Outcomes of elective cryopreserved single or double embryo transfers following failure to conceive after fresh single embryo transfer

Monteleone, Pedro Augusto Araújo; Mirisola, R.J.; Gonçalves, S.P.; Baracat, Edmund C.; Serafini, P.

doi:10.1016/j.rbmo.2016.04.011

Cited by 11 publications

(10 citation statements)

References 30 publications

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“…Additionally, the DET approach for the second ET maintained a high incidence of multiple pregnancies. 23 The use of eSET in the United States and Latin America (LA) is lower than in European countries, where the government limits the number of embryos transferred and where treatments are financially supported by the public health system. This difference can be attributed to the fact that the decision-making process regarding the number of embryos transferred in the United States and LA is the shared responsibility of the couple and their doctor.…”

Section: Discussionmentioning

confidence: 99%

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Transfer of 2 Embryos Using a Double-Embryo Transfer Protocol Versus 2 Sequential Single-Embryo Transfers: The Impact on Multiple Pregnancy

et al. 2018

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Section: Discussionmentioning

confidence: 99%

“…Additionally, the DET approach for the second ET maintained a high incidence of multiple pregnancies. 23…”

Section: Discussionmentioning

confidence: 99%

Transfer of 2 Embryos Using a Double-Embryo Transfer Protocol Versus 2 Sequential Single-Embryo Transfers: The Impact on Multiple Pregnancy

et al. 2018

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“…Gamete processing, fertilization, and embryo culture and transfer to the uterus proceeded as previously described [ 18 ]. Elective single-embryo transfers (eSETs) were performed in all IVF cycles.…”

Section: Patients Materials and Methodsmentioning

confidence: 99%

Successful Pregnancies After Adequate Hormonal Replacement in Patients With Combined Pituitary Hormone Deficiencies

Correa

Bianchi

França

et al. 2017

Journal of the Endocrine Society

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Context:Women with hypopituitarism have lower pregnancy rates after ovulation induction. Associated pituitary hormone deficiencies might play a role in this poorer outcome.Objective:We evaluated fertility treatment and pregnancy outcomes in five women with childhood-onset combined pituitary hormone deficiencies (CPHD).Patients and Methods:Five women with CPHD were referred for fertility treatment after adequacy of hormone replacement was determined. Patients were subjected to controlled ovarian stimulation (COS) for timed intercourse, intrauterine insemination, or in vitro fertilization, according to the presence or absence of other infertility factors (male or tubal).Results:All women became pregnant. The number of COS attempts until pregnancy was achieved varied between 1 and 5. The duration of COS resulting in at least one dominant follicle varied between 9 and 28 days, and total gonadotropin consumed varied between 1200 and 3450 IU. Two patients with severely suppressed basal gonadotropin levels since an early age had a cancelled COS cycle. All pregnancies were singleton except one (monochorionic twin gestation). The gestational ages at birth ranged from 35 weeks to 39 weeks and 4 days; three patients underwent cesarean section, and two had vaginal deliveries. Only one newborn was small for gestational age (delivered at 35 weeks).Conclusion:Adequate hormonal replacement prior to ovarian stimulation resulted in successful pregnancies in patients with childhood-onset CPHD, indicating that hormone replacement, including growth hormone, is an important step prior to fertility treatments in these patients.

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“…A previous study demonstrated that elective SET employed in women younger than 38 years of age in U.S. clinics have decreased multiple pregnancy rates with no impact on cumulative live-birth rates (Mancuso et al ., 2016). Our group demonstrated that the accumulated outcome of two sequential SET is similar to DET in good prognosis patients (Monteleone et al ., 2018), and the transfer of two embryos after a SET failure did not have advantages compared to a second SET (Monteleone et al ., 2016). In addition, the single euploid blastocyst transfer prompts the same clinical outcome of two untested blastocysts, while reducing the risk of multiple pregnancies in women of 42 years or younger (Forman et al ., 2013).…”

Section: Introductionmentioning

confidence: 99%

Should single embryo transfer be used in patients with any kind of infertility factor? Preliminary outcomes

Monteleone

Petersen

Peregrino

et al. 2019

JBRA Assisted Reproduction

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Objective: Multiple embryos have been transferred to compensate for low implantation rates, which in turn, increase the likelihood of multiple pregnancies. Despite the publication of clinical guidelines and a reduction in the number of embryos transferred, double embryo transfer still is the most common practice. There is no clear evidence of who should receive the single embryo transfer (SET), and it is more commonly indicated for patients of good prognosis. However, it is not clear how much the presence of other infertility factors can affect the SET prognosis. The aim of this study was to evaluate differences in clinical pregnancy rates (CPR) of frozen-thawed SET cycles for women presenting with different infertility factors. Methods: Retrospective cohort study evaluating 305 frozen-thawed SET cycles performed in the last 10 years in a private IVF center. We included patients undergoing ovarian stimulation cycles, using ejaculated sperm and a frozen-thawed ET. Embryos were routinely vitrified and warmed up, and the blastocysts were transferred after endometrium preparation. The cycles were categorized according to the infertility factor classified by the Society for Assisted Reproductive Technologies (SART) as anatomic female factor (n=55), endocrine female factor (n=26), endometriosis (n=37), male factor (n=60), ovarian insufficiency (n=26), unexplained (n=24), multiple factors (n=45) and other (n=32). CPR were compared between the groups and the multivariate analysis was performed to evaluate the association of each infertility factor and the CPR, adjusted for confounders. Results: The women varied in age from 18 to 44 years (35.9±3.8), presented Body Mass Index of 22.4±3.1kg/m 2 , baseline serum FSH of 7.4±8.3 IU/ml, and had a mean of 11.0±8.4 MII oocytes recovered and 6.4±5.3 embryos cryopreserved. The CPR, according to infertility factors were: anatomic female factor (25.9%), endocrine female factor (30.8%), endometriosis (27.8%), male factor (20.7%), ovarian insufficiency (21.7%), unexplained (9.5%), multiple factors (17.1%) and other (20.7%). Multivariate analysis did not show significant association of infertility factors and CPR adjusted for confounders. Conclusions: Patients presenting different infertility factors seem to have a satisfactory CPR for a SET cycle, except those with unexplained infertility. This is a preliminary outcome and the number of patients by category is small; in addition, the retrospective characteristics of the study are its limitations. Overall, our findings suggest that patients presenting any infertility factor, except unexplained infertility, are suitable to receive a SET with satisfactory outcomes.

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Outcomes of elective cryopreserved single or double embryo transfers following failure to conceive after fresh single embryo transfer

Cited by 11 publications

References 30 publications

Transfer of 2 Embryos Using a Double-Embryo Transfer Protocol Versus 2 Sequential Single-Embryo Transfers: The Impact on Multiple Pregnancy

Transfer of 2 Embryos Using a Double-Embryo Transfer Protocol Versus 2 Sequential Single-Embryo Transfers: The Impact on Multiple Pregnancy

Successful Pregnancies After Adequate Hormonal Replacement in Patients With Combined Pituitary Hormone Deficiencies

Should single embryo transfer be used in patients with any kind of infertility factor? Preliminary outcomes

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