study

BackgroundThe increased risk of pregnancy complications in the ART population has been reported, but the source of these risks remains controversial. The study aims to evaluate the association between ART treatments and patient characteristics with maternal and neonatal outcomes. MethodsThis was a retrospective analysis of 45,159 singleton pregnant women at a hospital between 2018 and 2021. The maternal and neonatal outcomes included pregnancy-induced hypertension (PIH), preeclampsia (PE), gestational diabetes mellitus (GDM), placental abruption (PA), placenta accreta spectrum (PAS), postpartum hemorrhage (PPH), cesarean section, iatrogenic and spontaneous preterm birth, small for gestational age (SGA), low birth weight (LBW), macrosomia, and birth defects. We assessed the outcomes among the fresh embryo transfer (ET), frozen embryo transfer (FET), and spontaneous conception (SC) groups. Potential risk factors were further analyzed in the ART population. ResultsFET was associated with higher risks for PIH (SC: AOR, 1.97(1.51–2.57); fresh ET: AOR, 1.68(1.03–2.72)), PE (SC: 2.28(1.86–2.80); fresh ET: AOR, 1.61(1.11–2.33)), PAS (SC: AOR, 3.89(3.39–4.46); fresh ET: AOR, 2.23(1.70–2.92)), PPH (SC: AOR, 3.46(2.76–4.34)); fresh ET: 2.09(1.39–3.14)), and macrosomia (SC: 1.53(1.25–1.86); fresh ET: AOR, 2.87(1.89–4.35). Fresh ET was associated with higher risks for PA (SC: AOR, 2.19(1.51–3.18); FET: AOR, 0.39(0.17–0.90)), SGA (SC: AOR, 1.56(1.06–2.31), FET: AOR, 0.42(0.19–0.91)), and LBW (SC: AOR, 2.24(1.82–2.77), FET: AOR, 0.63 (0.44–0.89)), and fresh ET is an independent risk factor for PA and SGA. Furthermore, the risk of GDM was associated with the biological characteristic of low-fertility patients. ConclusionsEmbryo status (fresh or frozen) is a key factor affecting the maternal and neonatal outcomes in ART treatments, while biological characteristics of infertile patients also play a certain role.

Is there an association between the ‘October 7th’ events and IVF outcomes in Israel?

Research questionIs there an association between the ‘October 7th’ 2023 events and IVF outcomes in Israel? Designin this retrospective cohort study the study group was women treated during the 4 weeks after ‘October 7th’, compared with a matched control group treated between 1 January 2021 and 6 October 2023. Each study group participant was matched with three separate control subjects of the same female age at oocyte retrieval, with a matching body mass index (BMI), IVF cycle number and ovarian reserve parameters. ResultsThe study included 580 patients. The 145 women who underwent oocyte retrieval or frozen embryo transfer after 7 October 2023 were compared with 435 women treated before 7 October. The mean age of the study group was 35.6 ± 6 years, and the mean BMI 24.7 ± 5.3 kg/m2. Pregnancy rates per embryo transfer were similar between the groups (22.4% versus 30.5%, P = 0.28 in fresh cycles; 16.9% versus 27.1%, P = 0.12 in frozen embryo transfers). Among women who underwent oocyte retrieval there were no differences in the ovarian stimulation protocols (P = 0.95), number of oocytes retrieved (P = 0.16) or number of fertilized oocytes (P = 0.34). There was no difference in the rate of good-quality embryos between groups (P = 0.053). Among women who underwent frozen embryo transfers, during the study period more patients had natural cycles (52.5% versus 24%, P < 0.001), and there was no difference in maximal endometrial thickness before embryo transfer (P = 0.33). ConclusionsIt appears that there is no association between the ‘October 7’ events and IVF outcomes.

Comparison of Clinical Outcomes in the Slow-Developing Blastocysts With or Without Preimplantation Genetic Testing-Aneuploidy on Day 6 in the Frozen–Thawed Cycle

