The deferred embryo transfer strategy improves cumulative pregnancy rates in endometriosis-related infertility: A retrospective matched cohort study

Bourdon, Mathilde; Santulli, Piétro; Maignien, Chloé; Gayet, Vanessa; Pocate-Cheriet, Khaled; Marcellin, Louis; Chapron, Charles

doi:10.1371/journal.pone.0194800

Cited by 59 publications

(39 citation statements)

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“…Women in the control group had more often a fresh ET strategy than in the OMA group (p<0.001), but the type of transfer did not impact the ovarian response to stimulation (p = 0.981). In line with current scientific knowledge, the deferred ET strategy may increase pregnancy chances in endometriosis-affected women population [ 37 ]. However, the absence of randomized controlled studies in this population and the absence of superiority of this strategy in non-endometriosis women does not allow to differentiate between deferred ET and a fresh ET strategies [ 38 , 39 ].…”

Section: Discussionmentioning

confidence: 71%

Endometriosis and ART: A prior history of surgery for OMA is associated with a poor ovarian response to hyperstimulation

et al. 2018

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BackgroundMany women whose fertility may have been impaired by endometriosis require assisted reproductive technology (ART) in order to become pregnant. However, the influence of ovarian endometriosis (OMA) on ovarian responsiveness to hyperstimulation has not been clearly established.ObjectiveTo evaluate the risk of a poor ovarian response (POR) to stimulation and ART outcomes in women with OMA.Materials and methodsWe conducted a large observational controlled matched cohort study in a tertiary care university hospital between 01/10/2012 and 31/12/2015. After matching by age and anti-Müllerian hormone (AMH) levels, 201 infertile women afflicted with OMA (the OMA group) and 402 disease-free women (the control group) undergoing an ART procedure were included in the study. The main outcomes that we measured were a POR to hyperstimulation (i.e., ≤ 3 oocytes retrieved, or cancelled cycles), the clinical pregnancy rate, and the live birth rate.All of the women with endometriosis underwent a pre-ART work-up, in order to obtain an accurate diagnosis and staging of their disease. An OMA diagnosis was based on published imaging criteria (obtained by transvaginal sonography or magnetic resonance imaging) or on histological analysis for patients with a prior history of endometriosis surgery. The statistical analyses were conducted using univariate and multivariate logistic regression models.ResultsThe incidence of a POR to hyperstimulation was significantly higher for the OMA group than for the control group [62/201 (30.8%) versus 90/402 (22.3%), respectively; p = 0.02]. However, no significant differences were found between the OMA and the control group in terms of the clinical pregnancy rate [53/151 (35%) versus 134/324 (41.3%), respectively; p = 0.23] and the live birth rate [39/151 (25.8%) versus 99/324 (30.5%), respectively; p = 0.33]. By multivariate analysis, a prior history of surgery for OMA was found to be an independent factor associated with a POR to stimulation [OR = 2.1; 95% CI: 1.1–4.0], unlike OMA without a prior history of surgery [OR: 1.5; 95% CI: 0.9–2.2].ConclusionThe presence of OMA during ART treatment increased the risk of a POR to hyperstimulation, although the live birth rate was not affected. Furthermore, having OMA and having previously undergone surgery for OMA was identified as an independent risk factor for a POR.

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Section: Discussionmentioning

confidence: 71%

Endometriosis and ART: A prior history of surgery for OMA is associated with a poor ovarian response to hyperstimulation

et al. 2018

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“…In terms of ongoing pregnancy rate we found a similarly reduction of ongoing pregnancy rate in the endometriosis group compared to the control one in the freeze all cycles, consequently we cannot conclude that endometriosis women have better ART outcome after freeze all cycle. This data is supported by the recent study of Roque and colleagues [19], that reported that even if initial studies showed that the freeze-all strategy could be beneficial for certain groups of infertility including endometriosis patients [20], there is still lack of evidence to support its routine use not only for indications as endometriosis but also for implantation failure. In conclusion the data published until now is very controversial about better ART outcomes after freeze all cycles in endometriosis patients [19].…”

Section: Discussionmentioning

confidence: 78%

Does Endometriosis Influence the Embryo Quality and/or Development? Insights from a Large Retrospective Matched Cohort Study

et al. 2020

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In vitro fertilization can be an effective tool to manage the endometriosis-associated infertility, which accounts for 10% of the strategy indications. Nevertheless, a negative effect of endometriosis on IVF outcomes has been suggested. The aim of this study was to evaluate the potential effect of endometriosis in the development of embryos at cleavege stage in assisted reproduction treatment cycles. A total of 429 cycles from women previously operated for moderate/severe endometriosis were compared with 851 cycles from non-affected women. Patients were matched by age, number of oocyte retrieved and study period. A total of 3818 embryos in cleavage stage have been analyzed retrospectively. Overall, no difference was found between women with and without endometriosis regarding the number of cleavage stage embryos obtained as well as the percentage of good/fair quality embryos. Excluding cycles in which no transfers were performed or where embryos were frozen in day three, no difference was observed for blastulation rate or the percentage of good/fair blastocysts obtained. Despite similar fertilization rate and number/quality of embryos, a reduction in ongoing pregnancy rate was observed in patients affected, possibly due to an altered endometrial receptivity or to the limited value of the conventional morphological evaluation of the embryo.

