scholarly journals Natural cycle frozen blastocyst transfer after a failed fresh embryo transfer: do we have to wait?

2018 ◽  
Vol 110 (4) ◽  
pp. e226
Author(s):  
J. Stewart ◽  
M. Irani ◽  
J. Chervenak ◽  
P. Chung ◽  
G. Schattman ◽  
...  
Keyword(s):  
Embryo Transfer ◽  
Blastocyst Transfer ◽  
Natural Cycle ◽  
Fresh Embryo Transfer

scholarly journals Ideal Stage of Embryo Transfer to Improve Outcomes for Women of Advanced Maternal Age

2021 ◽  
Author(s):  
Xue Wang ◽  
Yaling Xiao ◽  
Zhengyi Sun ◽  
Jingran Zhen ◽  
Qi Yu
Keyword(s):  
Embryo Transfer ◽  
Maternal Age ◽  
Formation Rate ◽  
Live Birth Rate ◽  
Advanced Maternal Age ◽  
Blastocyst Transfer ◽  
Fresh Embryo Transfer ◽  
Advantages And Disadvantages ◽  
Cancellation Rate ◽  
Freezing Cycle

Abstract Background The purpose of this retrospective study was to optimise the transplantation strategy for women of advanced maternal age to achieve live births within the shortest time. Methods Data were collected from patients older than 40 years who underwent assisted reproductive therapy at our centre from 1 January 2009 to 31 December 2019. A total of 1233 cases of fresh cleavage embryo transfer cycles, 280 cases of frozen-thawed blastocyst transfer cycles, and 26 cases of frozen-thawed cleavage embryo transfer cycles were included. Multivariable logistic regression was performed to adjust for confounding factors. Results The main outcome was the live birth rate. The secondary outcomes were the clinical pregnancy rate, spontaneous abortion rate, and neonatal outcomes. We found that the blastocyst formation rate of patients older than 40 years was 23.5%, the freezing cycle rate was 19.8%, and the fresh embryo transfer rate was 83.0%. Conclusions Cleavage embryo transfer should be performed first to reduce the cycle cancellation rate. If the number of retrieved oocytes is more than eight, then blastocyst transplantation can be considered after fully discussing the advantages and disadvantages of blastocyst culture with patients. Alternatively, cleavage embryo transfer can be performed first, and frozen-thawed blastocyst transfer can be performed next if cleavage embryo transfer is unsuccessful.

scholarly journals Preparation of the Endometrium for Frozen Embryo Transfer: A Systematic Review

2021 ◽  
Vol 12 ◽  
Author(s):  
Sezcan Mumusoglu ◽  
Mehtap Polat ◽  
Irem Yarali Ozbek ◽  
Gurkan Bozdag ◽  
Evangelos G. Papanikolaou ◽  
...  
Keyword(s):  
Embryo Transfer ◽  
Hormone Replacement ◽  
Treatment Protocol ◽  
Frozen Embryo Transfer ◽  
Blastocyst Transfer ◽  
Natural Cycle ◽  
Serum Progesterone ◽  
Replacement Treatment ◽  
Near Future ◽  
Natural Cycles

Despite the worldwide increase in frozen embryo transfer, the search for the best protocol to prime endometrium continues. Well-designed trials comparing various frozen embryo transfer protocols in terms of live birth rates, maternal, obstetric and neonatal outcome are urgently required. Currently, low-quality evidence indicates that, natural cycle, either true natural cycle or modified natural cycle, is superior to hormone replacement treatment protocol. Regarding warmed blastocyst transfer and frozen embryo transfer timing, the evidence suggests the 6th day of progesterone start, LH surge+6 day and hCG+7 day in hormone replacement treatment, true natural cycle and modified natural cycle protocols, respectively. Time corrections, due to inter-personal differences in the window of implantation or day of vitrification (day 5 or 6), should be explored further. Recently available evidence clearly indicates that, in hormone replacement treatment and natural cycles, there might be marked inter-personal variation in serum progesterone levels with an impact on reproductive outcomes, despite the use of the same dose and route of progesterone administration. The place of progesterone rescue protocols in patients with low serum progesterone levels one day prior to warmed blastocyst transfer in hormone replacement treatment and natural cycles is likely to be intensively explored in near future.

scholarly journals Natural vs. programmed cycles for frozen embryo transfer: study protocol for an investigator-initiated, randomized, controlled, multicenter clinical trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Sheriza Baksh ◽  
Anne Casper ◽  
Mindy S. Christianson ◽  
Kate Devine ◽  
Kevin J. Doody ◽  
...  
Keyword(s):  
Corpus Luteum ◽  
Embryo Transfer ◽  
Live Birth ◽  
Frozen Embryo Transfer ◽  
Obstetric Outcomes ◽  
Natural Cycle ◽  
Fresh Embryo Transfer ◽  
Maternal Risk ◽  
Link Type ◽  
Parallel Group

