Obstetric outcomes after transfer of vitrified blastocysts

Wikland, Matts; Hardarson, Thorir; Hillensjø, Torbjörn; Westin, Cecília Buzatto; Westlander, Göran; Wood, Maureen J.; Wennerholm, Ulla‐Britt

doi:10.1093/humrep/deq117

Cited by 151 publications

(94 citation statements)

References 26 publications

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“…Deliveries included all live born babies and stillborns after 28 weeks of gestation. Perinatal mortality included mortality in live borns within 7 days of age and stillborns after 28 weeks of gestation (Wikland et al, 2010).…”

Section: Outcome Measuresmentioning

confidence: 99%

“…Although vitrification is now used widely in assisted reproduction treatment (ART) clinics, there are still concerns regarding the safety of vitrification. Most published reports looking at the neonatal outcomes after transfer of vitrified embryos have used blastocyst-stage embryos (Takahashi et al, 2005;Mukaida et al, 2009;Wikland et al, 2010). Reported data on children born after transfer of Day 3 vitrified embryos are relatively rare (Rama Raju et al, 2009;Kato et al, 2012;Shi et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

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Obstetric and neonatal outcomes after transfer of vitrified early cleavage embryos

Liu

Teng

et al. 2013

Human Reproduction

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what is known already: Vitrification has been successfully used for cryopreserving human oocytes and blastocyst-stage embryos. Most published studies looking at the neonatal outcomes after transfer of vitrified embryos refer to blastocyst-stage embryos. Information on children born after transfer of Day 3 vitrified embryos is relatively rare. study design, size, duration: A retrospective, single-centre study of children born after Day 3 embryo transfer from fresh, slow frozen or vitrified embryos during the period January 2006 to May 2011 was conducted. Each patient contributed only one cycle per group. Children born were followed-up at 7-30 days after delivery. Outcome measures include obstetric and neonatal outcomes, which were evaluated by medical records and questionnaires sent to parents. main results and the role of chance: Frequencies of hypertensive disorder, gestational diabetes, placenta previa and abruptio placenta were similar in all groups. Five hundred and forty five, 986 and 1914 singleton babies were born from vitrified, slow freezing and fresh transfers, and the median gestational ages were 38.7, 38.7 and 38.7 weeks, respectively. Preterm birth (32 -37 weeks) occurred in 7.5, 9.2 and 7.8% of the vitrified, slow freeze and fresh groups, respectively. The median birthweight from vitrified embryos (3455.3 g) was higher than that from slow freezing (3352.3 g) and fresh (3355.8 g) transfers (P , 0.0001 for both). The rate of perinatal mortality was 0.4% for all transfer groups. Three hundred and eighty two, 734 and 1322 twin babies were born from vitrified, slow freezing and fresh transfers, respectively. There were no differences among groups in mean gestational age and in the rate of preterm birth. The median birthweight for babies born from vitrified embryos (2587.4 g) was higher than that from the slow freezing (2538.8 g) or fresh (2494.4 g) transfer groups (vitrified versus fresh: P ¼ 0.0015; vitrified versus slow freeze: P ¼ 0.049). The rate of low birthweight (1500-2500 g) from vitrified (30.4%) was lower than that from fresh (36.2%) transfer (P ¼ 0.034).limitations, reasons for caution: The main limitation of this study is that the obstetric and neonatal data were obtained by questionnaires sent to the parents without checking medical records. This is, especially, problematic for reporting on congenital malformations, so birth defects were excluded from the data.wider implications of the findings: Transfer of vitrified and warmed Day 3 embryos does not seem to have an adverse effect on neonatal outcome. Children born following the transfer of vitrified embryos seem to have a higher birthweight when compared with those of fresh or slow frozen embryos. study funding/competing interest(s): This study received no outside funding and none of the authors has any conflict of interest.

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Section: Outcome Measuresmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Obstetric and neonatal outcomes after transfer of vitrified early cleavage embryos

Liu

Teng

et al. 2013

Human Reproduction

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“…In a study by Wikland et al, no difference in birth weight was observed after the transfer of vitrified blastocysts or slow-frozen early cleavage stage embryos [31]. The blastocyst culture itself has been found to have an impact on the birth weight of newborns, complicating the comparison of two cryopreservation techniques using embryos from different stages [32,33].…”

Section: Discussionmentioning

confidence: 99%

The freezing method of cleavage stage embryos has no impact on the weight of the newborns

