Comparison of pregnancy outcomes after vitrification at the cleavage and blastocyst stage: a meta-analysis

Zeng, Meifang; Su, SuQin; Li, Liuming

doi:10.1007/s10815-017-1040-1

Cited by 26 publications

(21 citation statements)

References 59 publications

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“…In patients with frozen embryo transfer, the transfer of blastocyst was an independent predictor of clinical pregnancy after adjustment for confounders, supporting the superiority of blastocyst transfer for IVF success in frozen cycles. The data in the literature do not uniformly support our results, a recent meta-analysis showing that CPR is similar in transfers of frozen blastocysts or cleavage-stage embryos [17]. In turn, other authors showed that frozen blastocyst transfer is superior to cleavage-stage embryo transfer in both poor and normal responders [18].…”

Section: Resultscontrasting

confidence: 99%

The Corelation Between Serum Estradiol (C23H32O3) Impact on Selected Biomarkers and Outcome of Fresh Embryo Transfer in Comparison with Freeze All Strategy in in vitro Fertilisation Patients

Albu¹,

Albu²,

Sima³

et al. 2020

Rev. Chim.

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In stimulated cycles the endometrium could be more advanced than the embryos, with a possible negative impact on their implantation capacity. Therefore, there is an ongoing debate regarding the best transfer strategy: freeze-all versus fresh embryos transfer. Our study aimed to analyse if the frozen only embryos-transfer strategy for in vitro fertilisation (IVF) has higher clinical pregnancy rate (CPR) than the traditionally fresh transfer. We performed a retrospective study in a private centre of reproductive medicine. We included only patients who performed fresh embryo transfers (n=245) and patients with all the embryos frozen and then transferred into a non-stimulated cycle (n=117). The reasons for delayed transfer were an increased risk of ovarian hyperstimulation syndrome or the increase of late follicular phase serum progesterone level. The mean age of the study group was 34.33�b4.28 years and mean AMH was 3.68�b3.56 ng/mL. Patients with fresh transfer were significantly older (p[0.0001) and obtained significantly lower number of oocytes at egg retrieval (p[0.0001) and lower zygotes number (p[0.0001) in comparison with patients with frozen transfer. After adjustment for confounders, CPR was significantly higher in patients with fresh transfer in comparison with those with frozen transfer in total group (OR 2.7, p=0.001) and in patients with cleavage stage embryo transfer (OR 6, p=0.008), but not in patients with blastocyst transfer. Similarly, the implantation rate was significantly higher in total group and in both subgroups (p[0.0001). Our study shows that the freeze all strategy should not be performed in all the patients, being inferior to fresh transfer in the total study group and cleavage stage embryo transfers. The decision to transfer frozen embryos should take into account the availability of blastocysts for transfer and the risk benefit profile.

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Section: Resultscontrasting

confidence: 99%

The Corelation Between Serum Estradiol (C23H32O3) Impact on Selected Biomarkers and Outcome of Fresh Embryo Transfer in Comparison with Freeze All Strategy in in vitro Fertilisation Patients

Albu¹,

Albu²,

Sima³

et al. 2020

Rev. Chim.

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“…Because more embryos are achieved on day 3 in group 2, culturing embryos to blastocyst stage for transfer is a good option. Day 5–6 embryos have lower rate of segmental aneuploidy (19) and higher viability for implantation (20) than day 2–3 embryos. Preimplantation genetic testing for aneuploidies (PGT-A) are also beneficial for advanced women to select an euploid embryo to transfer (21).…”

Section: Discussionmentioning

confidence: 99%

Cumulative Live Birth Rates of Good and Low Prognosis Patients According to POSEIDON Criteria: A Single Center Analysis of 18,455 Treatment Cycles

