Journal of Yeungnam Medical Science

Yeungnam University College of Medicine, Yeungnam University Institute Medical Science (영남대 의대 학술지 편집위원회)
권호 표지
DOI QR코드

DOI QR Code

Clinical factors that affect the pregnancy rate in frozen-thawed embryo transfer in the freeze-all policy

  • Hwang, Seo Yoon (Department of Obstetrics and Gynecology, Pusan National University Hospital, Pusan National University School of Medicine) ;
  • Jeon, Eun Hye (Department of Obstetrics and Gynecology, Pusan National University Hospital, Pusan National University School of Medicine) ;
  • Kim, Seung Chul (Department of Obstetrics and Gynecology, Pusan National University Hospital, Pusan National University School of Medicine) ;
  • Joo, Jong Kil (Department of Obstetrics and Gynecology, Pusan National University Hospital, Pusan National University School of Medicine)
  • Received : 2019.05.21
  • Accepted : 2019.09.11
  • Published : 2020.01.31
Download PDF
⟨ Previous Next ⟩

Abstract

Background: This study was conducted to analyze clinical factors that can affect pregnancy rates in normal responders undergoing the freeze-all policy in in vitro fertilization. Methods: We evaluated 153 embryo transfer cycles in 89 infertile women with normal response to controlled ovarian stimulation (COS). After COS, all embryos were cultured to the blastocyst stage, and good quality blastocysts were vitrified for elective frozen-thawed embryo transfer (FET). Clinical variables associated with COS and the results of COS and culture, including the number of retrieved oocytes, fertilized oocytes, and frozen blastocysts were compared between the pregnant group and the non-pregnant group. Results: After a single cycle of COS for each patient, 52 patients became pregnant while 37 did not. Significant differences were observed in the number of matured oocytes, fertilized oocytes, frozen blastocysts, and transferred embryos. The number of frozen blastocysts in the pregnant group was almost twice that in the non-pregnant group (5.6±3.1 vs. 2.8±1.9, p<0.001). The area under the receiver operating characteristic curve for the 4 frozen blastocysts was 0.801 in the pregnant group. Conclusion: In the freeze-all policy, the number of matured oocytes, number of fertilized oocytes, and number of frozen blastocysts might be predictive factors for pregnancy.

Keywords

References

  1. Shapiro BS, Daneshmand ST, Garner FC, Aguirre M, Hudson C. Clinical rationale for cryopreservation of entire embryo cohorts in lieu of fresh transfer. Fertil Steril 2014;102:3-9. https://doi.org/10.1016/j.fertnstert.2014.04.018
  2. Maheshwari A, Pandey S, Shetty A, Hamilton M, Bhattacharya S. Obstetric and perinatal outcomes in singleton pregnancies resulting from the transfer of frozen thawed versus fresh embryos generated through in vitro fertilization treatment: a systematic review and meta-analysis. Fertil Steril 2012;98:368-77. https://doi.org/10.1016/j.fertnstert.2012.05.019
  3. Devroey P, Polyzos NP, Blockeel C. An OHSS-Free Clinic by segmentation of IVF treatment. Hum Reprod 2011;26:2593-7. https://doi.org/10.1093/humrep/der251
  4. Blockeel C, Drakopoulos P, Santos-Ribeiro S, Polyzos NP, Tournaye H. A fresh look at the freeze-all protocol: a SWOT analysis. Hum Reprod 2016;31:491-7. https://doi.org/10.1093/humrep/dev339
  5. Veleva Z, Orava M, Nuojua-Huttunen S, Tapanainen JS, Martikainen H. Factors affecting the outcome of frozen-thawed embryo transfer. Hum Reprod 2013;28:2425-31. https://doi.org/10.1093/humrep/det251
  6. Son JB, Jeong JE, Joo JK, Na YJ, Kim CW, Lee KS. Measurement of endometrial and uterine vascularity by transvaginal ultrasonography in predicting pregnancy outcome during frozen-thawed embryo transfer cycles. J Obstet Gynaecol Res 2014;40:1661-7. https://doi.org/10.1111/jog.12406
  7. Roque M, Lattes K, Serra S, Sola I, Geber S, Carreras R, et al. Fresh embryo transfer versus frozen embryo transfer in in vitro fertilization cycles: a systematic review and meta-analysis. Fertil Steril 2013;99:156-62. https://doi.org/10.1016/j.fertnstert.2012.09.003
  8. Ishihara O, Kuwahara A, Saitoh H. Frozen-thawed blastocyst transfer reduces ectopic pregnancy risk: an analysis of single embryo transfer cycles in Japan. Fertil Steril 2011;95:1966-9. https://doi.org/10.1016/j.fertnstert.2011.02.015
  9. Shapiro BS, Daneshmand ST, De Leon L, Garner FC, Aguirre M, Hudson C. Frozen-thawed embryo transfer is associated with a significantly reduced incidence of ectopic pregnancy. Fertil Steril 2012;98:1490-4. https://doi.org/10.1016/j.fertnstert.2012.07.1136
  10. Ishihara O, Araki R, Kuwahara A, Itakura A, Saito H, Adamson GD. Impact of frozen-thawed single-blastocyst transfer on maternal and neonatal outcome: an analysis of 277,042 single-embryo transfer cycles from 2008 to 2010 in Japan. Fertil Steril 2014;101:128-33. https://doi.org/10.1016/j.fertnstert.2013.09.025
  11. Kalra SK, Ratcliffe SJ, Coutifaris C, Molinaro T, Barnhart KT. Ovarian stimulation and low birth weight in newborns conceived through in vitro fertilization. Obstet Gynecol 2011; 118:863-71. https://doi.org/10.1097/AOG.0b013e31822be65f
  12. Basile N, Garcia-Velasco JA. The state of "freeze-for-all" in human ARTs. J Assist Reprod Genet 2016;33:1543-50. https://doi.org/10.1007/s10815-016-0799-9
  13. Roque M, Valle M, Guimaraes F, Sampaio M, Geber S. Cost-effectiveness of the freeze-all policy. JBRA Assist Reprod 2015;19:125-30. https://doi.org/10.5935/1518-0557.20150028
  14. Roque M, Valle M, Guimaraes F, Sampaio M, Geber S. Freeze-all cycle for all normal responders? J Assist Reprod Genet 2017;34:179-85. https://doi.org/10.1007/s10815-016-0834-x