Does freeze‐all policy affect IVF outcome in poor ovarian responders?

Roque, Matheus; Valle, Marcello; Sampaio, Marcos; Geber, Selmo

doi:10.1002/uog.19000

Cited by 26 publications

(17 citation statements)

References 44 publications

(98 reference statements)

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“…In 2018, Roque et al reported a meta-analysis and indicated that the e-FET strategy resulted in a significantly higher LBR in hyper-responders (RR = 1.16; 95% CI: 1.05-1.28). However, the CLBR was not significantly different in the overall population (RR = 1.04; 95% CI: 0.97-1.11) [39]. Notably, the meta-analyses combined studies that randomized patients after the oocyte yield was known and excluded patients with an inadequate or excessive ovarian response.…”

Section: Plos Onementioning

confidence: 98%

Section: Plos Onementioning

confidence: 99%

“…Although some observational studies have compared fresh ET and freeze-all strategies, no RCTs have evaluated the effects of the e-FET strategy on poor responders [39][40][41][42]. Three of these observational studies including cleavage-stage ETs did not report any benefit of using the freeze-all strategy [39][40][41]. Contrary to this findings, in 2017, Berkkannoglu et al compared fresh ET and freeze-all strategies in poor responders (�4 oocytes) with both cleavage-and blastocyst-stage embryos and reported improved pregnancy outcomes from blastocyst transfers, thus favoring the freeze-all strategy [43].…”

Section: Plos Onementioning

confidence: 99%

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Impact of elective frozen vs. fresh embryo transfer strategies on cumulative live birth: Do deleterious effects still exist in normal & hyper responders?

Boynukalın¹,

Turgut²,

Gültomruk

et al. 2020

PLoS ONE

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Background Is freeze-all strategy effective in terms of cumulative live birth rates (CLBRs) in all patients? Methods This retrospective single-center study analyzed the CLBRs of 2523 patients undergoing fresh or electively frozen blastocyst transfer cycles. In 1047, cycles, the fresh embryo transfer (ET) strategy was applied for the 1 st ET, whereas electively frozen ET (e-FET) was performed in 1476 cycles. Female age � 37 and blastocysts frozen via vitrification were included. The patients in each arm were further stratified into four subgroups according to the number of oocytes retrieved as follows: Group A: 1-5, group B: 6-10, group C: 11-15 and group D: 16-25 oocytes retrieved. The primary endpoint was the CLBR. The secondary endpoints were the ovarian hyperstimulation syndrome (OHSS) rate and the live birth rates (LBRs) following fresh ETs and e-FETs for the first transfers. Result(s) The CLBR was similar between the fresh ET and e-FET arms in group A (35/76 (46.1%) vs 29/67 (43.3%), p = 0.74) and group B (165/275 (60%) vs 216/324 (66.7%), p = 0.091), whereas significantly higher rates were detected in favor of the e-FET arm within group C (328/460 (71.3%) vs 201/348 (57.8%), p<0.001) and group D (227/348 (65.2%), vs 446/625 (71.5%), p<0.001). The OHSS rate was also found to be higher in the fresh ET arm among group C (12/348 (3.4%) vs 0/460 (0%), p<0.001) and group D (38/348 (10.9%) vs 3/625 (0.5%), p<0.001) patients than e-FET arm. Perinatal and obstetrical outcomes were nonsignificantly different between fresh and e-FET arms. However, the birth weights were significantly lower for fresh ET, 3064 versus 3201 g for singletons (p<0.001)

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Section: Plos Onementioning

confidence: 98%

Section: Plos Onementioning

confidence: 99%

Section: Plos Onementioning

confidence: 99%

See 1 more Smart Citation

Impact of elective frozen vs. fresh embryo transfer strategies on cumulative live birth: Do deleterious effects still exist in normal & hyper responders?

