Objective
To evaluate the relation of endometrial thickness (EnT) and endometrial pattern (EnP) to euploid embryo transfer (ET) outcomes.
Design
Retrospective cohort
Setting
Private academic clinic
Patients
Patients (n=277, 36.1±4.0 years) whose embryos (n=476) underwent aneuploidy screening with fresh (n=176) or frozen (n=180) ET from July 2010–March 2014.
Interventions
EnT and EnP were measured on trigger day and at ET. Patients were stratified by age and cycle type (fresh or frozen). Cycle data were combined at trigger day but separated at ET day.
Main Outcome Measures
Outcome measures were implantation (IR), pregnancy (PR) and clinical pregnancy (CPR) rates.
Analysis was conducted by chi-square and Fisher exact test with significance at p<0.05.
Results
234 gestational sacs, 251 pregnancies and 202 clinical pregnancies resulted from 356 cycles.
EnT (9.6±1.8mm; range 5–15mm) at trigger day (n=241 cycles) as a continuous or categorical (≤8 vs >8mm) variable was not associated with IR, PR or CPR.
EnT at day of fresh (9.7±2.2mm; range 4.4–17.9mm) (n=176 cycles) or frozen ET (9.1±2.1mm; range 4.2–17.7mm) (n=180 cycles) was not associated with IR, PR or CPR.
Type 3 EnP at trigger day was associated with increased serum progesterone at trigger and decreased IR compared with type 2 EnP.
EnP at fresh or frozen ET was not associated with IR, PR or CPR.
Conclusions
Within the study population, EnT was not significantly associated with clinical outcomes of euploid ETs. A type 3 EnP at trigger day suggests a prematurely closed window of implantation.
Purpose The aim of this study is to compare implantation and live birth rates (LBR) between fresh euploid embryo transfers versus cryo-all cycles with a subsequent embryo transfer into a prepared endometrium. Material and Methods This is a retrospective cohort study. Patients who underwent an IVF cycle with PGS with trophectoderm biopsy from January 2011 to July 2015 were included. Patients were divided into three groups: "Fresh Only," "Frozen Embryo Transfer ('FET) Only," and "Fresh ET then FET." For "Fresh Only" group (n = 345), PGS results were received within 24 h. For "FET Only" group (n = 514), results were expected after 24 h, and embryos were cryopreserved after biopsy; only FET was performed in this group (no fresh transfer). For "FET with a previous fresh ET" (n = 139) group, patients underwent a fresh ET with a subsequent FET, in which the same cohort of embryos was utilized. The main outcome measures were pregnancy rate (PR), clinical PR, implantation rate (IR), LBR, and early pregnancy loss rate. Results IRs were statistically higher in the "FET Only" group when compared to the "Fresh Only" group (59.5 vs. 50.6 %, p < 0.01) and the "FET with a previous fresh ET" (59.5 vs. 50.6 %, p < 0.05). LBR was statistically significant in the "FET Only" group when compared to the "Fresh Only" group (57.6 vs. 46.5 %, p < 0.005) but not when compared to "FET with a previous fresh ET" group (57.6 vs. 47.7 %, p = 0.07). Conclusions This analysis suggests euploid embryos to be more likely to implant and achieve a LBR in a synthetic FET cycle than in a fresh cycle.
This review provides an analysis of the most commonly identified NCAs after PGS and in first-trimester D&C samples in an infertile population utilizing ART. Although monosomies comprised >50% of all cytogenetic anomalies identified after PGS, there were very few identified in the post-D&C samples. This suggests that although monosomies occur frequently in the IVF population, they commonly do not implant. Despite this difference, this study demonstrated that the specific NCAs observed after PGS analysis and D&C were comparable.
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