ObjectivesThis study investigated the potential of the slow-developing blastocysts using preimplantation genetic testing-aneuploidy (PGT-A) in patients undergoing frozen–thawed embryo transfer, stratified by age. MethodsA retrospective analysis was performed including a total of 743 cycles, the first frozen embryo transfer (FET) cycle with single embryo transfer, who underwent treatment between January 2020 and July 2023 in a single fertility centre, Gangnam CHA Fertility Center. A total of 743 cycles, in which we performed intracellular sperm injection and freeze-all strategy, from 743 patients were included. The patient group was divided into 4 groups as follows: group 1 (G1), 208 FET on day 5; group 2 (G2), 177 FET with PGT-A on day 5; group 3 (G3), 220 FET on day 6; group 4 (G4), 138 FET with PGT-A on day 6. We also divided into 2 groups—under 35 years of age and over 35 years of age—and performed the analysis separately for each group. ResultsIn the under 35 years of age group, there were no significant differences in clinical pregnancy and miscarriage rates in G1 and G2 (67.2% vs. 63.8%, not statistically significantly different). Also, G4 had a higher clinical pregnancy rate than G3, but it was not significant (51.8% vs. 54.7%, not statistically significantly different). In the 35 years or older group, G2 had higher pregnancy rates than G1 and lower miscarriage rates (clinical pregnancy rate: 43.3% vs. 67.7%, P = 0.001, miscarriage rate: 22.5% vs. 3.4%, P = 0.001). In addition, G4 had a higher pregnancy rate than G3 and a lower miscarriage rate (clinical pregnancy rate: 31.8% vs. 46.9%, P = 0.003, miscarriage rate: 22.9% vs. 2.2%, P = 0.023). ConclusionsIn the under-35-year-old group, PGT-A on day 5 and day 6 showed a high pregnancy rate and a low miscarriage rate. Therefore, using PGT-A seems advantageous for patients of an advanced maternal age.

Comparing risk factors and neonatal outcomes in women with intrahepatic cholestasis of pregnancy between assisted reproductive technology and spontaneous conception.

The aim of the present study was to investigate the incidence of intrahepatic cholestasis of pregnancy (ICP) as well as neonatal outcomes between conception via invitro fertilization (IVF) compared with spontaneous conception (SC) and screen the risk factors of ICP in IVF. This retrospective cohort study included 4467 puerperae who conceived via IVF, and 28 336 puerperae who conceived spontaneously and linked the information from neonates. The general linear model (GLM), multivariate logistic regression analysis, a forest plot, and nomogram were used to assess impact factors and risk prediction. Logistic analysis adjusted for confounders revealed significant differences in the ICP rate of singleton delivery (4.24% vs 3.41%, adjusted OR [aOR] = 1.26; 95% confidence interval [CI] 1.03-1.53, P = 0.025) and in groups with total bile acids (TBA) ≥40 and <100 μmol/L (14.77% vs 10.39%, aOR = 1.31; 95% CI: 1.06-1.63, P = 0.023) between IVF and SC. When we divided newborns into singleton and twins delivery, the GLM revealed a higher rate with Apgar score <7 (13.44% vs 3.87%, aOR = 3.85; 95% CI: 2.07-7.17, P < 0.001) and fetal distress for IVF in comparison with SC (19.32% vs 5.55%, OR = 3.48; 95% CI: 2.39-6.95, P < 0.001) in the singleton group. In multivariate logistic regression analysis, body mass index (BMI) (aOR = 1.29; P = 0.031), number of embryo transfers (ET) (single ET vs double ET, aOR = 2.82; P < 0.001), E2 level on the ET day (aOR = 2.79; P = 0.011), fresh ET which compared with frozen ET (FET) (aOR = 1.45; P = 0.014), embryo stage (cleavage embryo vs blastocyst, aOR = 1.75; P = 0.009) and severe ovarian hyperstimulation syndrome (OHSS) which compared with non-OHSS (aOR = 3.73; P = 0.006) were independent predictors of ICP. These predictive factors in the logistic regression model were integrated into the nomogram (C-index = 0.735; 95% CI: 0.702-0.764); for each patient, higher total points indicated a higher risk of ICP. We observed that the ICP rate of singleton delivery was higher in IVF than in SC. In ICP patients, there were higher rates of neonatal Apgar score <7 and fetal distress in IVF than SC and found the predictors of ICP in IVF.

