In vitro fertilization outcome in frozen versus fresh embryo transfer in women with elevated progesterone level on the day of HCG injection: An RCT

Aghahosseini, Marzieh; Aleyasin, Ashraf; Sarfjoo, Fatemeh Sadat; Mahdavi, Atossa; Yaraghi, Mansooreh; Saeedabadi, Hojattollah

doi:10.29252/ijrm.15.12.757

Cited by 13 publications

(6 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The finding that the ‘freeze-all’ strategy resulted in a similar cumulative live birth rate among high responders compared with the ‘fresh-transfer’ strategy is consistent with previous RCTs. The nine RCTs that have evaluated the live birth rate following a ‘freeze-all’ strategy compared with a ‘fresh-transfer’ strategy were all performed in normal or high responders where the minimum average number of oocytes retrieved was 12 in both groups (Ferraretti et al , 1999; Shapiro et al , 2011a,b; Chen et al , 2016; Aghahosseini et al , 2017; Coates et al , 2017; Aflatoonian et al , 2018; Shi et al , 2018; Vuong et al , 2018). A recent systematic review and meta-analysis based on five of these RCTs reporting cumulative live birth rate (Ferraretti et al , 1999; Shapiro et al , 2011a,b; Chen et al , 2016; Vuong et al , 2018) showed no differences in cumulative live birth rates between the ‘freeze-all’ and ‘fresh-transfer’ strategies (risk ratio 1.04, 95% CI 0.97–1.11) (Roque et al , 2018b).…”

Section: Discussionmentioning

confidence: 99%

Cumulative live birth rates following a ‘freeze-all’ strategy: a population-based study

Wang

Bowman

et al. 2019

Human Reproduction Open

View full text Add to dashboard Cite

STUDY QUESTION What is the cumulative live birth rate following a ‘freeze-all’ strategy compared with a ‘fresh-transfer’ strategy? SUMMARY ANSWER The ‘freeze-all’ strategy resulted in a similar cumulative live birth rate as the ‘fresh-transfer’ strategy among high responders (>15 oocytes retrieved) but did not benefit normal (10–15 oocytes) and suboptimal responders (<10 oocytes). WHAT IS KNOWN ALREADY Frozen-thawed embryo transfer is associated with a decreased risk of adverse obstetric and perinatal outcomes compared with fresh embryo transfer. It is unclear whether the ‘freeze-all’ strategy should be offered to all women undergoing ART treatment. STUDY DESIGN, SIZE, DURATION A population-based retrospective cohort study using data collected by the Victorian Assisted Reproductive Treatment Authority. This study included 14 331 women undergoing their first stimulated ART cycle with at least one oocyte fertilised between 1 July 2009 and 30 June 2014 in Victoria, Australia. Demographic characteristics, type of ART procedures and resulting pregnancy and birth outcomes were recorded for the stimulated cycle and associated thaw cycles until 30 June 2016, or until a live birth was achieved, or until all embryos from the stimulated cycle had been used. PARTICIPANTS/MATERIALS, SETTING, METHODS Women were grouped by whether they had undergone the ‘freeze-all’ strategy ( n = 1028) where all embryos were cryopreserved for future transfer, or the ‘fresh-transfer’ strategy ( n = 13 303) where selected embryo(s) were transferred in the stimulated cycle, and remaining embryo(s) were cryopreserved for future use. A discrete-time survival model was used to evaluate the cumulative live birth rate following ‘freeze-all’ and ‘fresh-transfer’ strategy. MAIN RESULTS AND THE ROLE OF CHANCE A total of 1028 women undergoing ‘freeze-all’ strategy and 13 303 women undergoing ‘fresh-transfer’ strategy had 1788 and 22 334 embryo transfer cycles resulting in 452 and 5126 live births, respectively. Most women (61.3%) in the ‘freeze-all’ group had more than 15 oocytes retrieved in the stimulated cycle compared with 18.1% of women in the ‘fresh-transfer’ group ( P < 0.001). For high responders (>15 oocytes), the cumulative live birth rate in the ‘freeze-all’ group was similar to the ‘fresh-transfer’ group (56.8% vs. 56.2%, adjusted hazard ratio (AHR) 0.90, 95% CI 0.77–1.04). However, the likelihood of a live birth was lower in the ‘freeze-all’ group compared with the ‘fresh-transfer’ group among normal responders (10–15 oocytes) (33.2% vs. 46.3%, AHR 0.62, 95% CI 0.46–0.83) and suboptimal responders (<10 oocytes) (14.6% vs. 28.0%, AHR 0.67, 95% CI 0.14–1.01). During the minimum follow-up time of 2 years, 34.1%, 24.4% and 8.4% of suboptimal, normal and high responders, respectively, in th...

show abstract

Section: Discussionmentioning

confidence: 99%

Cumulative live birth rates following a ‘freeze-all’ strategy: a population-based study

Wang

Bowman

et al. 2019

Human Reproduction Open

View full text Add to dashboard Cite

show abstract

“…Our study is the first to compare the freeze-all strategy to fresh ET into the aforementioned subgroups. Evaluating the freeze-all strategy in all of these subgroups from poor to hyper-responders is important, as all the RCTs available for evaluating the LBR following the freeze-all strategy were performed in normal and high responders with a minimum mean number of retrieved oocytes of 12 ( Chen et al ., 2016 ; Shapiro et al ., 2011a ; b ; Shi et al ., 2018 ; Vuong et al ., 2018 ; Wei et al ., 2019 ; Coates et al ., 2017 ; Ferraretti et al ., 1999 ; Aghahosseini et al ., 2017 ; Aflatoonian et al ., 2018 ).…”

