Day 3 ET, single blastocyst transfer (SBT) or frozen-thawed embryo transfer (FET): which is preferable for high responder patients in IVF/ICSI cycles?

Abstract

Purpose To compare the clinical outcomes after day 3 embryo transfer, day 5 single blastocyst transfer (SBT) and frozenthawed embryo transfer (FET) in high responder patients (>15 retrieved oocytes) undergoing IVF/ICSI treatment. Methods A retrospective analysis of three embryo transfer strategies for the high responder patients in IVF/ICSI cycles. The 1041 high responder patients diagnosed as primary infertility with more than 15 oocytes retrieved were recruited in Day 3 ET group, 308 patients with more than 15 oocytes retrieved first transferred with one blastocyst in SBT group and 425 patients with more than 15 oocytes retrieved in fresh cycle, first transferred with one frozen-thawed blastocyst were assigned in FET group. Results In the high responder patients, the clinical pregnancy rate after day 5 SBT was significantly lower than that of day 3 ET (43.18 % VS 57.16 %, p <0.05). In addition, the clinical pregnant rate and implantation rate of FET cycles were significantly higher than SBT cycles (59.06 % vs. 43.18 % and 64.70 % vs. 47.40 %, p <0.05). The multiple pregnancy rate in FET cycles was markedly lower than that of day 3 ET (2.35 % VS 34.97 %, p <0.05).Conclusions FET was the preferable strategy for the high responder patients in IVF/ICSI cycles to obtain both desirable clinical outcome and lower multiple pregnancy rates.

The effects of blastocyst morphological score and blastocoele re-expansion speed after warming on pregnancy outcomes

“…With refinements in embryo cryopreservation technology in recent years allowing almost all embryos to survive the vitrification/warming process, vitrified-warmed embryo transfer (VET) has become increasingly common. VET is advantageous in that it effectively prevents in vitro fertilization-associated complications such as ovarian hyperstimulation syndrome [ 1 ], is associated with better obstetric and perinatal outcomes [ 2 ], and maximizes the embryo utilization rate and increases the cumulative pregnancy rate [ 3 4 ], particularly for slowly developing embryos [ 5 ] and patients exhibiting early progesterone elevation [ 6 ].…”

Is measurement of progesterone level prior to FSH stimulation useful in GnRH-antagonist cycles?

“…the current suggestion in managing such patients is to proceed to the freeze-all protocol and subsequent freeze-thawed et, with reported ongoing pregnancy rate per transfer of up to 57% (Wu et al, 2014;shapiro et al, 2010). however, only one of our cycles employed this strategy in 2011-12. there are possible limitations in the present study.…”

Which is better for mothers and babies: fresh or frozen-thawed blastocyst transfer?

“… CPR, MR, LBR, PR Wang 2005 [ 54 ] Infants conceived through ART procedures and born in Australia Any age 7676/3824 Retrospective cohort study 1996 to 2000 LBW. Wei 2019 [ 7 ] Women with regular menstrual cycles undergoing their first cycle of in-vitro fertilization 28.8 (3.0) / 28·8 (3.0) 825/825 RCT Aug 2016, to Jun 2017 R, CPR, MR, MPR, LBR, OPR, PR, EPR, PP, PH, PTD, GDM, PIH, LGA, SGA, NM Wennerholm 1997 [ 55 ] Birth after IVF with cryopreserved–thawed embryos in Sweden 34.0 ± 3.1/ 33.6 ± 3.3 209/209 Matched cohort study Jun1990 to Jul 1995 PH, PTD, GDM, PIH, LBW Wennerholm 2013 [ 56 ] Singletons conceived after FET in Denmark, Norway and Sweden 33.3 ± 4.0/33.7 ± 3.9 42,242/6647 Retrospective cohort study Until Dec 2007 PTD, LGA, SGA, VSGA, LBW, HBW, Wikland 2010 [ 57 ] Children born after vitrified BTor fresh BT 34.7 (22.0–44.0)/35.4 (26.3–45.3) 203/103 Retrospective cohort study Jan 2006 to May 2008 MR, LBR, PR, EPR, PP, PA, GDM, PIH, LGA, SGA, LBW, Wu 2014 [ 58 ] High responder patients diagnosed as primary infertility with more than 15 oocytes retrieved 29.02 ± 2.87/ 29.05 ± 2.48 50/69 Retrospective cohort study Jan to Nov 2012 IR, CPR, MPR, Wu 2019 [ 59 ] Patients with advanced endometriosis undergoing first embryo transfer cycles No statement 255/ 506 Retrospective cohort study Mar 2006 to Mar 2017 IR, CPR, MR, EPR, LBR, PTD, VPTD, LBW, VLBW Xiong 2019 [ 60 ] Women who underwent fresh or frozen ET 33.39 ± 3.75 /34.07 ± 4.14 101/ 179 Retrospective cohort study. Aug 2014 to Jul 2017.…”