Conditional and cumulative live birth rates after blastocyst transfer

Abstract

We aimed to investigate live birth rate (LBR), cumulative live birth rate (CLBR) for consecutive fresh and frozen-thawed in vitro fertilization (IVF) cycles, and CLBR after an entire IVF programme involving multiple ovarian stimulations using blastocyst transfer only. Study design: From January 1 st 2014 to December 31 st 2018, we included women aged 18-45 years who initiated IVF or intracytoplasmic sperm injection at Aagaard Fertility Clinic, Denmark. The primary outcome was live birth, and secondary outcomes were a positive hCG blood test and ongoing pregnancy confirmed by ultrasonography. All proportions were estimated for initiated and transferred cycles with 95 % confidence intervals (CI). We used a conservative strategy, assuming that none of the women who did not return for further treatments had a live birth. Results: 871 women contributed 2236 initiated/1670 transferred fresh and/or frozen-thawed cycles. LBRs for first fresh cycles were 22.8 % (95 %-CI: 19.8À26.0) and 35.7 % (95 %-CI: 31.4À40.2) for initiated and transferred cycles, respectively. LBRs for first frozen-thawed cycles were 30.6 % (95 %-CI: 26.4À35.1) and 31.7 % (95 %-CI: 27.4À36.3) for initiated and transferred cycles, respectively. CLBRs for consecutive cycles were 18.2 % (95 %-CI: 16.2À20.3) for fresh initiated cycles, 29.7 % (95 %-CI: 26.6À32.9) for fresh transferred cycles, 25.5 % (95 %-CI: 22.6À28.5) for frozen-thawed initiated cycles, and 26.4 % (95 %-CI: 23.5À29.6) for frozen-thawed transferred cycles. For 436 women who contributed with an entire IVF programme we found a CLBR of 64.0 % (95 %-CI: 59.3À68.5). Conclusion:Compared to other studies of CLBR after multiple ovarian stimulations using cleavage stage transfer, our study presents a considerable effect in the IVF success rate when using blastocyst transfer only. In a clinical setting, transfer of blastocysts seems to be a viable method.

Implantation of embryos. The way for the improvement of the cumulative life birth rate (CLBR) in the assisted reproductive technology (ART)

“…It appeared that implantation of embryos is the most limiting factor in the treatment of infertility and hence, quite understandable interest in so called endometrial receptivity. This receptivity, besides normal and good quality of blastocyst, plays a crucial role in the process of implantation and finally decides about the life birth ratio as well as about the cumulative life birth ratio, the truest results of infertility treatment [7][8][9]. The implantation of embryos is a very complex process which involves both the embryo and maternal endometrium and the key to this process is the cascade of molecular mechanisms regulated by endocrine, paracrine and autocrine modulators both of embryonic and maternal origin [10][11][12][13].…”

Longitudinal analysis of vaginal microbiota during IVF fresh embryo transfer and in early pregnancy

“…This leads to many couples seeking infertility treatments of which in vitro fertilization (IVF) is considered to be the most effective ( 2 ). However, only a few IVF cycles lead to pregnancy and childbirth, since only about 30%–35% of women achieve live birth after IVF–embryo transfer (IVF-ET) ( 3 , 4 ). For a successful IVF-ET, the fertilized egg or blastocyst must be able to attach and implant to a healthy endometrium.…”