A freeze-all strategy does not increase live birth rates in women of advanced reproductive age

Abstract

Research question Does a freeze-all strategy improve live birth rates in women of different age groups? Design Retrospective cohort study of 1882 first embryo transfer cycles, performed between January 2013 and December 2015. Reproductive outcomes between fresh (FRESH) or frozen (FROZEN) embryo transfers were compared in patients stratified by age: < 35, between 35 and 38, or > 38 years. Student's t test for independent samples and χ 2 analyses were used as needed. A multivariable logistic regression analysis was performed adjusting for age, triggering drug, number of retrieved oocytes, number of transferred embryos, and percentage of top-quality embryos. Main results and the role of chance Live birth rates (LBR) were significantly higher for FROZEN in the < 35 years group (43.7% vs 24%; p < 0.001). In both the 35-38 and > 38 years groups, LBR for FROZEN vs FRESH were not statistically different (30.9% in the FROZEN group vs 29.3% in the FRESH group, p = 0.70, and 19.8% in the FROZEN group vs 12.7% in the FRESH group, p = 0.07, respectively). The multivariate analysis found a significantly positive effect of performing FROZEN on LBR in the younger group (OR 2.46,; p = 0.005) but had no impact in women between 35 and 38 years (OR 1.01, 95% CI 0.55-1.83; p = 0.98) or older (OR 0.96, 95% CI 0.43-2.13; p = 0.92). Conclusions Performing a freeze-all strategy seems to result in better reproductive outcomes when compared with a fresh ET in women under 35 years, with no significant impact on older women.

Is a freeze-all strategy necessary for all embryo transfers : Fresh embryo transfer without progesterone elevation results in an equivalent pregnancy rate to cryopreserved embryo transfer

“…These tendencies were evident in patients younger than 38 years old, whereas no such differences were observed in those aged over 39 years. Similar results have been reported in a previous study (17).…”

IVF Outcome Comparisons Between Fresh Embryo Transfers and Embryo Banking Cycles With Subsequent Thawed Transfers Vary Between Good-, Intermediate- and Poor-prognosis Patients

“…Yet another retrospective study in a general infertile population was recently published since completion of here presented manuscript, though this time based on patient age. Once again, the study demonstrated outcome bene ts for an all-freeze strategy in only good-prognosis patients, this time de ned as women under age 35 [24]. That age group in a large majority, however, represent exactly the approximately 15% of good-prognosis patients in an average IVF patient population, with another 15% being poor-and 70% average-prognosis patients [13].…”

Prolonged Cryopreservation Negatively Affects Embryo Transfer Outcomes Following the Elective Freeze-All Strategy: A Multicenter Retrospective Study

“…Multivariable logistic regression analysis was performed to explore the associations of storage duration with ectopic pregnancy and miscarriage. The potential confounding factors were adjusted in models according to previous studies, including maternal age at oocyte pick-up (OPU) (continuous), body mass index (BMI) (continuous), reproductive center, infertility type (primary or secondary), cause of infertility (female factors, male factors, both, or unexplained), duration of infertility (continuous), endometrium preparation regimen (natural, programmed, or ovarian stimulation), oocyte yield (continuous), and the stage (cleavage or blastocyst), quality (high-quality or not), and number (continuous) of transferred embryos ( 19 , 30 , 31 ). Tests for overall linear trends were conducted using the median concentration in each group as a continuous variable.…”