Clinical outcomes after elective double-embryo transfer in frozen cycles for women of advanced maternal age

Abstract

We aimed to determine the clinical outcome of double cleavage-stage embryo transfers in frozen-thawed embryo transfer cycles for older women.This study analyzed a total of 8189 cleavage-stage frozen-thawed embryo transfer cycles between January 2013 and December 2017 at Sir Run Run Shaw Hospital. All cycles were sorted into 3 groups based on patient age: 35 years (Group A), 36 to 37 years (Group B), and ≥38 years (Group C). The clinical pregnancy rate (CPR), implantation rate (IR), live birth rate (LBR), miscarriage rate, multiple pregnancy rate (MPR), preterm birth rate, and low-birth-weight rate were compared between the 3 groups.Significant differences in CPR, IR, LBR, MPR, and premature birth rate were found among the 3 groups. The CPR, IR, LBR, and MPR in Group A were higher than those in Group C. Transfers of 2 high-quality embryos resulted in significant differences in CPR, IR, LBR, MPR, and neonatal weight among the 3 groups, but no differences in premature birth and abortion rates were observed. Transfers with 1 high-quality and 1 fair-quality embryo resulted in significant differences in CPR, IR, and LBR among the 3 groups. Comparison of transfers of 2 high-quality embryos with 1 high-quality and 1 fair-quality embryo showed that the CPR and LBR were significantly lower for the latter in Groups A and C, but Group B had no salient changes.Higher IR and LBR and lower MPR may be achieved by selection of optimal embryo types for patients of different ages. Two highquality embryos need to be transferred in women older than 38 years. For women aged 36 to 37 years, 1 high-quality embryo or 1 high-quality plus 1 fair-quality embryo should be singled out for transfer. For women younger than 35 years, a single high-quality embryo should be selected for transfer. Abbreviations: BMI = body mass index, CPR = clinical pregnancy rate, FET = frozen-thawed embryo transfers, HCG = human chorionic gonadotropin, HMG = human menopausal gonadotropin, ICSI = intracytoplasmic sperm injection, IR = implantation rate, IVF = in vitro fertilization, LBR = live birth rate, MPR = multiple pregnancy rate.

Effect of frozen-thawed embryo transfer with a poor-quality embryo and a good-quality embryo on pregnancy and neonatal outcomes

“…Patients 35 years and older had only a small benefit from the transfer of a second poor-quality blastocyst-stage embryo, as there was no obvious increase in the LBR, whereas the MBR increased by 8.3%. These findings are in line with previous data showing the benefit of SET in patients younger than 35 years [ 13 , 28 ]. Interestingly, the study by Wang et al [ 14 ] showed that in patients aged < 35 years, the multiple pregnancy rate (MPR) was significantly greater in the GQE + PQE group than in the single GQE group, with no significant differences in the LBR.…”

Surgical management of cornual heterotopic using intraoperative sonography depth resection guidance: case report

“…The incidence of heterotopic pregnancy is overall rare but it increases with increased number of embryos transferred during a single IVF cycle. 5,6 Decision for multiple embryo transfer is frequently influenced by maternal age as advanced maternal age is associated with lower pregnancy and live birth rates. 5 Other factors that may influence number of embryos transferred include history of past IVF outcomes, financial considerations, embryo quality, and patient preference.…”

“…5,6 Decision for multiple embryo transfer is frequently influenced by maternal age as advanced maternal age is associated with lower pregnancy and live birth rates. 5 Other factors that may influence number of embryos transferred include history of past IVF outcomes, financial considerations, embryo quality, and patient preference. 5,7 To reduce the risks associated with multiple gestation pregnancies the American Society for Reproductive Medicine (ASMR, formerly The American Fertility Society) recommends limiting the number of embryos transferred during a single cycle with an aim to promote transfer of a single gestation.…”

“…5 Other factors that may influence number of embryos transferred include history of past IVF outcomes, financial considerations, embryo quality, and patient preference. 5,7 To reduce the risks associated with multiple gestation pregnancies the American Society for Reproductive Medicine (ASMR, formerly The American Fertility Society) recommends limiting the number of embryos transferred during a single cycle with an aim to promote transfer of a single gestation. 7 The updated 2021 recommendations state that patients with a favorable prognosis should receive single embryo transfer if <35 years old, strong consideration should be made for single embryo transfer between 35-37 years old, and patients 38-40 years of age should have no more than 3 untested cleavage-stage embryos or 2 blastocysts transferred.…”

Risk Factors of Preterm Birth and Low Birth Weight in Singletons Conceived Through Frozen Embryo Transfer: A Retrospective Study

“…Several studies have investigated that, the characteristics of the treated couple and FET cycle parameters were associated with preterm birth and low birth weight in the FET cycles. 15 , 16 However, some studies have found no association between FET with preterm birth and low birth weight. 17 In general, there are still inconsistent results on the relationship between different indicators of FET and fetal preterm birth and low weight at home and abroad.…”