Impact of single embryo transfer policy on perinatal outcomes in fresh and frozen cycles—analysis of the Japanese Assisted Reproduction Technology registry between 2007 and 2012

Takeshima, Kazumi; Jwa, Seung Chik; Saito, Hidekazu; Nakaza, Aritoshi; Kuwahara, Akira; Ishihara, Osamu; Irahara, Minoru; Hirahara, Fumiki; Yoshimura, Yasunori; Sakumoto, Tetsuro

doi:10.1016/j.fertnstert.2015.10.002

Cited by 48 publications

(40 citation statements)

References 22 publications

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“…2; additionally, the practice in that country transitioned away from fresh embryo transfer and toward transfer of frozen-thawed embryos as demonstrated in Fig. 1b [7, 8, 21]. By 2012, only 27% of all ART live birth in Japan were from fresh cycles and 73% were from frozen-thawed cycles.…”

Section: Resultsmentioning

confidence: 99%

“…A detailed analysis of changes in Japanese perinatal outcomes, associated with the country’s rapidly changing ART practice patterns, was recently published [21]. In 2012, 96.0% of all ART pregnancies were singletons, 4.0% were twins and 0.05% were higher order multiples.…”

Section: Resultsmentioning

confidence: 99%

“…Preterm delivery rates also decreased between 2007 and 2012 from 13.5 to 9.4% in pregnancies conceived with fresh embryos and from 12.7 to 9.6% in those conceived with frozen-thawed embryos. Additionally, caesarian delivery rates decreased from 35.6% in 2007 to 32.8% in 2012 in fresh cycles but did not change in frozen cycles [21]. …”

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Systematic review of worldwide trends in assisted reproductive technology 2004–2013

Kushnir

Barad

Albertini

et al. 2017

Reprod Biol Endocrinol

260

193

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BackgroundAssisted Reproductive Technology (ART) has undergone considerable changes over the last decade, with consequences on ART outcomes in different regions of the world being unknown.MethodsWe conducted a systematic review of published national and regional ART registry data to assess how changes in clinical practice between 2004 and 2013 have impacted outcomes in Australia and New Zealand, Canada, Continental Europe, the United Kingdom (U.K.), Japan, Latin America, and the United States (U.S.). The data reflect 7,079,145 total ART cycles utilizing both fresh and previously cryopreserved embryos from autologous oocytes that resulted in 1,454,724 live births. This review focused on the following measures: ART cycle volume, use of cryopreserved embryos, single embryo transfer (SET), live birth rates in fresh and frozen-thawed cycles, and perinatal outcomes in recent years.ResultsSETs and utilization of frozen-thawed embryos increased worldwide over the study period. In 2012 SET utilization in all ART cycles was highest in Japan and Australia/New Zealand (82.6% and 76.3% respectively) and lowest in Latin America (16.0%). While gradual improvements in live birth rates were observed in most regions, some demonstrated declines. By 2012–2013, fresh cycle live birth rates were highest in the U.S. (29%) and lowest in Japan (5%). In Japan, the observed decline in fresh cycle live birth rate coincided with transition to minimal stimulation protocols, transfer of frozen-thawed rather than fresh embryos, and implementation of an SET policy. Similarly, implementation of an SET policy in parts of Canada was followed by a decline in fresh cycle live birth rate. Increasing live birth rates in frozen-thawed embryo cycles, seen all over the world, partially compensated for declines in fresh ART cycles. During 2012–2013 Australia/New Zealand and Japan reported the lowest multiple delivery rates of 5.6 and 4% respectively while the US had the highest of 27%. In recent years, preterm delivery rates in all regions ranged between 9.0 to 16.6% for singletons, 53.9 to 67.3% for twins, and 91.4 to 100% for triplets and higher order multiples. Inconsistencies in the way perinatal outcome data are presented by various registries, made comparison between regions difficult.ConclusionsART practices are characterized by outcome differences between regions. International consensus on the definition of ART success, which accounts for perinatal outcomes, may help to standardize worldwide ART practice and improve outcomes.Trial registrationPROSPERO (CRD42016033011)Electronic supplementary materialThe online version of this article (doi:10.1186/s12958-016-0225-2) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Systematic review of worldwide trends in assisted reproductive technology 2004–2013

Kushnir

Barad

Albertini

et al. 2017

Reprod Biol Endocrinol

260

193

View full text Add to dashboard Cite

show abstract

“…Cryopreservation enables physicians to save the embryos generated through assisted reproductive technology (ART) and reduces the risk of ovarian hyperstimulation syndrome [1]. With the assistance of cryopreservation, we can also prevent multiple gestations by transferring fewer embryos [2]. In parallel, an HRC-FET helps patients with irregular cycles reduce the frequency of hospital visits, schedule the date of FET with ease, and decrease the cancelation rates of embryo transfer.…”