et al. 2019

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Objective: To investigate the characteristics and outcomes of low prognosis patients defined by POSEIDON criteria undergoing IVF treatment. Design: Retrospective cohort analysis. Setting: An IVF clinic in a public hospital. Patients: 18,455 fresh aspirated IVF cycles with subsequently frozen embryo transfer from Jan 2014 to Jan 2017 in a single IVF clinic were included in the analysis. The low prognosis patients were categorized into 4 groups based on POSEIDON criteria: group 1: age < 35, antral follicle count (AFC) ≥ 5, number of oocytes retrieved ≤ 9 in the previous cycle; group 2: age ≥ 35, AFC≥5, number of oocytes retrieved ≤ 9 in the previous cycle; group 3: age < 35, AFC < 5; group 4: age ≥ 35, AFC < 5. The non-low prognosis patients: group 5: AFC ≥ 5, previous number of oocytes retrieved > 9 oocytes; group 6: AFC ≥ 5, no previous ovarian stimulation. Intervention(s): None. Main Outcome Measure: The primary outcome was cumulative live birth rate (CLBR). Result(s): Taking group 1 as reference, the CLBR from young women in group 3 (35.5%, OR 0.9, 95% CI 0.7–1.2) was slightly lower than that in group 1 (44.6%, p = 0.615). The CLBR in group 2 (24.5%, OR 0.6, 95% CI 0.4–0.8, p = 0.004) and group 4 (12.7%, OR 0.4, 95% CI 0.3–0.6, p < 0.001) was significant lower than that in group 1. In non-poor prognosis patients, the CLBR from young women in group 5 (53.5% OR 1.3 95% CI 0.9, 1.7, p = 0.111) was a slight higher than the reference group 1 while the highest CLBR was originated from the first IVF patients with good ovarian reserve in group 6 (66.9%, OR 2.0, 95% CI 1.6, 2.4). Conclusion(s): The CLBRs and implantation rates in the young women (group 3) with diminished ovarian reserve was similar in those young women (group 1), and was significantly higher than in advanced age women with a fair ovarian reserve (group 2). Though patients in group 2 had better ovarian reserve, more oocytes and more embryos, the pregnancy outcome was inferior to that of group 3 patients with poorer ovarian reserve, fewer oocytes and fewer embryos.

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“…Thus, it has been voiced that the stage of freezing may not exert an impact on the implantation success rate or the clinical pregnancy rate. On a recent meta-analysis, the clinical pregnancy rate between vitrification warming cycles on cleavage or blastocyst stage poses no difference (Risk Ratio 0.97, 95% Confidence Interval) despite the fact that the implantation rate was higher for the blastocyst transfers [32].…”

Section: Discussionmentioning

confidence: 99%

Cleavage Stage versus Blastocyst Stage Embryo Transfer in Oocyte Donation Cycles

Kontopoulos¹,

Simopoulou

Zervomanolakis³

et al. 2019

Medicina

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Background and Objective: During the last few years, a trend has been noted towards embryos being transferred at the blastocyst stage, which has been associated with improved rates regarding implantation and clinical pregnancy in comparison to cleavage stage embryo transfers. There is a limited number of studies investigating this notion in oocyte donation cycles employing cryopreserved embryos. The aim of this study is to evaluate the implantation potential and clinical pregnancy rates between the day 3 cleavage stage and blastocyst stage embryo transfers in oocyte donation cycles employing vitrified embryos. Methods: This is a retrospective evaluation of oocyte donation frozen–thawed transfers completed in our clinic from January 2017 to December 2017. Intracytoplasmic sperm injection was conducted for all oocytes. Following fertilization, all embryos were cryopreserved either at the cleavage or blastocyst stage. Embryo transfer of two embryos was performed under direct sonographic guidance in all cases. Results: Our results confirmed a 55.6% clinical pregnancy (CP) resulting from day 3 embryo transfers, a 68.8% CP from day 5, and 71.4% CP from day 6. Significantly improved pregnancy rates were related to embryo transfers at the blastocyst stage when compared to cleavage stage transfers (68.9% and 55.6% respectively, p = 0.016). The risk with regards to multiple pregnancies was similar. Conclusion: Our findings indicate that in oocyte donation cycles employing vitrified embryos, embryo transfer at the blastocyst stage is accompanied with a significant improvement in pregnancy rates and merits further investigation.

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Comparison of pregnancy outcomes after vitrification at the cleavage and blastocyst stage: a meta-analysis

Cited by 26 publications

References 59 publications

The Corelation Between Serum Estradiol (C23H32O3) Impact on Selected Biomarkers and Outcome of Fresh Embryo Transfer in Comparison with Freeze All Strategy in in vitro Fertilisation Patients

The Corelation Between Serum Estradiol (C23H32O3) Impact on Selected Biomarkers and Outcome of Fresh Embryo Transfer in Comparison with Freeze All Strategy in in vitro Fertilisation Patients

Cumulative Live Birth Rates of Good and Low Prognosis Patients According to POSEIDON Criteria: A Single Center Analysis of 18,455 Treatment Cycles

Cleavage Stage versus Blastocyst Stage Embryo Transfer in Oocyte Donation Cycles

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