Increased male live-birth rates after blastocyst-stage frozen-thawed embryo transfers compared with cleavage-stage frozen-thawed embryo transfers: a SART registry study

Abstract Background The number and the quality of embryos transferred are important predictors of success in in vitro fertilization (IVF) cycles. In the presence of more than one good quality embryo on the transfer day, double-embryo transfer (DET) can be performed with these embryos, but generally, different quality embryos are present in the available transfer cohort. We aimed to investigate the effect of transferring a poor quality embryo along with a good quality embryo on IVF outcomes. Methods In this study, 2298 fresh IVF/intracytoplasmic sperm injection (ICSI) cycles with two good quality embryos (group A), one good and one poor quality embryo (group B), and single good quality embryo (group C) transfers were examined. All groups were divided into two subgroups according to the transfer day as cleavage or blastocyst stage. Clinical pregnancy and live birth rates were the primary outcomes. Results In the cleavage stage transfer subgroups, the clinical pregnancy rates were lower in the single-embryo transfer (SET) subgroup compared with DET subgroups, but the difference was not statistically significant compared with DET with mixed quality embryos. The live birth rates were comparable between the three groups. In the blastocyst transfer subgroups, the clinical pregnancy and live birth rates were significantly higher in DET with two good quality embryos than DET with mixed quality embryos and SET groups. Multiple pregnancy rates were higher in both DET groups in terms of transfer day (p = 0.001). Conclusion DET with mixed quality embryos results with lower clinical pregnancy and live birth rates compared with DET with two good quality embryos at the blastocyst stage. At cleavage stage transfer, there is no difference in live birth rates between the two groups.

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Live birth rates after transfer of equal number of blastocysts or cleavage-stage embryos in IVF. a systematic review and meta-analysis

Fertility and Sterility ◽

10.1016/j.fertnstert.2007.07.1064 ◽

2007 ◽

Vol 88 ◽

pp. S317

Author(s):

E.G. Papanikolaou ◽

E. Kolibianakis ◽

C. Venetis ◽

H. Tournaye ◽

B. Tarlatzis ◽

...

Keyword(s):

Systematic Review ◽

Live Birth ◽

Meta Analysis ◽

Cleavage Stage ◽

Birth Rates ◽

Live Birth Rates

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Blastocyst transfer increases cumulative-live-birth-rates and reduces time and cost to livebirth compared with cleavage stage in recipients of donated oocytes. A randomized controlled trial

Reproductive BioMedicine Online ◽

10.1016/j.rbmo.2022.01.001 ◽

2022 ◽

Author(s):

E. Clua ◽

I. Rodríguez ◽

G. Arroyo ◽

A. Racca ◽

F. Martínez ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Live Birth ◽

Controlled Trial ◽

Blastocyst Transfer ◽

Cleavage Stage ◽

Birth Rates ◽

Live Birth Rates ◽

Randomized Controlled ◽

Cumulative Live Birth

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P–013 Sperm freezing does not affect live birth rates: results from 6,594 cycles in normozoospermic patients

Human Reproduction ◽

10.1093/humrep/deab130.012 ◽

2021 ◽

Vol 36 (Supplement_1) ◽

Author(s):

M Torra ◽

M Tutusaus ◽

D Garcia ◽

R Vassena ◽

A Rodríguez

Keyword(s):