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“… 1995 to 2015. GDM,hyper, Preterm, Very preterm, Belva 2008 [ 18 ] All pregnancies after transfer of FET No statement 6402/1351 Unmatched cohort study No statement MR, MPR, LBR, OPR, PR, EPR, LBW, Stil Bourdon 2018 [ 19 ] Women with endometriosis infertile 34.3 ± 3.9/34.3 ± 4.1 135/135 Retrospective matched cohort study Oct 2012 to Dec 2014 LBR, MPR, OPR Cavoretto2020 [ 20 ] Women undergoing fresh ET or FET 35.9 ± 3.9/34.9 ± 5.1 164 / 203 Prospective longitudinal study Jan 2016 to Dec 2018 GDM, PTD, PE, SGA, LGA Chen 2016 [ 21 ] Infertile women with PCOS 28.2 ± 3.1/28.1 ± 3.0 762/746 Retrospective matched cohort study Jun 2013 to May 2015 CPR, MR, LBR, OPR, PR, OHSS, PTD, PIH, Stil Coates 2017 [ 22 ] Patients undergoing IVF treatment using preimplantation genetic screening 36.6 (25–42)/ 36.7 (27–42) 88/91 RCT Dec 2013 to Aug 2015 IR, MPR, LBR, OPR Eum 2016 [ 23 ] Women who underwent one or two fresh ET or FET Using a cutoff of 35 years 69/206 Retrospective study Jan 2013 to Dec 2014. IR, CPR, MR, LBR, MPR Fauque 2010 [ 24 ] Women with adequate ovarian function < 36 years No statement Prospective NRCT 2005 to 2007 CPR, MR, LBR, MPR, EPR.…”

Section: Resultsmentioning

confidence: 99%

Which is better for mothers and babies: fresh or frozen-thawed blastocyst transfer?

Yang

Sha

et al. 2020

BMC Pregnancy Childbirth

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Background In recent years, there have been many reports on the pregnancy outcomes of fresh blastocyst transfer (BT) and frozen-thawed BT, but the conclusions are controversial and incomplete. To compare the pregnancy outcomes, maternal complications and neonatal outcomes of fresh and frozen-thawed BT in the context of in vitro fertilization or intracytoplasmic sperm injection (IVF/ICSI) cycles, we conducted a meta-analysis. Methods A meta-analysis was conducted by searching the PubMed, Embase, and Cochrane Library databases through May 2020. Data were extracted independently by two authors. Results Fifty-four studies, including 12 randomized controlled trials (RCTs), met the inclusion criteria. Fresh BT was associated with a lower implantation rate, pregnancy rate, ongoing pregnancy rate, and clinical pregnancy rate and higher ectopic pregnancy rate than frozen-thawed BT according to the results of the RCTs. The risks of moderate or severe ovarian hyperstimulation syndrome, placental abruption, placenta previa and preterm delivery were higher for fresh BT than for frozen-thawed BT. The risk of pregnancy-induced hypertension and pre-eclampsia was lower for fresh BT; however, no significant differences in risks for gestational diabetes mellitus and preterm rupture of membrane were found between the two groups. Compared with frozen-thawed BT, fresh BT appears to be associated with small for gestational age and low birth weight. No differences in the incidences of neonatal mortality or neonatal malformation were observed between fresh and frozen-thawed BT. Conclusions At present there is an overall slight preponderance of risks in fresh cycles against frozen, however individualization is required and current knowledge does not permit to address a defintive response.

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The deferred embryo transfer strategy improves cumulative pregnancy rates in endometriosis-related infertility: A retrospective matched cohort study

Cited by 59 publications

References 54 publications

Endometriosis and ART: A prior history of surgery for OMA is associated with a poor ovarian response to hyperstimulation

Endometriosis and ART: A prior history of surgery for OMA is associated with a poor ovarian response to hyperstimulation

Does Endometriosis Influence the Embryo Quality and/or Development? Insights from a Large Retrospective Matched Cohort Study

Which is better for mothers and babies: fresh or frozen-thawed blastocyst transfer?

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