Boynukalın¹,

Turgut²,

Gültomruk

et al. 2020

PLoS ONE

View full text Add to dashboard Cite

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“…However, due to advances in the field of cryobiology [7,8], this is no longer necessary. Ovarian stimulation can conclude with elective freezing of oocytes or embryos, with similar results to those of a fresh embryo transfer [9] even in patients with poor response [10]. In fact, one of the proposed strategies in patients with poor response is the accumulation of oocytes for subsequent fertilization [11].…”

Section: Introductionmentioning

confidence: 95%

Luteal phase stimulation versus follicular phase stimulation in poor ovarian responders: results of a randomized controlled trial

Llácer

Moliner

Luque

et al. 2020

Reprod Biol Endocrinol

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Background: In young women with poor ovarian response, luteal-phase ovarian stimulation (LPOS) is a potential method for collecting competent oocytes. The aim of this study was to assess the efficacy of LPOS compared with follicular phase ovarian stimulation (FPOS) in young women with poor ovarian response (POR). Methods: This single-center, prospective, randomized pilot study compared LPOS and FPOS in women with POR fulfilling Bologna criteria who underwent in vitro fertilization at the Instituto Bernabeu. The primary outcome was the number of metaphase II (MII) oocytes obtained by follicular puncture. Results: Sixty women were included in the study, with 27 women completing LPOS and 30 undergoing FPOS. There was no statistically significant difference in the number of MII oocytes obtained between the LPOS group and the FPOS group (2.1 ± 2.0 vs. 2.6 ± 2.2, p = 0.31). Length of stimulation was also similar in both groups (8.35 ± 2.8 vs. 8.15 ± 4.1 days, p = 0.69). Similarly, there was no significant difference in the follicle-stimulating hormone total dose, number of cumulus-oocyte complexes, survival rate, fertilization rate, or cancellation rate between groups. A significantly higher Ovarian Sensitivity Index was observed in the LPOS group versus the FPOS group (0.96 vs. 0.57, p = 0.037). Conclusion: LPOS was comparable with FPOS in terms of efficacy and may improve ovarian responsiveness in young women with POR.

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“…The switch from slow programmed frozen methods to current vitrification methods has greatly improved ART efficiency (Zhu et al, ). Thus, freezing embryos has become a routine practice for ART units, and some units have recently even started to use the “freeze‐all” strategy for certain patients (Bhattacharya, ; Roque, Valle, Sampaio, & Geber, ). Although these techniques are currently an indispensable component of ART, increase in apoptotic gene expression and DNA fragmentation (Park et al, ) and lower hatching rates of mouse blastocysts (Yao et al, ) have been reported to result from cryopreservation.…”

Section: Introductionmentioning

confidence: 99%

Changes in DNA methylation and imprinting disorders in E9.5 mouse fetuses and placentas derived from vitrified eight‐cell embryos

Wen

et al. 2019

Molecular Reproduction Devel

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Vitrification is increasingly used in assisted reproductive technology (ART) laboratories worldwide, and potential vitrification‐induced risks require further exploration. The effect of vitrification on changes in DNA methylation and imprinting disorders was investigated in E9.5 mouse fetuses and placentas. Fetus and placental tissues were collected from the natural mating (nautural conception [NC]) group, in vitro culture (IVC) group and vitrified embryo transfer (VET) group. The fetal crown‐rump length at E9.5 in both the IVC (0.210 ± 0.059 mm) and VET (0.205 ± 0.048 mm) groups was significantly reduced compared with the NC group (0.288 ± 0.083 mm). The global methylation levels of fetuses were decreased in the IVC group compared with the NC group and it was increased after vitrification compared with IVC (p < 0.05), similar to what was observed in the NC group (p > 0.05). The changes could be attributed to the disorders of DNA methyltransferases and ten‐eleven translocations. In the IVC and VET fetuses, a majority of maternally expressed genes were upregulated, which repressed fetal growth. Furthermore, vitrification led to a change in the methylation level of KvDMR1, which resulted in the disturbance of gene imprinting. According to our results, vitrification could contribute to increased methylation compared with IVC and contributes to a gene imprinting disorder rather than recovery. Despite the routine use of embryo vitrification in clinical settings, the effect that this procedure may have on genomic imprinting deserves much greater attention.

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Does freeze‐all policy affect IVF outcome in poor ovarian responders?

Cited by 26 publications

References 44 publications

Impact of elective frozen vs. fresh embryo transfer strategies on cumulative live birth: Do deleterious effects still exist in normal & hyper responders?

Impact of elective frozen vs. fresh embryo transfer strategies on cumulative live birth: Do deleterious effects still exist in normal & hyper responders?

Luteal phase stimulation versus follicular phase stimulation in poor ovarian responders: results of a randomized controlled trial

Changes in DNA methylation and imprinting disorders in E9.5 mouse fetuses and placentas derived from vitrified eight‐cell embryos

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