Top

BMC Pregnancy and Childbirth

Published in:

Open Access 01-12-2021 | ICSI | Research

Effects of immediate versus delayed frozen embryo transfer in high responder patients undergoing freeze-all cycles

Authors: Na Zuo, Yingzhuo Gao, Ningning Zhang, Da Li, Xiuxia Wang

Published in: BMC Pregnancy and Childbirth | Issue 1/2021

Abstract

Background

Frozen embryo transfer (FET) can greatly improve the pregnancy outcomes for high responder patients. However, it is not known whether the timing of FET is a risk factor on pregnancy outcomes in high responder patients undergoing freeze-all cycles.

Methods

A retrospective cohort study to compare the pregnancy outcomes of the immediate and delayed FET groups in high responder patients undergoing freeze-all cycles. The two groups were defined as that FET took place either within the first menstrual cycle following oocyte retrieval or afterwards. Propensity score matching was used to make the potential risk factors of the two groups comparable. Multivariable regression analysis was used to study the effect of the timing of FET on pregnancy outcomes in the entire cohort and propensity score-matched cohort, even in different controlled ovarian hyperstimulation protocol cohorts as subgroup analysis.

Results

We obtained 1130 patients in immediate FET group and 998 patients in delayed FET group, and the average age of the two groups were 30.30 and 30.63. We showed that the immediate FET group were equivalent to delayed FET group in the entire cohort [clinical pregnancy rate (CPR), 61.0% versus 63.4%, adjusted odd ratio (OR), 0.939, 95% confidence interval (CI), 0.781–1.129; spontaneous abortion rate (SAR), 10.1% versus 12.6%, adjusted OR, 0.831, 95% Cl (0.628–1.098); live birth rate (LBR), 49.9% versus 49.2%, adjusted OR, 1.056, 95% Cl (0.883–1.263)]. The same results were obtained by χ² test in the propensity score-matched cohort (CPR, 60.5% versus 63.5%; SAR, 11.6% versus 12.3%; LBR, 48% versus 49.3%) (P > 0.05). Subgroup analysis indicated that pregnancy outcomes of immediate FET were no difference to delayed FET in gonadotropin-releasing hormone agonist (GnRH-a) protocol (P > 0.05). The SAR of the immediate FET group were lower than that of the delayed FET group in GnRH antagonist protocol (adjusted OR, 0.645, 95% CI, 0.430–0.966) (P < 0.05), no differences were observed in CPR and LBR (P > 0.05).

Conclusions

The pregnancy outcomes of immediate FET were no difference to delayed FET in high responder population undergoing freeze-all cycles.

Chen CH, Zhang X, Barnes R, Confino E, Milad M, Puscheck E, et al. Relationship between peak serum estradiol levels and treatment outcome in in vitro fertilization cycles after embryo transfer on day 3 or day 5. Fertil Steril. 2003;80(1):75–9. https://doi.org/10.1016/S0015-0282(03)00504-1.CrossRefPubMed

Junovich G, Mayer Y, Azpiroz A, Daher S, Iglesias A, Zylverstein C, et al. Ovarian stimulation affects the levels of regulatory endometrial NK cells and angiogenic cytokine VEGF. Am J Reprod Immunol. 2011;65(2):146–53. https://doi.org/10.1111/j.1600-0897.2010.00892.x.CrossRefPubMed

Haouzi D, Assou S, Mahmoud K, Tondeur S, Reme T, Hedon B, et al. Gene expression profile of human endometrial receptivity: comparison between natural and stimulated cycles for the same patients. Hum Reprod. 2009;24(6):1436–45. https://doi.org/10.1093/humrep/dep039.CrossRefPubMed

Venetis CA, Kolibianakis EM, Bosdou JK, Tarlatzis BC. Progesterone elevation and probability of pregnancy after IVF: a systematic review and meta-analysis of over 60 000 cycles. Hum Reprod Update. 2013;19(5):433–57. https://doi.org/10.1093/humupd/dmt014.CrossRefPubMed

Ozgur K, Berkkanoglu M, Bulut H, Isikli A, Coetzee K. Higher clinical pregnancy rates from frozen-thawed blastocyst transfers compared to fresh blastocyst transfers: a retrospective matched-cohort study. J Assist Reprod Genet. 2015;32(10):1483–90. https://doi.org/10.1007/s10815-015-0576-1.CrossRefPubMedPubMedCentral

Practice Committee of the American Society for Reproductive Medicine. Electronic address. Prevention and treatment of moderate and severe ovarian hyperstimulation syndrome: a guideline. Fertil Steril 2016, 106(7):1634–1647, DOI: https://doi.org/10.1016/j.fertnstert.2016.08.048.

