A Prospective Study of Factors Affecting Pregnancy Rate Following Fresh Embryo Transfer

Abstract

Background: Couples often want to know their chance of having a positive outcome if they opt for assisted reproductive techniques (ARTs) and hence this prospective study was aimed to examine variable predictor parameters for its success. Aim: The aim of the study was to assess factors favoring positive outcome following fresh embryo transfer (FrET). Materials and methods: In this study, 200 couples-both with primary and secondary infertility-undergoing embryo transfer (ET) following controlled ovarian hyperstimulation and those obtaining at least one transferable embryo were included. In addition to the routine infertility data, the couples underwent long protocol which started on day 21 of menstrual cycle and continued till oocyte retrieval in next cycle. After that either FrET or were planned for "freeze all" embryos followed by frozen embryo transfer (FET). The success was measured in terms of serum beta human chorionic gonadotropin (β-HCG) on day 15 and by transvaginal ultrasonography (TVS) at 6 weeks. The data was analyzed using descriptive and inferential statistical analysis. Results: Primary infertility was the most common type of infertility (84.5%). Although 42% patients became HCG positive but clinical pregnancy was achieved only in 39.5%. Clinical pregnancy was achieved in 84.8% of cases of primary infertility and 15.20% of cases of secondary infertility. Among the causes of infertility, combined factor infertility (41.5%) was the most common cause. The pregnancy rate was less when very high doses (5.1%) and longer duration (39.2%) of gonadotropins were used. There was a significant association between clinical pregnancy and the total number of oocytes (p = 0.008), the total number of metaphase II (MII) oocytes (p = 0.003), and the total number of embryos (0.002) but not with endometrial thickness (ET) in the range of 8-14mm (p = 0.702). Conclusion:Familiarity with the predicting factors can help to prevent overtreatment and balance the decision to achieve pregnancy either through ART or by natural conception.