scholarly journals Fresh versus frozen embryo transfer: a retrospective cohort study

2019 ◽  
Vol 8 (9) ◽  
pp. 3774
Author(s):  
Raksha K. Shetty ◽  
Purnima K. Nadkarni ◽  
Pooja P. Singh ◽  
Prabhakar Singh ◽  
Aditi A. Nadkarni ◽  
...  
Keyword(s):  
Cohort Study ◽  
Pregnancy Rate ◽  
Embryo Transfer ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Pregnancy Rates ◽  
Clinical Pregnancy ◽  
Frozen Embryo Transfer ◽  
Clinical Pregnancy Rate ◽  
Transfer Strategies

Background: Elective frozen embryo transfer (FET), has recently increased significantly with improvements in cryopreservation techniques. Observational studies and randomized controlled trials suggested that the endometrium in stimulated cycles is not optimally prepared for implantation; risk of ovarian hyperstimulation syndrome reduced and pregnancy rates increased following FET and perinatal outcomes are less affected after FET. However, the evidence is not unequivocal and recent randomised control trials challenge the use of elective FET for the general IVF population. Pregnancy rates were analysed in a cohort of patients undergoing embryo transfers.Methods: This was a retrospective cohort study of patients who underwent embryo transfers from April 2018 to March 2019 at study centre in Surat.175 cycles of embryo transfers (119 fresh and 56 frozen) were included in the study. Outcomes measured were positive pregnancy, clinical pregnancy and ongoing clinical pregnancy rates achieved in the IVF-ET cycles.Results: There were no statistically significant differences between positive pregnancy rate (54.6% versus 60.7%, Odds ratio (OR) 0.78; 95% Confidence Interval (CI) 0.41-1.49), clinical pregnancy rate (48.73% versus 57.14%, OR 0.52; 95% CI 0.1- 2.64) and ongoing clinical pregnancy rate  (45.38% versus 51.78% OR 1.4; 95% CI 0.29 - 6.67) in fresh ET and FET cycles, respectively, p < 0.05 was considered statistically significant for all measures.Conclusions: Despite the observed higher rates of positive biochemical, clinical and ongoing clinical pregnancy per transfer in the FET cohort, these did not reach statistical significance. Thus, both transfer strategies are reasonable options, although there is a trend favouring the freeze-all strategy.

scholarly journals Uterus Size May Affect Reproductive Outcome in Women with Adenomyosis After Gnrh- Agonist Pretreatment Undergoing Frozen Embryo Transfer Cycles: A Retrospective Cohort Study

2020 ◽  
Author(s):  
Wei Xiong ◽  
Ruiyi Tang ◽  
Peng Wu ◽  
Zhengyi Sun ◽  
jingran zhen ◽  
...  
Keyword(s):  
Cohort Study ◽  
Pregnancy Rate ◽  
Embryo Transfer ◽  
Live Birth ◽  
Gnrh Agonist ◽  
Retrospective Cohort Study ◽  
Pregnancy Outcomes ◽  
Retrospective Cohort ◽  
Clinical Pregnancy ◽  
Frozen Embryo Transfer

Abstract Background: GnRH-agonist is used to treat adenomyosis, but its efficacy in adenomyosis patients with uterine enlargement undergoing frozen embryo transfer (FET) is unclear. Methods：The retrospective cohort study comprised 112 adenomyosis patients with uterine enlargement undergoing the first FET circle. A long-term GnRH-a pretreatment was administered to 112 patients with uterine enlargement. These patients were divided into two groups according to the therapeutic effect: patients with a normal-size uterus after GnRH-a treatment (GN group) and patients with an enlarged uterus after GnRH-a treatment (GL group). Results：Not all patients can shrink their uterus to a satisfactory level. After receiving GnRH-a pretreatment, the uterus returned to normal size in 77% of patients (GN group), and 23% of patients had a persistently enlarged uterus (GL group). The pregnancy rate, clinical pregnancy rate, ongoing pregnancy rate, and live birth rate were significantly higher in the GN group than in the GL group. Controlling for the confounding factors, normal uterus size (odds ratio [OR] 4.50; P=0.03) and low body mass index (OR 3.13; P=0.03) affected the odds of achieving live birth. The cut-off value selected on the ROC curve of uterus volume after GnRH-a treatment for detecting live birth was 144.7Conclusions：GnRH-a pretreatment was associated with the regression of adenomyosis lesions and improved clinical pregnancy outcomes in the adenomyosis patients with uterine enlargement whose lesion are GnRH-a susceptible on FET cycles. However, about a quarter of patients may not be less responsive to GnRH-a and have poorer pregnancy outcomes, especially in overweight women.

scholarly journals Progestin-primed ovarian stimulation vs mild stimulation in women with advanced age above 40: a retrospective cohort study

2019 ◽  
Vol 17 (1) ◽  
Author(s):  
Qian Peng ◽  
Xiang Cao ◽  
Jing Wang ◽  
Lin Wang ◽  
Jun Xu ◽  
...  
Keyword(s):  
Cohort Study ◽  
Pregnancy Rate ◽  
Retrospective Cohort Study ◽  
Ovarian Stimulation ◽  
Retrospective Cohort ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
Advanced Age ◽  
Significant Difference ◽  
Mild Stimulation