Live Birth ◽

Study Groups ◽

Oocyte Donation ◽

Blastocyst Stage ◽

Reproductive Outcomes ◽

Sperm Cryopreservation ◽

Birth Rates ◽

Live Birth Rates ◽

Cryopreserved Sperm ◽

Fresh Semen

Abstract Study question Does sperm cryopreservation influence the reproductive outcomes of normozoospermic patients undergoing elective ICSI? Summary answer After controlling for confounders, the use of cryopreserved semen from normozoospermic patients does not affect pregnancy and live birth rates after ICSI. What is known already Sperm cryopreservation with slow freezing is a common practice in ART. While frozen-thawed semen typically presents reduced motility and vitality, its use for ICSI is generally considered adequate in terms of reproductive outcomes. Nevertheless, most studies comparing reproductive outcomes between fresh versus cryopreserved sperm include patients with oligo- and/or asthenozoospermia, where the altered quality of the sample can partially mask the full effect of freezing/thawing. The objective of this study is to ascertain whether ICSI using fresh or cryopreserved semen from normozoospermic patients results in similar fertilization rates and reproductive outcomes. Study design, size, duration Retrospective cohort of 6,594 couples undergoing their first elective ICSI cycle between January 2011 and December 2019, using normozoospermic partner semen (fresh or cryopreserved). All cycles involved a fresh embryo transfer, either at cleavage or blastocyst stage. Cycles were divided in 4 groups: fresh semen with partner’s oocytes (FSPO, n = 1.878), cryopreserved semen with partner’s oocytes (CSPO, n = 142), fresh semen with donor oocytes (FSDO, n = 2.413), and cryopreserved semen with donor oocytes (CSDO, n = 2.161). Participants/materials, setting, methods A slow freezing protocol using GM501 SpermStore medium (Gynemed, Lensahn) was used for all sperm cryopreservation. Sperm washing, capacitation, and selection prior to ICSI were performed equally for fresh and frozen-thawed samples, using pellet swim-up in IVF® medium (Vitrolife, Göteborg). Fertilization rate (FR), pregnancy (biochemical, clinical, and ongoing) and live birth (LB) rates were compared among study groups using Pearson’s Chi square and Student’s t-test. A p-value <0.05 was considered statistically significant. Main results and the role of chance Male and female age, sperm concentration and motility after ejaculation, and number of oocytes inseminated were similar between study groups compared (FSPO vs. CSPO, FSDO vs. CSDO). As expected, oocyte donation cycles resulted in higher LB rate than cycles in which partner’s oocytes were used (30.04% vs 18.17%, p < 0.001). In cycles using partner’s oocytes, no significant differences were observed between fresh and cryopreserved sperm in FR, pregnancy and LB rates (p > 0.05 for all outcomes). However, in oocyte donation, the mean FR after ICSI using cryopreserved semen (73.6 ± 19.6) was lower than the FR obtained with fresh semen (75.1 ± 19.2), p = 0.010. Similarly, in oocyte donation cycles, the biochemical pregnancy rate was significantly lower when using cryopreserved semen (48.5% in CSDO vs. 52.3% in FSDO, p = 0.009), while clinical, ongoing pregnancy and LB rates were similar between both semen status (p > 0.05). In oocyte donation, a subgroup analysis including only the ICSI cycles with embryo transfer at blastocyst stage (n = 1.187 for FSDO, n = 337 for CSDO) confirmed that the LB rate was comparable between fresh and cryopreserved semen groups (34.7% vs 35.6% respectively, p = 0.76), without significant differences in pregnancy rates neither (p > 0.05 for all outcomes). Limitations, reasons for caution Caution should be exerted when extrapolating these results to different protocols for sperm cryopreservation and selection, or to IVM and classical IVF cycles, which were excluded from analysis. Due to the retrospective nature of the study, some uncontrolled for variables may affect the results. Wider implications of the findings: Sperm cryopreservation does not affect pregnancy and live birth rates in normozoospermic patients, although it may lower slightly fertilization rates. In line with previous studies including patients with an apparent male factor detected after routine semen analysis, sperm cryopreservation is a safe and convenient technique. Trial registration number Not applicable

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Vitrification of cleavage stage day 3 embryos results in higher live birth rates than conventional slow freezing: a RCT

Human Reproduction ◽

10.1093/humrep/dev134 ◽

2015 ◽

Vol 30 (8) ◽

pp. 1820-1830 ◽

Cited By ~ 32

Author(s):

S. Debrock ◽

K. Peeraer ◽

E. Fernandez Gallardo ◽

D. De Neubourg ◽

C. Spiessens ◽

...

Keyword(s):

Live Birth ◽

Slow Freezing ◽

Cleavage Stage ◽

Birth Rates ◽

Live Birth Rates ◽

Day 3 Embryos

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Live birth rates after transfer of equal number of blastocysts or cleavage-stage embryos in IVF. A systematic review and meta-analysis

Human Reproduction ◽

10.1093/humrep/dem339 ◽

2007 ◽

Vol 23 (1) ◽

pp. 91-99 ◽

Cited By ~ 175

Author(s):

Evangelos G. Papanikolaou ◽

Efstratios M. Kolibianakis ◽

Herman Tournaye ◽

Christos A Venetis ◽

Human Fatemi ◽

...

Keyword(s):

Systematic Review ◽

Live Birth ◽

Meta Analysis ◽

Cleavage Stage ◽

Birth Rates ◽

Live Birth Rates

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Effect of Age and Morphology on Live Birth Rate After Cleavage Stage Embryo Transfer

Reproductive Sciences ◽

10.1007/s43032-020-00249-9 ◽

2020 ◽

Vol 28 (1) ◽

pp. 43-51

Author(s):

Michael Awadalla ◽

Nicole Vestal ◽

Lynda McGinnis ◽

Ali Ahmady

Keyword(s):

Embryo Transfer ◽

Live Birth ◽

Birth Rate ◽

Live Birth Rate ◽

Cleavage Stage ◽

Birth Rates ◽

Live Birth Rates ◽

Cleavage Stage Embryo ◽

Stage Embryo ◽

Best Fit

AbstractAccurate knowledge of the live birth rate for cleavage stage embryos is essential to determine an appropriate number of embryos to transfer at once. Results from previous studies lack details needed for practical use. This is a mathematical analysis and model building study of day 3 cleavage stage embryo transfers. A total of 996 embryos were transferred in 274 fresh and 83 frozen embryo transfers. Embryo morphology was divided into 4 groups based on number of cells and fragmentation percentage. Each embryo transfer was modeled as an equation equating the sum of the live birth rates of the transferred embryos to the number of live births that resulted. The least squares solution to the system of embryo transfer equations was determined using linear algebra. This analysis was repeated for ages 35 to 42 years old at oocyte retrieval. The best fit live birth rates per embryo in the age group centered on 35 years old were 29%, 13%, 10%, and 9% for embryos in the 8-cell with ≤ 5% fragmentation, 8-cell with > 5% fragmentation, 9–12 cell, and 6–7 cell groups, respectively. Cleavage stage embryos with fewer than 6 cells on day 3 had very low best fit live birth rates close to 0% at age 39 years and were excluded from the primary analysis to prevent overfitting. These live birth rates can be used with a simple embryo transfer model to predict rates of single and multiple gestation prior to a planned cleavage stage embryo transfer.

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