Measuring The Level of The Hormone Progesterone on The Day of Transfer of Fresh and Frozen Embryos and Its Impact on Pregnancy Outcomes

Objective: Prediction of the effect of the hormone progesterone on pregnancy results that measured on the day of transfer of fresh and frozen embryos. Method: This research at reproductive centres in Baghdad from May 2022 to April 2023 examined how serum progesterone levels affect embryo transfers in ICSI procedures in 100 fresh or frozen cycle women. The study examined clinical data and endometrial preparation techniques to determine if progesterone levels affect pregnancy rates. Data were analysed using SPSS to determine how pre-transfer hormonal levels affected implantation and pregnancy outcomes. Participants were selected according on inclusion and exclusion criteria. The study shows that progesterone is essential for IVF embryo transfers. Results: Compared to frozen cycles in females, fresh cycles had greater mean age and progesterone levels but lower COC number and 2PN levels, with no changes in BMI, MII, or injectable MII. Frozen cycles produced more good-grade embryos, whereas fresh cycles produced more fair-grade embryos. There were no differences in the number of "C" embryos. Fresh cycle groups had greater pregnancy rates (59.1%) than frozen cycle groups (38.9%), but progesterone levels did not change between cycle types. Conclusion: The study found that fresh cycles include older participants, greater progesterone but lower COC and 2PN levels, and higher pregnancy rates than frozen cycles. BMI, MII levels, embryo count, poor grade "C" embryos, and progesterone levels associated to pregnancy outcomes did not differ across groups.

"Effect of Adding LH Activity During Controlled Ovarian Hyperstimulation: A Comparison of Standard vs. Low-Dose Human Chorionic Gonadotropin on Pregnancy Rates Following Frozen Embryo Transfer"

"Effect of Adding LH Activity During Controlled Ovarian Hyperstimulation: A Comparison of Standard vs. Low-Dose Human Chorionic Gonadotropin on Pregnancy Rates Following Frozen Embryo Transfer"

"Effect of Adding LH Activity During Controlled Ovarian Hyperstimulation: A Comparison of Standard vs. Low-Dose Human Chorionic Gonadotropin on Pregnancy Rates Following Frozen Embryo Transfer"

"Effect of Adding LH Activity During Controlled Ovarian Hyperstimulation: A Comparison of Standard vs. Low-Dose Human Chorionic Gonadotropin on Pregnancy Rates Following Frozen Embryo Transfer"

Effect of Adding LH Activity During Controlled Ovarian Hyperstimulation: A Comparison of Standard vs. Low-Dose Human Chorionic Gonadotropin on Pregnancy Rates Following Frozen Embryo Transfer

Effect of Adding LH Activity During Controlled Ovarian Hyperstimulation: A Comparison of Standard vs. Low-Dose Human Chorionic Gonadotropin on Pregnancy Rates Following Frozen Embryo Transfer

Economic evaluation of GnRH-agonist long protocol and GnRH-antagonist protocol in IVT/ICSI among the Chinese population: using pharmacoeconomic models

ObjectiveThis paper uses health economics methods to discuss the cost-effectiveness value of long protocol and antagonist protocol for in vitro fertilisation and embryo transfer (ET) in the Chinese population.DesignHealth economic...

Recryopreservation impairs blastocyst implantation potential via activated endoplasmic reticulum stress pathway and induced apoptosis.

Recryopreservation (recryo) is occasionally applied in clinical, while the underlying mechanism of impaired clinical outcomes after recryo remains unclear. In this study, frozen embryo transfer (FET) cycles of single blastocyst transfer in an academic reproductive medicine center were enrolled. According to the number of times blastocysts experienced cryopreservation, they were divided into the cryopreservation (Cryo) group and the Recryo group. Donated human blastocysts were collected and detected for mechanism exploration. It was found that recryo procedure resulted in impaired blastocyst developmental potential, including decreased implantation rate, reduced biochemical pregnancy rate, declined clinical pregnancy rate, higher early miscarriage rate, and lower live birth rate. Moreover, recryo led to impaired trophectoderm (TE) function, exhibiting lower human chorionic gonadotropin levels 12 days after FET. In addition, single-cell RNA sequencing showed that the expression of genes involved in cell adhesion and embryo development were altered. More specifically, activated endoplasmic reticulum (ER) pathway and induced apoptosis were further verified by immunofluorescence and terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL) assay involving in the recryo procedure. In conclusion, recryo could interfere with the process of blastocyst implantation by impairing TE function, affecting blastocyst adhesion, activating ER stress pathway and inducing apoptosis. It provides caution to embryologists about the potential risk of recryopreservation.

