Optimal euploid embryo transfer strategy, fresh versus frozen, after preimplantation genetic screening with next generation sequencing: a randomized controlled trial

Coates, A.; Kung, A.; Mounts, Emily L.; Hesla, John S.; Bankowski, Brandon; Barbieri, Elizabeth; Ata, Barış; Cohen, Jacques; Munné, Santiago

doi:10.1016/j.fertnstert.2016.12.022

Cited by 131 publications

(98 citation statements)

References 35 publications

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“…The ability to determine which individuals may be more susceptible to developing subsequent cardiac and/or vascular disease would be of great importance for public health strategies, hence, the clinical relevance of continuing long‐term studies in this population. The challenge here is that ART techniques keep changing rapidly over time, evolving relevant improvements in ovarian stimulation protocols, oocyte and embryo vitrification techniques and culture conditions . Discrepancies among studies could be explained by improvements made to these techniques over time in order to achieve pregnancy, transferring the ‘best’ embryo in the optimal conditions.…”

Section: Discussionmentioning

confidence: 99%

Postnatal persistence of fetal cardiovascular remodelling associated with assisted reproductive technologies: a cohort study

Valenzuela-Alcaráz

Serafini

Bijnens

et al. 2018

BJOG

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Section: Discussionmentioning

confidence: 99%

Postnatal persistence of fetal cardiovascular remodelling associated with assisted reproductive technologies: a cohort study

Valenzuela-Alcaráz

Serafini

Bijnens

et al. 2018

BJOG

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“…A retrospective cohort study that included 20,687 women who started their first IVF cycle using the freeze-all strategy reported that the live birth rate was 50.74% after the first complete cycle, which was higher than the live birth rate using the conventional IVF strategy [22]. Alison’s study found the ongoing pregnancy rate and live birth rate were significantly higher in the freeze-all group compared with the fresh group when known euploid embryos were transferred [23]. As the transfer of frozen embryos yields a higher pregnancy rate, our focus was on how to improve pregnancy outcomes for the fresh cycle.…”

Section: Discussionmentioning

confidence: 99%

Effect of intrauterine injection of human chorionic gonadotropin before fresh embryo transfer on IVF and ICSI outcomes: a meta-analysis

Hou

Shi

Cai

et al. 2018

Arch Gynecol Obstet

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PurposeThis analysis was performed to evaluate the effects of intrauterine injection of human chorionic gonadotropin (hCG) before fresh embryo transfer (ET) on the outcomes of in vitro fertilization and intracytoplasmic sperm injection.MethodsRandomized controlled trials (RCTs) were identified by searching electronic databases. The outcomes of live birth, clinical pregnancy, implantation, biochemical pregnancy, ongoing pregnancy, ectopic pregnancy, and miscarriage between groups with and without hCG injections were analyzed. Summary measures were reported as risk ratios (RR) with 95% confidence intervals.ResultsSix RCTs on fresh embryo transfer (ET) were included in the meta-analysis. A total of 2759 women undergoing fresh ET were enrolled (hCG group n = 1429; control group n = 1330). Intrauterine injection of hCG significantly increased rates of biochemical pregnancy (RR 1.61) and ongoing pregnancy (RR 1.58) compared to controls. However, there were no significant differences in clinical pregnancy (RR 1.11), implantation (RR 1.17), miscarriage (RR 0.91), ectopic (RR 1.65) or live birth rates (RR 1.13) between the hCG group and control group.ConclusionThe current evidence for intrauterine injection of hCG before fresh ET does not support its use in an assisted reproduction cycle.

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“…A limitation of these hypothetical studies is the assumption that the live birth potential is the same for a fresh and warmed embryo transfer. A recent report of a randomized controlled trial [20], which compared fresh and vitrified-warmed embryo transfer following PGS, did not find a statistically significant difference in the number of live births per fresh (52%, 13/25) and warmed-vitrified (64%, 16/25) single embryo transfer, although the latter was greater with small numbers.…”

Section: Discussionmentioning

confidence: 99%

Towards a better understanding of preimplantation genetic screening for aneuploidy: insights from a virtual trial for women under the age of 40 when transferring embryos one at a time

Scriven

2017

Reprod Biol Endocrinol

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BackgroundThe aim of this theoretical study is to explore the cost-effectiveness of aneuploidy screening in a UK setting for every woman aged under the age of 40 years when fresh and vitrified-warmed embryos are transferred one at a time in a first full cycle of assisted conception.MethodsIt is envisaged that a 24-chromosome genetic test for aneuploidy could be used to exclude embryos with an abnormal test result from transfer, or used only to rank embryos with the highest potential to be viable; the effect on cumulative outcome is assessed. The cost associated with one additional live birth event and one clinical miscarriage avoided is estimated, and the time taken to complete a cycle considered. The numbers of individual woman for whom testing is likely to be beneficial or detrimental is also evaluated.ResultsAdding aneuploidy screening to a first treatment cycle is unlikely to result in a higher chance of a live birth event, and can be detrimental for some women. Premature termination of a clinical trial is likely to be biased in favour of genetic testing. Testing is likely to be an expensive way of reducing the chance of clinical miscarriage and shortening treatment time without a substantial reduction in the cost of testing, and is likely to benefit a minority of women. Selecting out embryos is likely to reduce the treatment time for women whether or not they have a baby, whilst ranking embryos only to reduce the time for those that have a child and not for those who need another stimulated cycle.ConclusionsAdding aneuploidy screening to IVF treatment for women under the age of 40 years is unlikely to be beneficial for most women. To achieve an unbiased assessment of the cost-effectiveness of genetic testing for aneuploidy, clinical trials need to take account of women who still have embryos available for transfer at the end of the study period. Specifying the proportions of women for whom testing is likely to be beneficial and detrimental may help better inform couples who might be considering adding aneuploidy screening to their treatment cycle.Electronic supplementary materialThe online version of this article (doi:10.1186/s12958-017-0269-y) contains supplementary material, which is available to authorized users.

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Optimal euploid embryo transfer strategy, fresh versus frozen, after preimplantation genetic screening with next generation sequencing: a randomized controlled trial

Abstract: NCT02000349.

Cited by 131 publications

References 35 publications

Postnatal persistence of fetal cardiovascular remodelling associated with assisted reproductive technologies: a cohort study

Postnatal persistence of fetal cardiovascular remodelling associated with assisted reproductive technologies: a cohort study

Effect of intrauterine injection of human chorionic gonadotropin before fresh embryo transfer on IVF and ICSI outcomes: a meta-analysis

Towards a better understanding of preimplantation genetic screening for aneuploidy: insights from a virtual trial for women under the age of 40 when transferring embryos one at a time

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