Pelkonen S, Koivunen R, Gissler M, Nuojua-Huttunen S, Suikkari AM, Hyden-Granskog C, et al. Perinatal outcome of children born after frozen and fresh embryo transfer: the Finnish cohort study 1995-2006. Hum Reprod. 2010;25(4):914–23. https://doi.org/10.1093/humrep/dep477.CrossRefPubMed

Liu SY, Teng B, Fu J, Li X, Zheng Y, Sun XX. Obstetric and neonatal outcomes after transfer of vitrified early cleavage embryos. Hum Reprod. 2013;28(8):2093–100. https://doi.org/10.1093/humrep/det104.CrossRefPubMed

Pelkonen S, Hartikainen AL, Ritvanen A, Koivunen R, Martikainen H, Gissler M, et al. Major congenital anomalies in children born after frozen embryo transfer: a cohort study 1995-2006. Hum Reprod. 2014;29(7):1552–7. https://doi.org/10.1093/humrep/deu088.CrossRefPubMed

10.

Maas KH, Baker VL, Westphal LM, Lathi RB. Optimal timing of frozen embryo transfer after failed IVF attempt. Fertil Steril. 2008;90:S285. https://doi.org/10.1016/j.fertnstert.2008.07.1101.CrossRef

11.

Volodarsky-Perel A, Eldar-Geva T, Holzer HE, Schonberger O, Reichman O, Gal M. Cryopreserved embryo transfer: adjacent or non-adjacent to failed fresh long GnRH-agonist protocol IVF cycle. Reprod BioMed Online. 2017;34(3):267–73. https://doi.org/10.1016/j.rbmo.2016.11.013.CrossRefPubMed

12.

Hsieh YY, Chang CC, Tsai HD. Comparisons of different dosages of gonadotropin-releasing hormone (GnRH) antagonist, short-acting form and single, half-dose, long-acting form of GnRH agonist during controlled ovarian hyperstimulation and in vitro fertilization. Taiwan J Obstet Gynecol. 2008;47(1):66–74. https://doi.org/10.1016/S1028-4559(08)60057-1.CrossRefPubMed

13.

Santos-Ribeiro S, Polyzos NP, Lan VT, Siffain J, Mackens S, Van Landuyt L, et al. The effect of an immediate frozen embryo transfer following a freeze-all protocol: a retrospective analysis from two centres. Hum Reprod. 2016;31(11):2541–8. https://doi.org/10.1093/humrep/dew194.CrossRefPubMed

14.

Papanikolaou EG, Pozzobon C, Kolibianakis EM, Camus M, Tournaye H, Fatemi HM, et al. Incidence and prediction of ovarian hyperstimulation syndrome in women undergoing gonadotropin-releasing hormone antagonist in vitro fertilization cycles. Fertil Steril. 2006;85(1):112–20. https://doi.org/10.1016/j.fertnstert.2005.07.1292.CrossRefPubMed

15.

Magnusson A, Kallen K, Thurin-Kjellberg A, Bergh C. The number of oocytes retrieved during IVF: a balance between efficacy and safety. Hum Reprod. 2018;33(1):58–64. https://doi.org/10.1093/humrep/dex334.CrossRefPubMed

16.

Hamdine O, Eijkemans MJ, Lentjes EW, Torrance HL, Macklon NS, Fauser BC, et al. Ovarian response prediction in GnRH antagonist treatment for IVF using anti-Mullerian hormone. Hum Reprod. 2015;30(1):170–8. https://doi.org/10.1093/humrep/deu266.CrossRefPubMed

17.

Scheinhardt MO, Lerman T, Konig IR, Griesinger G. Performance of prognostic modelling of high and low ovarian response to ovarian stimulation for IVF. Hum Reprod. 2018;33(8):1499–505. https://doi.org/10.1093/humrep/dey236.CrossRefPubMed

18.

Alpha Scientists in Reproductive M, Embryology ESIGo. The Istanbul consensus workshop on embryo assessment: proceedings of an expert meeting. Hum Reprod. 2011;26(6):1270–83.CrossRef

19.

Gardner DK, Surrey E, Minjarez D, Leitz A, Stevens J, Schoolcraft WB. Single blastocyst transfer: a prospective randomized trial. Fertil Steril. 2004;81(3):551–5. https://doi.org/10.1016/j.fertnstert.2003.07.023.CrossRefPubMed

20.

Zegers-Hochschild F, Adamson GD, de Mouzon J, Ishihara O, Mansour R, Nygren K, et al. International Committee for Monitoring Assisted Reproductive Technology (ICMART) and the World Health Organization (WHO) revised glossary of ART terminology, 2009. Fertil Steril. 2009;92(5):1520–4.CrossRef

21.