Effect on Pregnancy Outcome of Hysteroscopy Combined with Chronic Endometritis Screening before the Next Frozen-Thawed Embryo Transfer in Patients with Previous Failed Transfer Cycle

Background: Implantation failure, especially recurrent implantation failure (RIF), causes considerable distress in patients who undergo assisted reproductive techniques (ART). Mild pathologies inside the uterine cavity and disturbance of the uterine environment can decrease endometrial receptivity and cause implantation failure. To address this, hysteroscopy combined with endometrial pathological diagnosis has become more widespread. However, the specific time at which to perform the hysteroscopy remains controversial in the clinical practice of ART. Methods: This case-control studies enrolled a total of 1876 in-vitro fertilization embryo transfer (IVF-ET) or intracytoplasmic sperm injection embryo transfer (ICSI-ET) patients with a history of failed implantation were included in this study. From October 2019 to December 2022, these patients underwent office hysteroscopy and subsequent endometrial biopsy for CD138 immunohistochemistry to detect chronic endometritis (CE) in the Department of Reproductive Medicine, West China Second University Hospital, Sichuan University. Endometrial polys (EP) were removed during surgery, and for patients diagnosed with CE, oral doxycycline was taken for two consecutive weeks before the next frozen embryo transfer (FET). Patient demographic characteristics and pregnancy outcomes were reviewed and analyzed by logistic regression to evaluate outcomes. Results: Patients were divided into four groups according to hysteroscopy findings and pathological diagnosis: CE only, CE plus EP, EP only, and neither CE or EP. The biochemical pregnancy (p = 0.009), clinical pregnancy (p = 0.014), and live birth (p = 0.011) rates after the following FET cycle were significantly different between the four groups. Pregnancy outcomes for the CE plus EP group were better than for the other three groups. Multivariate logistic regression analysis revealed that the probability of live birth was significantly related to the mother’s age, the controlled ovarian stimulation (COS) protocol, the number of times with failed embryo transfer (ET) cycle, endometrial histology findings, the interval time between hysteroscopy and FET, the endometrial thickness on the day of embryo transfer, and the number and type of embryos transferred (p &lt; 0.05). Conclusions: Office hysteroscopy combined with diagnosis of endometrial pathology is a valuable approach for women with a history of implantation failure. This approach is not limited to RIF patients, and results in an increased pregnancy rate and shorter time to live birth in ART.

Transcriptomic Analysis of Vitrified-Warmed vs. Fresh Mouse Blastocysts: Cryo-Induced Physiological Mechanisms and Implantation Impact.

Blastocyst vitrification has significantly improved embryo transfer methods, leading to higher implantation success rates and better pregnancy outcomes in subsequent frozen embryo transfer cycles. This study aimed to simulate the transcriptional changes caused by vitrifying human blastocysts using mouse blastocysts as a model and to further investigate these changes' effects. Utilizing a human vitrification protocol, we implanted both vitrified and fresh embryos into mice. We observed the implantation success rates and performed transcriptomic analysis on the blastocysts. To validate the results from messenger RNA sequencing, we conducted reverse transcriptase-quantitative polymerase chain reaction (RT-qPCR) to measure the expression levels of specific genes. Based on mRNA profiling, we predicted the microRNAs responsible for the regulation and used qPCR basic microRNA assays for validation. Our observations revealed a higher implantation success rate for vitrified embryos than fresh embryos. Transcriptomic analysis showed that vitrified-warmed blastocysts exhibited differentially expressed genes (DEGs) primarily associated with thermogenesis, chemical carcinogenesis-reactive oxygen species, oxidative phosphorylation, immune response, and MAPK-related signaling pathways. RT-qPCR confirmed increased expression of genes such as Cdk6 and Nfat2, and decreased expression of genes such as Dkk3 and Mapk10. Additionally, gene-microRNA interaction predictions and microRNA expression analysis identified twelve microRNAs with expression patterns consistent with the predicted results, suggesting potential roles in uterine epithelial cell adhesion, trophectoderm development, invasive capacity, and immune responses. Our findings suggest that vitrification induces transcriptomic changes in mouse blastocysts, and even small changes in gene expression can enhance implantation success. These results highlight the importance of understanding the molecular mechanisms underlying vitrification to optimize embryo transfer techniques and improve pregnancy outcomes.

