Skip to main content
Top
Published in: BMC Pregnancy and Childbirth 1/2020

01-12-2020 | Infertility | Research article

Pregnancy and perinatal outcomes in pregnancies resulting from time interval between a freeze-all cycle and a subsequent frozen-thawed single blastocyst transfer

Authors: Shiqiao Hu, Bei Xu, Rui Long, Lei Jin

Published in: BMC Pregnancy and Childbirth | Issue 1/2020

Login to get access

Abstract

Background

Adverse obstetric outcomes are correlated with altered circulating hormone levels at the time implantation by the trophectoderm. What’ more, embryo freezing process may also have adverse effect on perinatal outcomes. This study aims to evaluate whether increasing interval time between a freeze-all cycle and a subsequent frozen-thawed single blastocyst transfer could have any effect on pregnancy and perinatal outcomes.

Methods

This was a retrospective cohort study included the first single blastocyst transfer in artificially cycles of all patients who underwent a freeze-all cycle between January 1st, 2016 and September 30th, 2018. All patients were divided into two groups according to the time interval between oocyte retrieval and the day of first frozen-thawed embryo transferred (FET): Group 1 (immediate FET cycles) and Group 2 (delayed FET cycles).

Results

No significant differences were reported between the two groups regarding the rates of clinical pregnancy, live birth, biochemical pregnancy and pregnancy loss even after adjusting for measured confounding. When accounting for perinatal outcomes, gestational age, birth weight, delivery mode, fetus gender, preterm birth, gestational hypertension, GDM, placenta previa, fetal malformation and low birthweight also did not vary significantly between the two groups. Only the incidence of macrosomia was more frequently in the Group 2 compared with the Group 1 (AOR 3.886, 95%CI 1.153–13.103, P = 0.029) after adjusting with a multiple logistic regression model.

