scholarly journals Efficiency of Autologous Egg Cryopreservation: Eight Years’ Experiences and Clinical Outcomes

2021 ◽  
Author(s):  
Cassie T. Wang ◽  
Xiangli Niu ◽  
Qiuyan Ruan ◽  
Weihua Wang

Oocyte cryopreservation is one of the state-of-art technologies in human reproductive medicine, which brings opportunities for women to preserve their fertility. In the present study, we analyzed the efficiency and outcomes of 8 years’ autologous egg cryopreservation: Frozen oocytes were warmed from 120 cycles and oocyte survival, fertilization, blastocyst development, clinical pregnancy, embryo implantation, live birth rates and birth weights were collected based on the patients’ ages of <35, 35–37 and > 37 years old. The details of oocyte cryopreservation and the efficiency were further analyzed based on different patient categories. During the study period, 849 oocytes from 120 cycles were warmed. Oocyte survival, fertilization, and blastocyst development were not affected by women’s ages at the time of cryopreservation. However, number of patients without blastocyst formation was significantly (P < 0.05) higher in patients >37 years old (31.2%) than that in patients <35 years old (13.1%). Higher live birth rates were observed in patients <35 (51.1%) and 35–37 (46.7%) years old than in patients >37 years old (28.6%) after fresh embryo transfer. Some patients did not have blastocysts mainly due to low fertilization by poor sperm or small number of oocytes warmed. These results indicate that the efficiency of oocyte cryopreservation, evaluated by live birth and embryo implantation rates is affected by women’s age, number of oocytes warmed and sperm quality.

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
R Heidenberg ◽  
A Lanes ◽  
E Ginsburg ◽  
C Gordon

Abstract Study question How do live birth rates differ in anovulatory women with polycystic ovary syndrome and hypothalamic hypogonadism compared to normo-ovulatory women undergoing fresh or frozen embryo transfer? Summary answer Live birth rates are similar among all groups undergoing fresh embryo transfer but are significantly lower in women with hypothalamic hypogonadism undergoing frozen embryo transfer. What is known already Conflicting data exist regarding pregnancy outcomes in patients with tubal factor infertility versus polycystic ovary syndrome (PCOS). Some studies demonstrate higher pregnancy and live birth rates for women with PCOS undergoing fresh embryo transfer, but other studies demonstrate no difference. Women with PCOS have higher live birth rates than those with tubal factor infertility when undergoing frozen embryo transfer. Fewer data are available regarding IVF outcomes in women with hypothalamic hypogonadism (HH) and tubal factor infertility. Several studies report comparable live birth rates with fresh embryo transfer, but there are no data on frozen embryo transfer outcomes. Study design, size, duration Retrospective cohort study of all fresh and frozen autologous embryo transfers performed for patients with oligo-anovulation (PCOS, n = 380 and HH, n = 39) and normo-ovulation (tubal factor infertility, n = 315) from 1/1/2012 to 6/30/2019. A total of 734 transfers from 653 patients were analyzed. Participants/materials, setting, methods Transfer outcomes, including implantation, miscarriage, clinical pregnancy and live birth rates, were assessed in fresh and frozen embryo transfer cycles. Adjusted relative risks (RR) and 95% confidence intervals (CI) were calculated adjusting for age, BMI, stimulation protocol, number of embryos transferred, embryo quality, endometrial stripe thickness and day of transfer. Poisson regression was used for counts and with an offset for ratios. Generalized estimating equations were used to account for patients contributing multiple cycles. Main results and the role of chance For fresh embryo transfer cycles, live birth rates are similar among patients with tubal factor infertility, PCOS and HH (29.5% vs. 37.9% vs. 35.9%, respectively, aRR 1.15 95% CI: 0.91–1.44 and aRR 1.23 95% CI: 0.81–2.00, respectively). When evaluating frozen embryo transfer cycles, patients with HH have lower live birth rates than patients with tubal factor infertility (26.5% vs. 42.6%, aRR 0.54 95% CI: 0.33–0.88) and patients with PCOS (26.5% vs. 46.7%, aRR 0.55 95% CI: 0.34–0.88). Additionally, patients with HH have higher chemical pregnancy rates and miscarriage rates than patients with tubal factor infertility (26.5% vs. 13.0% and 17.7% vs. 6.5%, respectively, RR 2.71 95% CI: 1.27–5.77 and RR 2.03 95% CI: 1.05–3.80, respectively). Point biserial correlation showed no significant correlation between live birth and endometrial stripe thickness in HH patients undergoing frozen embryo transfer (r = 0.028, p-value 0.876). Limitations, reasons for caution This study is limited by its retrospective nature and the small sample size of women with hypothalamic hypogonadism. Additionally, these data represent outcomes from a single academic center, so generalizability of our findings may be limited. Wider implications of the findings: Lower live birth rates for HH patients undergoing frozen embryo transfer cycles are not correlated with endometrial stripe thickness. This may be due to absent gonadotropin signaling on endometrial receptors. A prospective randomized trial of HH patients to modified natural versus programmed frozen embryo transfer would best support this hypothesis. Trial registration number Not applicable