Abstract Background Randomized trials of assisted reproductive technology (ART) have been designed for outcomes of clinical pregnancy or live birth and have not been powered for obstetric outcomes such as preeclampsia, critical for maternal and fetal health. ART increasingly involves frozen embryo transfer (FET). Although there are advantages of FET, multiple studies have shown that risk of preeclampsia is increased with FET compared with fresh embryo transfer, and the reason for this difference is not clear. NatPro will compare the proportion of preeclampsia between two commonly used protocols for FET,modified natural and programmed cycle. Methods In this two-arm, parallel-group, multi-center randomized trial, NatPro will randomize 788 women to either modified natural or programmed FET and follow them for up to three FET cycles. Primary outcome will be the proportion of preeclampsia in women with a viable pregnancy assigned to a modified natural cycle FET (corpus luteum present) protocol compared to the proportion of preeclampsia in pregnant women assigned to a programmed FET (corpus luteum absent) protocol. Secondary outcomes will compare the proportion of live births and the proportion of preeclampsia with severe features between the protocols. Conclusion This study has a potential significant impact on millions of women who pursue ART to build their families. NatPro is designed to provide clinically relevant guidance to inform patients and clinicians regarding maternal risk with programmed and modified natural cycle FET protocols. This study will also provide accurate point estimates regarding the likelihood of live birth with programmed and modified natural cycle FET. Trial registration ClinicalTrials.govNCT04551807. Registered on September 16, 2020

Female obesity does not impact live birth rate after frozen-thawed blastocyst transfer

2020 ◽  
Vol 35 (4) ◽  
pp. 859-865
Author(s):  
E Prost ◽  
A Reignier ◽  
F Leperlier ◽  
P Caillet ◽  
P Barrière ◽  
...  
Keyword(s):  
Embryo Transfer ◽  
Live Birth ◽  
Birth Rate ◽  
Embryo Quality ◽  
Live Birth Rate ◽  
Normal Weight ◽  
Blastocyst Transfer ◽  
Obese Women ◽  
Fresh Embryo Transfer ◽  
Weight Groups

Abstract STUDY QUESTION Does female obesity affect live birth rate after frozen-thawed blastocyst transfer? SUMMARY ANSWER Live birth rate was not statistically different between obese and normal weight patients after frozen-thawed blastocyst transfer (FBT). WHAT IS KNOWN ALREADY Obesity is a major health problem across the world, especially in women of reproductive age. It impacts both spontaneous fertility and clinical outcomes after assisted reproductive technology. However, the respective impact of female obesity on oocyte quality and endometrial receptivity remains unclear. While several studies showed that live birth rate was decreased in obese women after fresh embryo transfer in IVF cycle, only two studies have evaluated the effects of female body mass index (BMI) on pregnancy outcomes after frozen-thawed blastocyst transfer (FBT), reporting conflicting data. STUDY DESIGN, SIZE, DURATION This retrospective case control study was conducted in all consecutive frozen-thawed autologous blastocyst transfer (FBT) cycles conducted between 2012 and 2017 in a single university-based centre. A total of 1415 FBT cycles performed in normal weight women (BMI = 18.5–24.9 kg/m2) and 252 FBT cycles performed in obese women (BMI ≥ 30 kg/m2) were included in the analysis. PARTICIPANTS/MATERIALS, SETTING, METHODS Endometrial preparation was standard and based on hormonal replacement therapy. One or two blastocysts were transferred according to couple’s history and embryo quality. MAIN RESULTS AND THE ROLE OF CHANCE Female and male age, smoking status, basal AMH level and type of infertility were comparable in obese and normal weight groups. Concerning FBT cycles, the duration of hormonal treatment, the stage and number of embryos (84% single blastocyst transfer and 16% double blastocysts transfer) used for transfer were comparable between both groups. Mean endometrium thickness was significantly higher in obese than in normal weight group (8.7 ± 1.8 vs 8.1 ± 1.6 mm, P < 0.0001). Concerning FBT cycle outcomes, implantation rate, clinical pregnancy rate and live birth rate were comparable in obese and in normal weight groups. Odds ratio (OR) demonstrated no association between live birth rate after FBT and female BMI (OR = 0.92, CI 0.61–1.38, P = 0.68). LIMITATIONS, REASONS FOR CAUTION Anthropometric parameters such as hip to waist ratio were not used. Polycystic ovarian syndrome status was not included in the analysis. WIDER IMPLICATIONS OF THE FINDINGS Our study showed that live birth rate after frozen-thawed blastocyst transfer was not statistically different in obese and in normal-weight women. Although this needs confirmation, this suggests that the impairment of uterine receptivity observed in obese women after fresh embryo transfer might be associated with ovarian stimulation and its hormonal perturbations rather than with oocyte/embryo quality. STUDY FUNDING/COMPETING INTEREST(S) No external funding was received. There are no competing interests. TRIAL REGISTRATION NUMBER N/A.

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