Conclusions

We found delayed FET cycles for blastocyst transfer following freeze-all cycles may not improve the pregnancy outcomes. On the contrary, postponement of FET cycles may increase the risk of macrosomia. Therefore, FET cycles for blastocyst transfer should be done immediately to avoid adverse effects of delayed time on perinatal outcomes.
Literature
1.
go back to reference Santos-Ribeiro S, Siffain J, Polyzos NP, van de Vijver A, van Landuyt L, Stoop D, et al. To delay or not to delay a frozen embryo transfer after a failed fresh embryo transfer attempt? Fertil Steril. 2016;105:1202–7.CrossRef Santos-Ribeiro S, Siffain J, Polyzos NP, van de Vijver A, van Landuyt L, Stoop D, et al. To delay or not to delay a frozen embryo transfer after a failed fresh embryo transfer attempt? Fertil Steril. 2016;105:1202–7.CrossRef
2.
go back to reference Sharma V, Allgar V, Rajkhowa M. Factors influencing the cumulative conception rate and discontinuation of in vitro fertilization treatment for infertility. Fertil Steril. 2002;78:40–6.CrossRef Sharma V, Allgar V, Rajkhowa M. Factors influencing the cumulative conception rate and discontinuation of in vitro fertilization treatment for infertility. Fertil Steril. 2002;78:40–6.CrossRef
3.
go back to reference Chen YH, Wang Q, Zhang YN, Han X, Li DH, Zhang CL. Cumulative live birth and surplus embryo incidence after frozen-thaw cycles in PCOS: how many oocytes do we need? J Assist Reprod Genet. 2017;34:1153–9.CrossRef Chen YH, Wang Q, Zhang YN, Han X, Li DH, Zhang CL. Cumulative live birth and surplus embryo incidence after frozen-thaw cycles in PCOS: how many oocytes do we need? J Assist Reprod Genet. 2017;34:1153–9.CrossRef
4.
go back to reference Davenport MJ, Vollenhoven B, Talmor AJ. Gonadotropin-releasing hormone-agonist triggering and a freeze-all approach: the final step in eliminating ovarian Hyperstimulation syndrome? Obstet Gynecol Surv. 2017;72:296–308.CrossRef Davenport MJ, Vollenhoven B, Talmor AJ. Gonadotropin-releasing hormone-agonist triggering and a freeze-all approach: the final step in eliminating ovarian Hyperstimulation syndrome? Obstet Gynecol Surv. 2017;72:296–308.CrossRef
5.
go back to reference Stormlund S, Lossl K, Zedeler A, Bogstad J, Praetorius L, Nielsen HS, et al. Comparison of a 'freeze-all' strategy including GnRH agonist trigger versus a 'fresh transfer' strategy including hCG trigger in assisted reproductive technology (ART): a study protocol for a randomised controlled trial. BMJ Open. 2017;7:e16106.CrossRef Stormlund S, Lossl K, Zedeler A, Bogstad J, Praetorius L, Nielsen HS, et al. Comparison of a 'freeze-all' strategy including GnRH agonist trigger versus a 'fresh transfer' strategy including hCG trigger in assisted reproductive technology (ART): a study protocol for a randomised controlled trial. BMJ Open. 2017;7:e16106.CrossRef
6.
go back to reference Zech J, Brandao A, Zech M, Lugger K, Neururer S, Ulmer H, et al. Elective frozen-thawed embryo transfer (FET) in women at risk for ovarian hyperstimulation syndrome. Reprod Biol. 2018;18:46–52.CrossRef Zech J, Brandao A, Zech M, Lugger K, Neururer S, Ulmer H, et al. Elective frozen-thawed embryo transfer (FET) in women at risk for ovarian hyperstimulation syndrome. Reprod Biol. 2018;18:46–52.CrossRef
7.
go back to reference Weinerman R, Mainigi M. Why we should transfer frozen instead of fresh embryos: the translational rationale. Fertil Steril. 2014;102:10–8.CrossRef Weinerman R, Mainigi M. Why we should transfer frozen instead of fresh embryos: the translational rationale. Fertil Steril. 2014;102:10–8.CrossRef
8.
go back to reference Royster GT, Krishnamoorthy K, Csokmay JM, Yauger BJ, Chason RJ, DeCherney AH, et al. Are intracytoplasmic sperm injection and high serum estradiol compounding risk factors for adverse obstetric outcomes in assisted reproductive technology? Fertil Steril. 2016;106:363–70.CrossRef Royster GT, Krishnamoorthy K, Csokmay JM, Yauger BJ, Chason RJ, DeCherney AH, et al. Are intracytoplasmic sperm injection and high serum estradiol compounding risk factors for adverse obstetric outcomes in assisted reproductive technology? Fertil Steril. 2016;106:363–70.CrossRef