Section: Discussionmentioning

confidence: 99%

Fresh versus elective frozen embryo transfer: Cumulative live birth rates of 7,236 IVF cycles

Le¹,

Thinh²,

Nguyen³

et al. 2021

JBRA Assisted Reproduction

View full text Add to dashboard Cite

Objective: To determine whether elective frozen embryo transfer (eFET), or the 'freeze-all' strategy, associated with better cumulative clinical outcomes compared with fresh embryo transfer (ET).Methods: A total of 7,236 IVF cycles that were followed by a fresh ET or eFET between 2013 and 2017. The patients were subjected to controlled ovarian stimulation (COS) with a gonadotropin-releasing hormone (GnRH) antagonist protocol and cleavage-stage ET. Embryo cryopreservation was performed on day 3 by vitrification using an open system. A comparison of cumulative outcomes between the eFET (n=4,065cycles) and the fresh ET groups (n=3,171cycles) were performed. The analysis was performed in four groups of patients based on the number of retrieved oocytes: Group 1: poor responders (1-3 oocytes); Group 2: suboptimal responders (4-9 oocytes); Group 3: normal responders (10-15 oocytes); and Group 4: hyper-responders (>15 oocytes). The primary outcome was the cumulative live birth rate (CLBR) per stimulated cycle.Results: There were a total of 10,283 ETs (n=5,639 eFET group; n=4,644 fresh group). The freeze-all strategy is associated with improved CLBRs in normal and hyperresponders, but not in suboptimal and poor responders. In Group 1, there were 351 IVF cycles and 387 ETs in total, and the CLBR was 14.3% and 17.7% (p=0.584) for the eFET and fresh group, respectively. In Group 2, there were 2,074 IVF cycles and 2,465 ET in total, and the CLBR was 25.1% and 23.3% (p=0.083) in the eFET and fresh group, respectively. There was a significant difference in the CLBR in Groups 3 and 4, favouring the eFET strategy. In Group 3, 2226 IVF cycles and 3243 ET were performed. The CLBR was 40.5% in the eFET and 36.6% in the fresh group (p<0.001). In Group 4, there were 2547 IVF cycles and 3,188 ET in total, and the CLBR was 52.2% and 47.7% (p<0.001) in the eFET and fresh group, respectively. The number needed to treat to achieve one additional live birth was 25.9 in Group 3 and 22.3 in Group 4.Conclusions: The implementation of the freeze-all strategy should be individualized. The freeze-all strategy is associated with improved CLBRs in normal and hyperresponders, but not in suboptimal and poor responders.

show abstract

“…Editorials published in 2013 proposed that eFET would become accepted as the gold standard practice in IVF (19,20), although the evidence to support this claim at that time was based mostly on pooled observational data and only limited data from randomized trials. More studies have been conducted recently, and to date, 11 randomized controlled trials comparing eFET and fresh ET have been published (21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31).…”

Section: Cryopreservation Todaymentioning

confidence: 99%

The Future of Cryopreservation in Assisted Reproductive Technologies

2020

View full text Add to dashboard Cite

Societal changes and the increasing desire and opportunity to preserve fertility have increased the demand for effective assisted reproductive technologies (ART) and have increased the range of scenarios in which ART is now used. In recent years, the "freeze-all" strategy of cryopreserving all oocytes or good quality embryos produced in an IVF cycle to transfer later-at a time that is more appropriate for reasons of medical need, efficacy, or desirability-has emerged as an accepted and valuable alternative to fresh embryo transfer. Indeed, improvements in cryopreservation techniques (vitrification) and the development of more efficient ovarian stimulation protocols have facilitated a dramatic increase in the practice of elective frozen embryo transfer (eFET). Alongside these advances, debate continues about whether eFET should be a standard treatment option available to the whole IVF population or if it is important to identify patient subgroups who are most likely to benefit from such an approach. Achieving successful outcomes in ART, whether by fresh or frozen embryo transfer, is influenced by a wide range of factors. As well as the efficiency of IVF and embryo transfer protocols and techniques, factors affecting implantation include maternal aging, sperm quality, the vaginal and endometrial microbiome, and peri-implantation levels of serum progesterone. The safety of eFET, both during ART cycles and on longer-term obstetric and neonatal outcomes, is also an important consideration. In this review, we explore the benefits and risks of freeze-all strategies in different scenarios. We review available evidence on the outcomes achieved with elective cryopreservation strategies and practices and how these compare with more traditional IVF cycles with fresh embryo transfers, both in the general IVF population and in subgroups of special interest. In addition, we consider how to optimize and individualize "freeze-all" procedures to achieve successful reproductive outcomes.

show abstract

In vitro fertilization outcome in frozen versus fresh embryo transfer in women with elevated progesterone level on the day of HCG injection: An RCT

Cited by 13 publications

References 12 publications

Cumulative live birth rates following a ‘freeze-all’ strategy: a population-based study

Cumulative live birth rates following a ‘freeze-all’ strategy: a population-based study

Fresh versus elective frozen embryo transfer: Cumulative live birth rates of 7,236 IVF cycles

The Future of Cryopreservation in Assisted Reproductive Technologies

Contact Info

Product

Resources

About