Abstract Background Previous studies have demonstrated that progestin-primed ovarian stimulation (PPOS) protocol was a feasible and efficient method in in vitro fertilization (IVF) cycle. However, its application in women with advanced age has not been determined yet. The purpose of this study was to investigate its efficacy in women aged ≥40 years old. Methods This retrospective cohort study included patients with ages of ≥40 years old at the time of ovarian stimulation. The embryonic and clinical outcome of mild stimulation and PPOS were compared. Primary outcome was top-quality embryo rate on day 3, and secondary outcome was clinical pregnancy rate. Results Baseline characteristics of patients was similar in mild stimulation (122 cycles) and PPOS (47 cycles). No significant difference was found in the number of retrieved and mature oocytes and the fertilization and cleavage rates. Of interest, the rate of top-quality embryos was significantly higher in PPOS group (50.08% vs 33.29%, p = 0.015), with an increasing trend of viable embryo rate (73.55% vs 61.16%). A greater amount of gonadotropin was observed in PPOS group (2061.17 ± 1254.63 IU vs 1518.14 ± 547.25 IU, p < 0.05) in spite of comparable duration of stimulation. After FET cycle, no significant difference was found in the clinical pregnancy rates between mild stimulation (12.5%) and PPOS group (16.7%). Conclusions Higher percentage of top-quality embryos on Day 3 and comparable clinical pregnancy rate was obtained in PPOS protocol, which could be considered as a feasible ovarian stimulation protocol in women aged above 40 years old.

scholarly journals Clinical pregnancy rate following frozen embryo transfer is higher with blastocysts vitrified on day 5 than on day 6

2016 ◽  
Vol 33 (12) ◽  
pp. 1553-1557 ◽  
Author(s):  
Jigal Haas ◽  
Jim Meriano ◽  
Carl Laskin ◽  
Yaakov Bentov ◽  
Eran Barzilay ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Embryo Transfer ◽  
Clinical Pregnancy ◽  
Frozen Embryo Transfer ◽  
Clinical Pregnancy Rate

scholarly journals Retrospective cohort study on preparation regimens for frozen embryo transfer

2021 ◽  
Author(s):  
Monique Atkinson ◽  
Jenny Crittenden ◽  
Howard Smith ◽  
Cecilia Sjoblom Ahlstrom
Keyword(s):  
Cohort Study ◽  
Embryo Transfer ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Live Birth Rate ◽  
Frozen Embryo Transfer ◽  
Miscarriage Rate ◽  
Endometrial Preparation ◽  
Significant Difference ◽  
Natural Cycles

Objective: To examine the pregnancy outcomes from frozen embryo transfer (FET) cycles using different endometrial preparation regimens, compared to ovulation induction with letrozole (letrozole OI). Design: Retrospective cohort study. Setting: Fertility centre in Sydney, Australia. Patient(s): 6060 frozen embryo transfer cycles. Interventions: Cycles were stratified into one of four ways to achieve endometrial preparation. These were either a natural, letrozole OI, OI with follicle stimulating hormone (FSH OI) or a programmed cycle. Main Outcome Measure(s): The primary outcome was live birth rate per embryo transfer (LBR). Secondary outcomes included clinical pregnancy and biochemical pregnancy rates, adverse events including miscarriage, ectopic pregnancy, stillbirth, neonatal death and multiple births. Ovarian stimulation parameters were also analysed including time taken to reach the luteal phase and the number of blood or urine tests required for monitoring of the cycle. Results: The LBR following letrozole OI cycles was higher when compared to natural cycles (OR 1.27 (1.07 – 1.49)) and programmed cycles (OR 2.36 (1.67 – 3.34)). There was no significant difference between letrozole OI and FSH OI LBR (OR 0.99 (0.76 – 1.28)). An improved LBR with letrozole OI compared to natural cycles was maintained when only women with a normal length cycle were considered (OR 1.44 (1.10 – 1.89)). There was a significant reduction in miscarriage rates when letrozole OI was compared to programmed cycles (OR 0.46 (0.26 – 0.83)). Conclusion(s): The use of letrozole OI for endometrial preparation in an FET cycle may be associated with higher LBR and lower miscarriage rate, compared to using a programmed cycle.

scholarly journals Effectiveness of highly purified HMG plus r-FSH vs r-FSH alone vs r-FSH plus r-LH in IVF-ET/ ICSI patients：a retrospective cohort study

2020 ◽  
Author(s):  
Zhong-Kai Wang ◽  
She-ling Wu ◽  
Xiao-Na Yu ◽  
Hong-Wu Qiao ◽  
Hua Lou ◽  
...  
Keyword(s):  
Cohort Study ◽  
Subgroup Analysis ◽  
Retrospective Cohort Study ◽  
Ovulation Induction ◽  
Retrospective Cohort ◽  
Pregnancy Rates ◽  
Clinical Pregnancy ◽  
Current Standard ◽  
Significant Difference ◽  
Clinical Pregnancy Rates