Section: Introductionmentioning

confidence: 99%

Increased incidence of post-term delivery and Cesarean section after frozen-thawed embryo transfer during a hormone replacement cycle

Saito

Miyado

Yamatoya

et al. 2017

J Assist Reprod Genet

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Purpose This study aimed to clarify the risks of adverse pregnancy outcomes in patients who conceive singletons after frozen embryo transfer (FET) during a hormone replacement cycle and their offspring. Methods A retrospective cohort study was conducted in patients who conceived after FET, based on the Japaneseassisted reproductive technology registry for 2013. The perinatal outcomes in cases with live-born singletons achieved through natural ovulatory cycle FET (NC-FET) (n = 6287) or hormone replacement cycle FET (HRC-FET) (n = 10,235) were compared. Multiple logistic regression analyses were performed to determine the potential confounding factors. Results The frequencies of macrosomia (1.1% in NC-FET and 1.4% in HRC-FET; P = 0.058) were comparable between patients after NC-FET and HRC-FET. The proportions of post-term delivery (0.2% in NC-FET and 1.3% in HRC-FET; P < 0.001) and Cesarean section (33.6% in NC-FET and 43.0% in HRC-FET; P < 0.001) were higher in patients after HRC-FET than in patients after NC-FET. The risks of post-term delivery (adjusted odds ratio (AOR) 5.68, 95% confidence interval (CI) 3.30-9.80) and Cesarean section (AOR 1.64, 95% CI 1.52-1.76) were also higher in patients after HRC-FET than in patients after NC-FET. Conclusions Patients who conceived singletons after HRC-FET were at increased risk of post-term delivery and Cesarean section compared with those who conceived after NC-FET.

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“…In order to avoid multiple births as a result of assisted reproductive technology (ART), single embryo transfer (SET) has prevailed during the past 15 years in Japan 1. In addition, in order to avoid severe ovarian hyperstimulation syndrome (OHSS) that is caused by ART, an “all freeze” strategy has been actively used during the past 15 years in Japan 1.…”

Section: Introductionmentioning

confidence: 99%

Treatment period and medical care costs to achieve the first live birth by assisted reproductive technology are lower in the single embryo transfer period than in the double embryo transfer period: a retrospective analysis of women younger than 40 years of age

Kawahara

Ueda

Nakahori

et al. 2017

Reprod Medicine & Biology

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AimIt was examined whether the single embryo transfer policy makes the treatment period longer for couples to achieve their first live birth by assisted reproductive technology.MethodsThis study retrospectively analyzed women who started assisted reproductive technology at younger than 40 years of age in the authors’ organization. The treatment periods for couples to achieve the first live birth by assisted reproductive technology, between the women who started assisted reproductive technology from 2004 to 2009 (the double embryo transfer period group, n=250), in which the double embryo transfer was predominant, and the women who started assisted reproductive technology from 2010 to 2015 (the single embryo transfer period group, n=298), in which the single embryo transfer was predominant, were compared.ResultsThe age at the start of assisted reproductive technology, pregnancy rate per embryo transfer, and rate of women who achieved a live birth by assisted reproductive technology per number of women who tried assisted reproductive technology were all significantly higher in the single embryo transfer period group. Among the women who achieved a live birth by assisted reproductive technology, the incidence of multiple births and severe ovarian hyperstimulation syndrome, the treatment period, and medical care costs needed to achieve the first live birth were all significantly lower in the single embryo transfer period group.ConclusionIn the single embryo transfer period group, those women who were younger than 40 years of age achieved their first live birth by assisted reproductive technology more safely, quickly, and reasonably.

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Impact of single embryo transfer policy on perinatal outcomes in fresh and frozen cycles—analysis of the Japanese Assisted Reproduction Technology registry between 2007 and 2012

Abstract: The results suggest that the SET policy improved perinatal outcomes in Japan. The impact of SET policy was different in fresh and frozen cycles for several perinatal outcomes.

Cited by 48 publications

References 22 publications

Systematic review of worldwide trends in assisted reproductive technology 2004–2013

Systematic review of worldwide trends in assisted reproductive technology 2004–2013

Increased incidence of post-term delivery and Cesarean section after frozen-thawed embryo transfer during a hormone replacement cycle

Treatment period and medical care costs to achieve the first live birth by assisted reproductive technology are lower in the single embryo transfer period than in the double embryo transfer period: a retrospective analysis of women younger than 40 years of age

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