Venetis CA, Kolibianakis EM, Bosdou JK, Lainas GT, Sfontouris IA, Tarlatzis BC, et al. Estimating the net effect of progesterone elevation on the day of hCG on live birth rates after IVF: a cohort analysis of 3296 IVF cycles. Hum Reprod. 2015;30(3):684–91. https://doi.org/10.1093/humrep/deu362.CrossRefPubMed

22.

Higgins C, Healey M, Jatkar S, Vollenhoven B. Interval between IVF stimulation cycle and frozen embryo transfer: is there a benefit to a delay between cycles? Aust N Z J Obstet Gynaecol. 2018;58(2):217–21. https://doi.org/10.1111/ajo.12696.CrossRefPubMed

23.

Lattes K, Checa MA, Vassena R, Brassesco M, Vernaeve V. There is no evidence that the time from egg retrieval to embryo transfer affects live birth rates in a freeze-all strategy. Hum Reprod. 2017;32(2):368–74. https://doi.org/10.1093/humrep/dew306.CrossRefPubMed

24.

Huang J, Lu X, Xie Q, Lin J, Cai R, Kuang Y. Timing of frozen-thawed embryo transfer after controlled ovarian stimulation in a non-elective freeze-all policy. Ann Transl Med. 2019;7(23):752. https://doi.org/10.21037/atm.2019.11.74.CrossRefPubMedPubMedCentral

25.

Huang J, Lin J, Lu X, Cai R, Song N, Kuang Y. Delayed versus immediate frozen embryo transfer after oocyte retrieval: a systematic review and meta-analysis. J Assist Reprod Genet. 2020;37(8):1949–57. https://doi.org/10.1007/s10815-020-01857-9.CrossRefPubMed

26.

Lambalk CB, Banga FR, Huirne JA, Toftager M, Pinborg A, Homburg R, et al. GnRH antagonist versus long agonist protocols in IVF: a systematic review and meta-analysis accounting for patient type. Hum Reprod Update. 2017;23(5):560–79. https://doi.org/10.1093/humupd/dmx017.CrossRefPubMed

27.

Mao GH, Feng Z, He Y, Huang YR. Comparisons of the effects of long-acting and short-acting GnRH agonists on embryo quality, endometrial thickness and pregnancy rate in human in vitro fertilization. Arch Med Sci. 2014;10(1):161–6. https://doi.org/10.5114/aoms.2014.40743.CrossRefPubMedPubMedCentral

28.

Frazier T, Hogue CJR, Bonney EA, Yount KM, Pearce BD. Weathering the storm; a review of pre-pregnancy stress and risk of spontaneous abortion. Psychoneuroendocrinology. 2018;92:142–54. https://doi.org/10.1016/j.psyneuen.2018.03.001.CrossRefPubMed

29.

Boivin J, Gameiro S. Evolution of psychology and counseling in infertility. Fertil Steril. 2015;104(2):251–9. https://doi.org/10.1016/j.fertnstert.2015.05.035.CrossRefPubMed

30.

Conrad KP, Baker VL. Corpus luteal contribution to maternal pregnancy physiology and outcomes in assisted reproductive technologies. Am J Physiol Regul Integr Comp Physiol. 2013;304(2):R69–72. https://doi.org/10.1152/ajpregu.00239.2012.CrossRefPubMed

31.

Chen X, Man GCW, Liu Y, Wu F, Huang J, Li TC, et al. Physiological and pathological angiogenesis in endometrium at the time of embryo implantation. Am J Reprod Immunol. 2017;78(2):e12693. https://doi.org/10.1111/aji.12693.CrossRef

Title: Effects of immediate versus delayed frozen embryo transfer in high responder patients undergoing freeze-all cycles
Authors: Na Zuo
Yingzhuo Gao
Ningning Zhang
Da Li
Xiuxia Wang
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: ICSI
GnRH Agonists
Published in: BMC Pregnancy and Childbirth / Issue 1/2021
Electronic ISSN: 1471-2393
DOI: https://doi.org/10.1186/s12884-021-03919-x

2024 ASCO Annual Meeting

Springer Medicine

Effects of immediate versus delayed frozen embryo transfer in high responder patients undergoing freeze-all cycles

Abstract

Background

Methods

Results

Conclusions

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2021

What stakeholders think: perceptions of perinatal depression and screening in China’s primary care system

Resilience to maintain quality of intrapartum care in war torn Yemen: a retrospective pre-post study evaluating effects of changing birth volumes in a congested frontline hospital

A systematic review and meta-analysis of prevalence of insomnia in the third trimester of pregnancy

Fetal growth standards for Chinese twin pregnancies

The effect of sexual health education on sexual activity, sexual quality of life, and sexual violence in pregnancy: a prospective randomized controlled trial

Decision-making for prenatal genetic screening: how will pregnant women navigate a growing number of aneuploidy and carrier screening options?