9.
go back to reference Farhi J, Ben-Haroush A, Andrawus N, Pinkas H, Sapir O, Fisch B, et al. High serum oestradiol concentrations in IVF cycles increase the risk of pregnancy complications related to abnormal placentation. Reprod BioMed Online. 2010;21:331–7.CrossRef Farhi J, Ben-Haroush A, Andrawus N, Pinkas H, Sapir O, Fisch B, et al. High serum oestradiol concentrations in IVF cycles increase the risk of pregnancy complications related to abnormal placentation. Reprod BioMed Online. 2010;21:331–7.CrossRef
10.
go back to reference Jarvela IY, Pelkonen S, Uimari O, Makikallio K, Puukka K, Ruokonen A, et al. Controlled ovarian hyperstimulation leads to high progesterone and estradiol levels during early pregnancy. Hum Reprod. 2014;29:2393–401.CrossRef Jarvela IY, Pelkonen S, Uimari O, Makikallio K, Puukka K, Ruokonen A, et al. Controlled ovarian hyperstimulation leads to high progesterone and estradiol levels during early pregnancy. Hum Reprod. 2014;29:2393–401.CrossRef
11.
go back to reference Kalra SK, Ratcliffe SJ, Coutifaris C, Molinaro T, Barnhart KT. Ovarian stimulation and low birth weight in newborns conceived through in vitro fertilization. Obstet Gynecol. 2011;118:863–71.CrossRef Kalra SK, Ratcliffe SJ, Coutifaris C, Molinaro T, Barnhart KT. Ovarian stimulation and low birth weight in newborns conceived through in vitro fertilization. Obstet Gynecol. 2011;118:863–71.CrossRef
12.
go back to reference Roque M, Lattes K, Serra S, Sola I, Geber S, Carreras R, et al. Fresh embryo transfer versus frozen embryo transfer in in vitro fertilization cycles: a systematic review and meta-analysis. Fertil Stertil. 2013;99:156–62.CrossRef Roque M, Lattes K, Serra S, Sola I, Geber S, Carreras R, et al. Fresh embryo transfer versus frozen embryo transfer in in vitro fertilization cycles: a systematic review and meta-analysis. Fertil Stertil. 2013;99:156–62.CrossRef
13.
go back to reference Khong TY, De Wolf F, Robertson WB, Brosens I. Inadequate maternal vascular response to placentation in pregnancies complicated by pre-eclampsia and by small-for-gestational age infants. Br J Obstet Gynaecol. 1986;93:1049–59.CrossRef Khong TY, De Wolf F, Robertson WB, Brosens I. Inadequate maternal vascular response to placentation in pregnancies complicated by pre-eclampsia and by small-for-gestational age infants. Br J Obstet Gynaecol. 1986;93:1049–59.CrossRef
14.
go back to reference Labarrere CA, Althabe OH. Inadequate maternal vascular response to placentation in pregnancies complicated by preeclampsia and by small-for-gestational-age infants. Br J Obstet Gynaecol. 1987;94:1113–6.CrossRef Labarrere CA, Althabe OH. Inadequate maternal vascular response to placentation in pregnancies complicated by preeclampsia and by small-for-gestational-age infants. Br J Obstet Gynaecol. 1987;94:1113–6.CrossRef
15.
go back to reference Chen ZJ, Shi Y, Sun Y, Zhang B, Liang X, Cao Y, et al. Fresh versus frozen embryos for infertility in the polycystic ovary syndrome. New Engl J Med. 2016;375:523–33.CrossRef Chen ZJ, Shi Y, Sun Y, Zhang B, Liang X, Cao Y, et al. Fresh versus frozen embryos for infertility in the polycystic ovary syndrome. New Engl J Med. 2016;375:523–33.CrossRef
16.
go back to reference Ishihara O. Impact of frozen-thawed single-blastocyst transfer on maternal and neonatal outcome: an analysis of 277,042 single-embryo transfer cycles from 2008 to 2010 in Japan (vol 101, pg 128, 2014). Fertil Steril. 2014;101:1200.CrossRef Ishihara O. Impact of frozen-thawed single-blastocyst transfer on maternal and neonatal outcome: an analysis of 277,042 single-embryo transfer cycles from 2008 to 2010 in Japan (vol 101, pg 128, 2014). Fertil Steril. 2014;101:1200.CrossRef
17.
go back to reference Huang B, Ren X, Wu L, Zhu L, Xu B, Li Y, et al. Elevated progesterone levels on the day of oocyte maturation may affect top quality embryo IVF cycles. PLoS One. 2016;11.CrossRef Huang B, Ren X, Wu L, Zhu L, Xu B, Li Y, et al. Elevated progesterone levels on the day of oocyte maturation may affect top quality embryo IVF cycles. PLoS One. 2016;11.CrossRef
