Atosiban application in fresh embryo transfer cycle is effective for women undergoing repeated embryo implantation failures, especially for advanced-age obese patients

Abstract

Objectives To understand the effect of atosiban in pregnancy outcomes in the fresh embryo transfer (ET). Methods 689 cases (using atosiban) and 1377 age and embryo transfer cycle-matched controls were collected from the January 2016 to May 2022 to perform the fresh IVF-ET cycle. The essential characteristics and pregnancy outcomes including clinical pregnancy, ectopic pregnancy, abortion and live birth were analyzed. Conditional logistic regression analysis and subgroup analysis were performed. Results In the whole samples, atosiban had no effects in the pregnancy outcomes. Subgroup analyses suggested that atosiban could improve the clinical pregnancy in more than 3 embryo transfer cycles (OR = 1.667, 95%CI = 1.108–2.509, P = 0.014). Moreover, the improvement of clinical pregnancy was mainly present in the advanced-age women (Age ≥ 35 years: OR = 1.851, 95%CI = 1.136–3.014, P = 0.013), obesity (BMI ≥ 24 kg/m2: OR = 2.550, 95%CI = 1.105–5.883, P = 0.028) and cleavage stage embryo (D3 embryo: OR = 1.721, 95%CI = 1.098–2.696, P = 0.018) among the repeated implantation failures (RIF). Atosiban could also improve the live birth for the obese women. Further, in the RIF, atosiban application was strongly recommended for the advanced-age infertility women, who also had the risk of obesity (Clinical pregnancy: OR = 3.342, 95%CI = 1.249–8.942, P = 0.016; Live birth: OR = 12.123, 95%CI = 2.191–67.089, P = 0.004) and transferred the cleavage stage embryo (D3 embryo: OR = 1.922, 95%CI = 1.135–3.255, P = 0.015). Conclusion Atosiban in fresh ET cycle could improve the clinical pregnancy rate and live birth for the advanced-age and obese women undergoing more than 3 embryo transfer cycles, especially when transplanting the cleavage stage embryo.