Abstract Objective: To evaluate the effectiveness of highly purified human menopausal gonadotropins (hp-HMG) plus recombinant follicle stimulating hormone (r-FSH) vs r-FSH vs r-FSH plus recombinant luteinizing hormone （r-LH） in vitro fertilization (IVF) / intracytoplasmic sperm injection (ICSI) patients。Design :Retrospective cohort studyMethods:This was a retrospective study. Among a total number of 3568 patients who had undergone IVF/ICSI applications, 409 eligible patients were included.Total units of follitropin alpha preparations used in ovulation induction, total number of meiois-2 phase oocytes, total number of used oocytes in ICSI cycle, fertilization rate and clinical pregnancy rates of both groups were analyzed. In this retrospective cohort study, women undergoing IVF/ICSI Gonadotropin releasing hormone (GnRH) antagonist cycles downregulation. 409 patients were included in the study. Among them One group followed the current standard protocol of no LH or hp-HMG supplementation given(n=64). The other had LH supplementation in the form of r -LH (Luveris; Merck Serono, Switzerland) (n=221), Another group had hp-HMG supplementation in the form of hp-HMG (Menopur , Ferring,Germany)(n=121).In the Subgroup analysis were decided by AFC ,7 < AFC〈20 or AFC>20 of the three group.Result: Mean duration of stimulation and was longer in the group of patients treated with hp-HMG plus rFSH compared to the group of patients treated with r-FSH and the group of r-LH plus r-FSH (13.24 days and 12.72days and12.21days, respectively; P<0.05). The amount of GN does for patients treated withhp-HMG plus rFSH compared to the group of patients treated with r-FSH plus r-LH and the group of r-FSH alone respectively (P<0.05). Clinical pregnancy rates were 76.6% and 60.9% and 62.9% （P<0.05）in the groups of patients treated with hp-hMG plus rFSH, r-FSH plus r-LH,r-FSHalonerespectively. What’s morea greater live birth rate was noted in the hp-hMG plus r-FSH group, there was statistically significant difference between the three groups (P>0.05).in the subgroup analysis when AFC>20 hp-HMG plus rFSH group have more lower ovarian hyperstimulation syndrome （OHSS） than r-FSH plus r-LH and rFSH alone,respectively.Clonclusion:The higher oocyte yield with r-FSH does not result in higher quality embryos.hp-HMG or r-LH supplementation is an option for improving IVF outcome in patients ovulation induction with r-FSH during GnRH agonist down-regulation. Particularly, hp-HMG is recommended as it may have a beneficial action on implantation in selected group especially AFC more than 20patients.

Combined treatment of prednisone and hydroxychloroquine may improve outcomes of frozen embryo transfer in antinuclear antibody-positive patients undergoing IVF/ICSI treatment

Lupus ◽  
2021 ◽  
pp. 096120332110558
Author(s):  
Rui Gao ◽  
Wei Deng ◽  
Cheng Meng ◽  
Kemin Cheng ◽  
Xun Zeng ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Embryo Transfer ◽  
Pregnancy Loss ◽  
Loss Rate ◽  
Implantation Rate ◽  
Clinical Pregnancy ◽  
Frozen Embryo Transfer ◽  
Clinical Pregnancy Rate ◽  
High Quality ◽  
Biochemical Pregnancy

Background The influence of anti-nuclear antibody (ANA) on induced ovulation was controversial, and the effect of prednisone plus hydroxychloroquine (HCQ) treatment on frozen embryo transfer outcomes of in-vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) for ANA-positive women was unclear. Methods Fifty ANA-positive women and one-hundred ANA-negative women matched for age and anti-Mullerian hormone (AMH) were included from a Reproductive Medical Central of a University Hospital. Sixty-one oocytes pick-up (OPU) cycles in ANA+ group and one-hundred OPU cycles in ANA− group were compared; 30 frozen embryo transfer cycles without treatment and 66 with prednisone plus HCQ treatment among ANA-positive women were compared. Results There was no statistical difference in number of retrieved oocytes (13.66 ± 7.71 vs 13.72 ± 7.23, p = .445), available embryos (5.23 ± 3.37 vs 5.47 ± 3.26, p = .347), high-quality embryos (3.64 ± 3.25 vs 3.70 ± 3.52, p = .832), and proportion of high-quality embryos (26.5% vs. 26.7%, p = .940). Biochemical pregnancy rate (33.3% vs. 68.2%, p < .05), clinical pregnancy rate (20.0% vs. 50.1%, p < .05), and implantation rate (5.6% vs. 31.8%, p < .05) were lower, and pregnancy loss rate (83.3% vs. 23.1%, p < .05) was higher in patients with treatment than no treatment. Conclusion The influence of ANA on number of retrieved oocytes, available embryos, high-quality embryos, and proration of high-quality embryos was not found. The treatment of prednisone plus HCQ may improve implantation rate, biochemical pregnancy rate, and clinical pregnancy rate, and reduce pregnancy loss rate in frozen embryo transfer outcomes for ANA-positive women.

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