18.
go back to reference Zhu L, Xi Q, Zhang H, Li Y, Ai J, Jin L. Blastocyst culture and cryopreservation to optimize clinical outcomes of warming cycles. Reprod BioMed Online. 2013;27:154–60.CrossRef Zhu L, Xi Q, Zhang H, Li Y, Ai J, Jin L. Blastocyst culture and cryopreservation to optimize clinical outcomes of warming cycles. Reprod BioMed Online. 2013;27:154–60.CrossRef
19.
go back to reference Kuwayama M, Gabor V, Kato O, et al. Highly efficient vitrification method for clinical cryopreservation of human oocytes. Reprod BioMed Online. 2005;11(3):300–8.CrossRef Kuwayama M, Gabor V, Kato O, et al. Highly efficient vitrification method for clinical cryopreservation of human oocytes. Reprod BioMed Online. 2005;11(3):300–8.CrossRef
20.
go back to reference Craciunas L, Gallos I, Chu J, Bourne T, Quenby S, Brosens JJ, et al. Conventional and modern markers of endometrial receptivity: a systematic review and meta-analysis. Hum Reprod Update. 2019;25:202–23.CrossRef Craciunas L, Gallos I, Chu J, Bourne T, Quenby S, Brosens JJ, et al. Conventional and modern markers of endometrial receptivity: a systematic review and meta-analysis. Hum Reprod Update. 2019;25:202–23.CrossRef
21.
go back to reference Zhu Q, Zhu J, Wang Y, Wang B, Wang N, Yin M, et al. Live birth rate and neonatal outcome following cleavage-stage embryo transfer versus blastocyst transfer using the freeze-all strategy. Reprod BioMed Online. 2019;38:892–900.CrossRef Zhu Q, Zhu J, Wang Y, Wang B, Wang N, Yin M, et al. Live birth rate and neonatal outcome following cleavage-stage embryo transfer versus blastocyst transfer using the freeze-all strategy. Reprod BioMed Online. 2019;38:892–900.CrossRef
22.
go back to reference Evans J, Hannan NJ, Edgell TA, Vollenhoven BJ, Lutjen PJ, Osianlis T, et al. Fresh versus frozen embryo transfer: backing clinical decisions with scientific and clinical evidence. Hum Reprod Update. 2014;20:808–21.CrossRef Evans J, Hannan NJ, Edgell TA, Vollenhoven BJ, Lutjen PJ, Osianlis T, et al. Fresh versus frozen embryo transfer: backing clinical decisions with scientific and clinical evidence. Hum Reprod Update. 2014;20:808–21.CrossRef
23.
go back to reference Maheshwari A, Pandey S, Shetty A, Hamilton M, Bhattacharya S. Obstetric and perinatal outcomes in singleton pregnancies resulting from the transfer of frozen thawed versus fresh embryos generated through in vitro fertilization treatment: a systematic review and meta-analysis. Fertil Steril. 2012;98:368.CrossRef Maheshwari A, Pandey S, Shetty A, Hamilton M, Bhattacharya S. Obstetric and perinatal outcomes in singleton pregnancies resulting from the transfer of frozen thawed versus fresh embryos generated through in vitro fertilization treatment: a systematic review and meta-analysis. Fertil Steril. 2012;98:368.CrossRef
24.
go back to reference Zhao J, Xu B, Zhang Q, Li YP. Which one has a better obstetric and perinatal outcome in singleton pregnancy, IVF/ICSI or FET?: a systematic review and meta-analysis. Reprod Biol Endocrinol. 2016;14:51.CrossRef Zhao J, Xu B, Zhang Q, Li YP. Which one has a better obstetric and perinatal outcome in singleton pregnancy, IVF/ICSI or FET?: a systematic review and meta-analysis. Reprod Biol Endocrinol. 2016;14:51.CrossRef
25.
go back to reference Capodanno F, De Feo G, Gizzo S, Nicoli A, Palomba S, La Sala GB. Embryo quality before and after slow freezing: viability, implantation and pregnancy rates in 627 single frozen-thawed embryo replacement cycles following failure of fresh transfer. Reprod Biol. 2016;16:113–9.CrossRef Capodanno F, De Feo G, Gizzo S, Nicoli A, Palomba S, La Sala GB. Embryo quality before and after slow freezing: viability, implantation and pregnancy rates in 627 single frozen-thawed embryo replacement cycles following failure of fresh transfer. Reprod Biol. 2016;16:113–9.CrossRef
26.