Reproductive outcomes in women with advanced endometriosis in fresh versus frozen embryo transfer cycles

BackgroundART in women with endometriosis is associated with poor quality of the retrieved oocytes and lower fertilization and pregnancy rates, reflecting that endometriosis may influence fertility by altering the quality of both the oocyte and embryo quality and also by impairing the endometrial receptivity. On comparing endometriosis-affected patients to healthy counterparts, many differences were demonstrated at the endometrial level. Thus, choosing the appropriate method of embryo transfer is of utmost importance, particularly for patients with advanced endometriosis.ObjectiveThe aim of the present study was to compare the reproductive outcomes between fresh and frozen embryo transfer cycles in women with advanced endometriosis.Material and methodsA retrospective cohort study was conducted in the period from January 2018 until December 2021 for patients recruited from two IVF centers, Alexandria, Egypt. Careful review of paper and electronic medical records of infertile women (primary, relative, or secondary infertility) aged 18–37 years who were diagnosed with advanced endometriosis by means of laparoscopy and were scheduled for ICSI followed by either fresh embryo transfer (group I) or freeze-all embryos and deferred embryo transfer (group II) of day 5 embryo(s) was included in the study.ResultsTwo-hundred and eleven women were eligible and included in the study. Women in each study group were matched regarding baseline characteristics. Clinical pregnancy, implantation, and ongoing pregnancy rates were statistically significantly higher in the group of frozen embryo transfer (p < 0.001). Miscarriage rate was found to be higher in the group of fresh transfer compared to FET group but without a statistical significance (20.9% vs 9.2%, p = 0.072).ConclusionIn women with advanced endometriosis, freeze-all policy seems to be associated with better implantation, ongoing pregnancy rates.

IVF laboratory management through workflow-based RFID tag witnessing and real-time information entry

BackgroundDual-person inspection in IVF laboratories cannot fully avoid mix-ups or embryo transfer errors, and data transcription or entry is time-consuming and redundant, often leading to delays in completing medical records.MethodsThis study introduced a workflow-based RFID tag witnessing and real-time information entry platform for addressing these challenges. To assess its potential in reducing mix-ups, we conducted a simulation experiment in semen preparation to analyze its error correction rate. Additionally, we evaluated its impact on work efficiency, specifically in operation and data entry. Furthermore, we compared the cycle costs between paper labels and RFID tags. Finally, we retrospectively analyzed clinical outcomes of 20,424 oocyte retrieval cycles and 15,785 frozen embryo transfer cycles, which were divided into paper label and RFID tag groups.ResultsThe study revealed that comparing to paper labels, RFID tag witnessing corrected 100% of tag errors, didn’t affect gamete/embryo operations, and notably shorten the time of entering data, but the cycle cost of RFID tags was significantly higher. However, no significant differences were observed in fertilization, embryo quality, blastocyst rates, clinical pregnancy, and live birth rates between two groups.ConclusionsRFID tag witnessing doesn’t negatively impact gamete/embryo operation, embryo quality and pregnancy outcomes, but it potentially reduces the risk of mix-ups or errors. Despite highly increased cost, integrating RFID tag witnessing with real-time information entry can remarkably decrease the data entry time, substantially improving the work efficiency. This workflow-based management platform also enhances operational safety, ensures medical informational integrity, and boosts embryologist’s confidence.

Preovulation body mass index and pregnancy after first frozen embryo transfer in patients with polycystic ovary syndrome and insulin resistance

ObjectiveTo examine the association between preovulation body mass index and pregnancy outcomes after frozen embryo transfer in patients with polycystic ovary syndrome with insulin resistance. DesignThis was a single-center, retrospective cohort study. SubjectsWomen with infertility, diagnosed with polycystic ovary syndrome and insulin resistance, and treated at the Reproductive Medicine Center, Second People’s Hospital of Nanning, China, between January 2020 and August 2023, were included. ExposurePatients were divided into four groups according to their body mass index (BMI): slim (<18.5 kg/m2), normal (18.5≤ BMI <24 kg/m2), overweight (24≤ BMI <28 kg/m2), or obese (≥28 kg/m2). Main Outcome MeasuresThe main pregnancy outcomes included rates of embryo implantation, biochemical pregnancy, clinical pregnancy, and ongoing pregnancy. ResultsIn total, 282 eligible patients were included. A linear association was observed between the BMI and clinical pregnancy outcomes of the first frozen embryo transfer (P for nonlinearity>0.05). After accounting for all potential variables, each 1 kg/m2 increase in BMI was linked to a 2% decrease in the embryo implantation rate (P<0.05), 11% decrease in the frequency of biochemical pregnancy (P<0.05), and 9% decrease in the both clinical (P<0.05) and ongoing pregnancy rates. ConclusionIn patients with polycystic ovary syndrome and insulin resistance, a higher BMI was associated with lower rates of embryo implantation, biochemical pregnancy, clinical pregnancy, and ongoing pregnancy.