Kaartinen

Kananen²,

Huhtala

et al. 2016

J Assist Reprod Genet

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Purpose The aim of this study was to study the effect of the embryo freezing method on the birth weight of newborns from frozen embryo transfer (FET) cycles, and the pregnancy results of cleavage stage embryos cryopreserved by slow freezing or vitrification. Methods This is a retrospective cohort study undertaken in a University Hospital IVF unit using concurrently both the slow-freezing and the vitrification techniques. All frozenthawed and vitrified-warmed day 2 and day 3 embryo transfers during the time period from 1 April 2009 to 31 November 2013 were included in the study. Results There was no statistically significant weight difference between newborns from vitrified or slow-frozen embryos (3588 vs 3670 g). A higher post-thaw viability rate was achieved after cryopreservation by the vitrification technique compared to the slow-freezing protocol (83.4 vs 61.4 %). The miscarriage rate was lower in the vitrification group (15.7 vs 29.0 %). The live birth rates were similar (19.5 vs 19.1 %) in the slow-freezing and vitrification groups, respectively. Among vitrified embryos, 7.4 embryos needed to be thawed to produce one delivery; in the slow-freezing group, that number was 11.9. Conclusions The freezing method has no impact on the weight of the newborn.With lower post-thaw survival rates and higher miscarriage rates, the slow-freezing cryopreservation protocol is inferior to the vitrification technique.

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“…We agree that in such a scenario the use of a selection method cannot increase (but could decrease) the live birth rate per stimulated IVF cycle when all embryos are serially transferred (albeit potentially reducing the time to first delivery). Indeed, there may be an argument for vitrification of all embryos without fresh transfers, considering potentially superior peri-natal outcome of births resulting from transfer of thawed blastocysts (Wikland et al, 2010). In that study, more singletons born after transfer of fresh blastocysts were small for gestational age compared with singletons born after transfer of vitrified blastocysts.…”

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confidence: 87%

Embryo selection in IVF: is polar body array comparative genomic hybridization accurate enough?

Scriven

Ogilvie

2012

Human Reproduction

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The emergence of the array comparative genomic hybridization technique (aCGH) is considered an advance in preimplantation genetic testing. Analysis of the recently published pilot study using polar body aCGH indicates that the test accuracy compares favourably with the fluorescence in situ hybridization technique although a substantial number of euploid zygotes are still likely to be excluded incorrectly. A sound argument against selection in principle has recently been published, based on accumulating evidence that potentially all embryos can now be cryopreserved and transferred in subsequent frozen replacement cycles without impairing pregnancy rates. We suggest that vitrification and serial transfer without testing are likely to give patients the best chance for a successful pregnancy, and avoid the use of an expensive technology.Key words: PGS / PGD / aCGH / diagnostic accuracy Preimplantation genetic screening (PGS) for aneuploidy, using chromosome-specific fluorescence in situ hybridization (FISH) probes, has been offered extensively at many centres, with the aim of selecting euploid embryos for transfer and thus improving the efficiency of assisted conception. Randomized controlled trials of PGS using FISH have failed to demonstrate a beneficial effect on the live birth rate (Mastenbroek et al., 2011a), and the advent of new technology has led to the ESHRE-funded pilot study on PGS using the recently developed array comparative genomic hybridization (aCGH) technique to test polar bodies and hence to predict the chromosome status of the corresponding zygote (Geraedts et al., 2011). This pilot study has concluded that the ploidy of the zygote can be predicted with an acceptable accuracy using the new technology. We believe that this is worthy of further analysis. We have used the study results to estimate the measures of diagnostic accuracy and applied a theoretical model developed for preimplantation genetic testing for further sensitivity analysis and to provide a theoretical comparison using 23-chromosome FISH (Scriven and Bossuyt, 2010). In brief, the theoretical model calculates diagnostic accuracy measures uncomplicated by mosaicism for any number of chromosomes tested greater than two. The input values are the degree of aneuploidy per chromosome and the accuracy per chromosome, defined as the proportion of normal diploid nuclei with a normal signal pattern. In our analysis of the data from Geraedts et al. Table I shows the outcome

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Obstetric outcomes after transfer of vitrified blastocysts

Abstract: No adverse neonatal outcomes were observed in children born after transfer of vitrified, as compared with fresh blastocysts or after transfer of slow-frozen early cleavage stage embryos.

Cited by 151 publications

References 26 publications

Obstetric and neonatal outcomes after transfer of vitrified early cleavage embryos

Obstetric and neonatal outcomes after transfer of vitrified early cleavage embryos

The freezing method of cleavage stage embryos has no impact on the weight of the newborns

Embryo selection in IVF: is polar body array comparative genomic hybridization accurate enough?

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