Maternal and perinatal outcomes in programmed versus natural vitrified–warmed blastocyst transfer cycles

Makhijani, Reeva; Bartels, Chantal; Godiwala, Prachi N.; Bartolucci, Alison; Nulsen, John; Grow, Daniel R.; Benadiva, Claudio; Engmann, Lawrence

doi:10.1016/j.rbmo.2020.03.009

Cited by 51 publications

(34 citation statements)

References 38 publications

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“…Hence, up to 35% of patients with gestational hypertension develop preeclampsia (46). Our findings of an increased risk to develop HDP are in line with a growing body of evidence accumulating from mainly observational studies examining the impact of different FET protocols on maternal and neonatal outcomes (15,16,20,(47)(48)(49)(50)(51). Previous studies report on the more frequent occurrence of LGA infants and macrosomia after programmed FET cycles (16,43,48) while we found higher birthweight and birthweight percentile after FET with CL absence as well as CL absence as a significant predictor of higher birthweight and birthweight percentiles.…”

Section: Discussionsupporting

confidence: 84%

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Pregnancy Outcomes After Frozen-Thawed Embryo Transfer in the Absence of a Corpus Luteum

et al. 2021

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Background: Nowadays, frozen-thawed embryo transfer (FET) cycles represent a high proportion of fertility treatments worldwide. Recent studies suggest differences in pregnancy outcomes depending on the FET treatment protocol used. The reason for this is still unclear, but the number of corpora lutea (CL) at conception is discussed as a possible factor. This study aims to investigate whether maternal and neonatal outcomes for pregnancies following FET lacking a CL differ from FET with one or more CL in order to explore a potential link between CL absence and adverse pregnancy outcomes.Methods: The study was designed as a retrospective, multi-center observational study with two cohorts after singleton live birth [0 CL cohort (FET in a programmed cycle, n = 114) and ≥ 1 CL cohort (FET in a natural or stimulated cycle, n = 68)]. Participants completed a questionnaire on the outcome of pregnancy and birth records were analyzed in a descriptive way. Multivariable logistic and linear regressions were performed in order to explore associations between CL absence and pregnancy outcomes. The strength of the agreement between the information in the survey and the diagnoses extracted from the files was assessed by Cohen's Kappa.Results: The risk of hypertensive disorders of pregnancy was higher after FET in the absence of a CL compared to FET with CL presence (aOR 5.56, 95% CI 1.12 – 27.72). Birthweights and birthweight percentiles were significantly higher in the 0 CL group. CL absence was a predictor of higher birthweight (adjusted coefficient B 179.74, 95% CI 13.03 – 346.44) and higher birthweight percentiles (adjusted coefficient B 10.23, 95%, 95% CI 2.28 – 18.40) particularly in female newborns of the 0 CL cohort. While the strength of the agreement between the reported information in the survey and the actual diagnoses extracted from the files was good for the majority of outcomes of interest it was fair in terms of hypertension (κ = 0.38).Conclusion: This study supports observations suggesting a potential link between a lack of CL at conception and adverse maternal and neonatal outcomes. Further investigations on causes and pathophysiological relationships are yet to be conducted.

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Section: Discussionsupporting

confidence: 84%

“…However, the reasons behind this are still unknown. Recent studies imply a link between CL absence and specific maternal and neonatal outcomes, such as macrosomia (15), postterm birth (16), HDP (2), postpartum hemorrhage (15)(16)(17), and Cesarean section rate (15,16,(18)(19)(20).…”

Section: Introductionmentioning

confidence: 99%

Pregnancy Outcomes After Frozen-Thawed Embryo Transfer in the Absence of a Corpus Luteum

et al. 2021

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“…Hypertensive disorders in pregnancy are significantly increased following an HRT cycle compared with NC or mild OS-FET cycle (182)(183)(184)(185). The increased risk may relate to the absence of a corpus luteum leading to i) decreased serum relaxin and vascular endothelial growth factor levels ii) lower reactive hyperemia index, iii) lower angiogenic and nonangiogenic circulatory endothelial progenitor cells iv) a lack of drop in mean arterial pressure during pregnancy (186)(187)(188)(189).…”