2018 ◽  
Vol 110 (1) ◽  
pp. 95-102.e1 ◽  
Author(s):  
Mohamad Irani ◽  
Claire O'Neill ◽  
Gianpiero D. Palermo ◽  
Kangpu Xu ◽  
Chenhui Zhang ◽  
...  

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0246440
Author(s):  
Abdelhamid Benmachiche ◽  
Sebti Benbouhedja ◽  
Abdelali Zoghmar ◽  
Peter Samir Hesjaer Al Humaidan

Background Conflicting evidence still prevails concerning the effect of preovulatory elevated progesterone (EP4) on reproductive outcomes in fresh embryo transfer (ET). However, few studies have analyzed the effect of EP4 on the likelihood of pregnancy using multivariate regression approach. The potential confounding factors tested in these studies were limited to either patient’s characteristics or to stimulation related parameters. Yet, several studies have shown that postovulatory parameters such as midluteal progesterone (P4) level may be considered as a proxy variable of endometrial receptivity as well. Objective The aim of the present study was to estimate the independent effect of preovulatory P4 effect, if any, on the probability of live birth (LB) by considering the midluteal endocrine profile when controlling for the potential confounding factors. Methods This is a secondary data analysis of a cohort of fresh IVF/ICSI cycles triggered with GnRH agonist (n = 328) performed in a single IVF center during the period 2014–2016. Patients contributed only one cycle and were stratified into four groups according to preovulatory P4 quartiles. We assessed the association between preovulatory P4 and the odds of LB calculated by logistic regression analysis after controlling for the most clinically relevant confounders. The primary outcome measure: Live birth rates (LBR). Results Both preovulatory and midluteal P4 were significantly correlated with the ovarian response. Logistic regression analysis showed that preovulatory serum P4 did not have a significant impact on LBR. In contrast, midluteal serum P4 level was an important independent factor associated with LBR. The optimal chance of LBR was achieved with midluteal serum P4 levels of 41–60 ng/ml, [OR: 2.73 (1.29–5.78); p< 0.008]. Conclusion The multivariate analysis suggests that the midluteal P4 level seems to impact LBR more than the preovulatory P4 level in women undergoing IVF treatment followed by fresh ET.


2004 ◽  
Vol 16 (2) ◽  
pp. 208
Author(s):  
J. Catt ◽  
T. Wood ◽  
M. Henman ◽  
R. Jansen

Improvements in human IVF have led to increased pregnancy rates but at the expense of increasing twinning rates. Twins are a bad outcome for the offspring, parents and the healthcare system. An obvious solution to this is to transfer only one embryo and freeze the rest for potential further treatment. This study looked at the effect of doing this on the cumulative live birth rate (when the cryopreserved embryos were thawed and transferred). Patients less than 38 years of age presenting for IVF treatment and with more than two embryos suitable for transfer were offered the chance of transferring only one embryo (elective single embryo transfer, eSET) and freezing the rest. Those patients declining a single embryo transfer had two transferred and served as the controls. Patients not achieving a pregnancy returned for a frozen embryo transfer but were not restricted on the number transferred (to a maximum of two). Cumulative live birth rates were recorded over the ensuing two years. Statistical comparisons were made using paired chi-square tests. The live birth rates from the initial fresh transfer was 41% for eSET (41/111) and significantly higher (53%, P&lt;0.05) for the two-embryo transfer group. These differences were eliminated when the frozen embryos were factored in, both groups rising to 61% of patients treated (68 and 172 live births, respectively). The twinning rate was significantly reduced (P&lt;0.01) from 33% in the two-embryo transfer group to 6% (arising from 4 sets of twins in the frozen embryo transfers) in the eSET group. eSET in the fresh embryo transfer cycle does not affect the chances of a live birth and reduces the twinning rate at least fivefold. Currently, 70% of patients under the age of 38 are electing to have eSET.


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