go back to reference Maas KH, Baker VL, Westphal LM. Optimal timing of frozen embryo transfer after failed IVF attempt. Fertil Steril. 2008;90:S285.CrossRef Maas KH, Baker VL, Westphal LM. Optimal timing of frozen embryo transfer after failed IVF attempt. Fertil Steril. 2008;90:S285.CrossRef
27.
go back to reference Ng EH, Yeung WS. High serum oestradiol concentrations in fresh IVF cycles do not impair implantation and pregnancy rates in subsequent frozen-thawed embryo transfer cycles. Hum Reprod. 2000;2:250..CrossRef Ng EH, Yeung WS. High serum oestradiol concentrations in fresh IVF cycles do not impair implantation and pregnancy rates in subsequent frozen-thawed embryo transfer cycles. Hum Reprod. 2000;2:250..CrossRef
28.
go back to reference Santos-Ribeiro S, Polyzos NP, Vuong TNL, 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;31:2541–8.CrossRef Santos-Ribeiro S, Polyzos NP, Vuong TNL, 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;31:2541–8.CrossRef
29.
go back to reference Imudia AN, Awonuga AO, Kaimal AJ, Wright DL, Styer AK, Toth TL. Elective cryopreservation of all embryos with subsequent cryothaw embryo transfer in patients at risk for ovarian hyperstimulation syndrome reduces the risk of adverse obstetric outcomes: a preliminary study. Fertil Steril. 2013;99:168–73.CrossRef Imudia AN, Awonuga AO, Kaimal AJ, Wright DL, Styer AK, Toth TL. Elective cryopreservation of all embryos with subsequent cryothaw embryo transfer in patients at risk for ovarian hyperstimulation syndrome reduces the risk of adverse obstetric outcomes: a preliminary study. Fertil Steril. 2013;99:168–73.CrossRef
30.
go back to reference Imudia AN, Awonuga AO, Doyle JO, Kaimal AJ, Wright DL, Toth TL, et al. Peak serum estradiol level during controlled ovarian hyperstimulation is associated with increased risk of small for gestational age and preeclampsia in singleton pregnancies after in vitro fertilization. Fertil Steril. 2012;97:1374–9.CrossRef Imudia AN, Awonuga AO, Doyle JO, Kaimal AJ, Wright DL, Toth TL, et al. Peak serum estradiol level during controlled ovarian hyperstimulation is associated with increased risk of small for gestational age and preeclampsia in singleton pregnancies after in vitro fertilization. Fertil Steril. 2012;97:1374–9.CrossRef
31.
go back to reference Maheshwari A, Pandey S, Amalraj RE, Shetty A, Hamilton M, Bhattacharya S. Is frozen embryo transfer better for mothers and babies? Can cumulative meta-analysis provide a definitive answer? Hum Reprod Update. 2018;24:35–58.CrossRef Maheshwari A, Pandey S, Amalraj RE, Shetty A, Hamilton M, Bhattacharya S. Is frozen embryo transfer better for mothers and babies? Can cumulative meta-analysis provide a definitive answer? Hum Reprod Update. 2018;24:35–58.CrossRef
32.
go back to reference Luke B, Brown MB, Wantman E, Stern JE, Toner JP, Coddington CR. Increased risk of large-for-gestational age birthweight in singleton siblings conceived with in vitro fertilization in frozen versus fresh cycles. J Assist Reprod Genet. 2017;34:191–200.CrossRef Luke B, Brown MB, Wantman E, Stern JE, Toner JP, Coddington CR. Increased risk of large-for-gestational age birthweight in singleton siblings conceived with in vitro fertilization in frozen versus fresh cycles. J Assist Reprod Genet. 2017;34:191–200.CrossRef
33.
go back to reference Wei D, Liu JY, Sun Y, Shi Y, Zhang B, Liu JQ, et al. Frozen versus fresh single blastocyst transfer in ovulatory women: a multicentre, randomised controlled trial. Lancet. 2019;393:1310–8.CrossRef Wei D, Liu JY, Sun Y, Shi Y, Zhang B, Liu JQ, et al. Frozen versus fresh single blastocyst transfer in ovulatory women: a multicentre, randomised controlled trial. Lancet. 2019;393:1310–8.CrossRef
Metadata
Title
Pregnancy and perinatal outcomes in pregnancies resulting from time interval between a freeze-all cycle and a subsequent frozen-thawed single blastocyst transfer
Authors
Shiqiao Hu
Bei Xu
Rui Long
Lei Jin
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2020
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-020-02858-3

Other articles of this Issue 1/2020

BMC Pregnancy and Childbirth 1/2020 Go to the issue