Section: Maternal and Obstetric Outcomes After Different Fet Protocolsmentioning

confidence: 99%

Preparation of the Endometrium for Frozen Embryo Transfer: A Systematic Review

et al. 2021

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Despite the worldwide increase in frozen embryo transfer, the search for the best protocol to prime endometrium continues. Well-designed trials comparing various frozen embryo transfer protocols in terms of live birth rates, maternal, obstetric and neonatal outcome are urgently required. Currently, low-quality evidence indicates that, natural cycle, either true natural cycle or modified natural cycle, is superior to hormone replacement treatment protocol. Regarding warmed blastocyst transfer and frozen embryo transfer timing, the evidence suggests the 6th day of progesterone start, LH surge+6 day and hCG+7 day in hormone replacement treatment, true natural cycle and modified natural cycle protocols, respectively. Time corrections, due to inter-personal differences in the window of implantation or day of vitrification (day 5 or 6), should be explored further. Recently available evidence clearly indicates that, in hormone replacement treatment and natural cycles, there might be marked inter-personal variation in serum progesterone levels with an impact on reproductive outcomes, despite the use of the same dose and route of progesterone administration. The place of progesterone rescue protocols in patients with low serum progesterone levels one day prior to warmed blastocyst transfer in hormone replacement treatment and natural cycles is likely to be intensively explored in near future.

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“…Obstetric and perinatal outcomes after the use of different FET protocols have previously been compared. An increased risk of HDP, preterm prelabor rupture of membranes (PPROM), bleeding disorders, cesarean section (CS), post-term birth, macrosomia, and placenta accreta after programmed FET [12,13] is observed. CL may play an important role in these in the occurrence of these complications.…”

Section: Introductionmentioning

confidence: 99%

Adverse Obstetric and Perinatal Outcomes in 2333 Singleton Pregnancies Conceived After Different Endometrial Preparation Protocols: a Retrospective Study in China

Yang

Bai

Han

et al. 2022

Preprint

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Background: Frozen-thawed embryo transfer is rising worldwide. One adverse effect of programmed frozen embryo transfer (FET) reported in some studies is an increased risk of adverse obstetric and perinatal outcomes. Meanwhile, body mass index (BMI) also has adverse effect on obstetric and perinatal outcomes. In this study, we investigated that the influence of different endometrial preparation protocols on obstetric and perinatal outcomes and the role of BMI in it.Method: This retrospective study included 2333 singleton deliveries after frozen-thaw embryo transfer at our centre between 2014 and 2021, including 550 cycles with programmed FET, 1783 cycles with true natural cycle FET (tNC-FET). In further analysis according to BMI grouped by Asian criterion, group A (18.5kg/m2≤BMI<24.00kg/m2) included 1257 subjects, group B (24kg/m2≤BMI<28.00kg/m2) included 503 subjects and group C (BMI≥28 kg/m2) included 573 subjects. Baseline characteristics of the two groups were compared and analyzed. Binary logistic regression analyses were performed to explore the association between obstetric and perinatal outcomes and endometrial preparation protocols.Results: There were no significant differences in the placenta previa, gestational diabetes mellitus(GDM), preterm premature rupture of membranes (PPROM), cesarean section (CS) and macrosomia between the tNC-FET and programmed FET groups (P>0.05). The risk of hypertensive disorders in pregnancy (HDP) was increased in programmed FET group compared with the tNC-FET group (7.3% vs 4.4%, crude OR 1.714[1.156-2.542]; adjusted OR 1.845[1.031-3.300]). After dividing the patients into three groups according to the BMI, the risk of HDP in group C (14.4% vs 6.2%，crude OR 2.545 [1.424-4.548]; adjusted OR 4.712 [1.769-12.547]) was increased in programmed FET group compared with the tNC-FET group. But there was no statistically significant difference in group A and group B. Programmed FET group compared with the tNC-FET group, the risk of HDP increase as the body mass index increase.Conclusion: This study showed a tendency toward increasing risk of HDP in programmed FET cycle compared with the tNC-FET cycle, and the risk of HPD increases as BMI increases. Increased risk of preterm birth and low birth weight is linked to increased risk of HPD.

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Maternal and perinatal outcomes in programmed versus natural vitrified–warmed blastocyst transfer cycles

Cited by 51 publications

References 38 publications

Pregnancy Outcomes After Frozen-Thawed Embryo Transfer in the Absence of a Corpus Luteum

Pregnancy Outcomes After Frozen-Thawed Embryo Transfer in the Absence of a Corpus Luteum

Preparation of the Endometrium for Frozen Embryo Transfer: A Systematic Review

Adverse Obstetric and Perinatal Outcomes in 2333 Singleton Pregnancies Conceived After Different Endometrial Preparation Protocols: a Retrospective Study in China

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