Pregnancy potential and perinatal outcomes of embryos cryopreserved twice: a case–control study

Hallamaa, Marianne; Seikkula, Jaana; Willman, Sami F.; Ollila, Helena; Jokimaa, Varpu

doi:10.1016/j.rbmo.2021.06.028

Cited by 9 publications

(8 citation statements)

References 26 publications

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“…The neonatal outcome of re‐cryopreservation has been evaluated in several previous studies. A study by Murakami et al 21 showed higher birth weight and lower preterm birth rates in the re‐cryopreservation group, whereas Hallamaa et al 11 reported that re‐cryopreservation did not negatively affect neonatal outcomes. A recent meta‐analysis by Wang et al 20 also demonstrated that re‐cryopreservation has no effect on neonatal outcomes.…”

Section: Discussionmentioning

confidence: 96%

“…However, up to now, a limited number studies have explored the effectiveness of re‐cryopreservation of embryos, and their findings have been conflicting 10–12 . Hallamaa et al 11 demonstrated that re‐cryopreservation achieved live‐birth rates and neonatal outcomes similar to those achieved with cryopreservation only once, whereas Wang et al 10 and Bradley et al 12 found that the re‐cryopreservation process decreased the live‐birth rate. Notably, it prevented them from drawing solid conclusions without distinguishing variable cryopreservation methods or embryo types, which contribute to pregnancy outcomes 13,14 .…”

Section: Introductionmentioning

confidence: 99%

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Effect of re‐cryopreservation on pregnancy and neonatal outcomes: Analysis using propensity score matching

Xue

Shi

2023

Intl J Gynecology & Obste

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ObjectiveTo comprehensively assess the effect of re‐cryopreservation procedure on pregnancy and neonatal outcomes by using propensity matching (PSM) analysis.MethodsThe patients were divided into two groups according to the times of embryo cryopreservation: the cryopreservation group (n = 8034) and the re‐cryopreservation group (n = 66). To optimize the precision of the present study, we used PSM to adjust the different baseline characteristics between the two groups, including maternal age, the number of good‐quality embryos transferred and endometrial preparation protocols. The primary outcome was live‐birth rate. The secondary outcomes were biochemical pregnancy rate, clinical pregnancy rate, and miscarriage rate.ResultsWe found that the rates of biochemical pregnancy and clinical pregnancy were comparable between the two groups, whereas miscarriage rate was increased, resulting in significantly reduced live‐birth rate in the re‐cryopreservation group. No differences were observed in terms of neonatal outcomes, including cesarean section, birth weight, and malformation as well as pregnancy complications. Moreover, multivariable analysis demonstrated that re‐cryopreservation was an independent risk factor for live‐birth rate.ConclusionThe present study demonstrated the adverse effect of re‐cryopreservation on pregnancy outcomes, providing valuable information for clinical decision making and patient counseling.

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Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

Effect of re‐cryopreservation on pregnancy and neonatal outcomes: Analysis using propensity score matching

Xue

Shi

2023

Intl J Gynecology & Obste

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“…Notably the LBR was only between 13% and 15% in their population, despite the utilization of a multiple ET strategy, and they also pooled cases processed with slow freezing and vitrification protocols. Recently a two-centre retrospective analysis of single (n = 304) and double (n = 89) cryopreserved embryos with slow freezing and vitrification at variable embryonic stages, including 2PN zygotes, was conducted ( Hallamaa et al , 2021 ). They reported comparable outcomes from both strategies and endorse double cryopreservation for surplus embryos coming from a freeze-thaw cycle.…”

Section: Discussionmentioning

confidence: 99%

“…Among these studies, the inclusion of cohorts of embryos frozen at various embryonic stages and the use of various cryopreservation protocols within each group has limited interpretation of the results ( Kumasako et al , 2009 ; Koch et al , 2011 ; Murakami et al , 2011 ; Zheng et al , 2017 ; Farhi et al , 2019 ). The most recent multicentre study employing a cohort of vitrified and slow-frozen embryos in a retrospective analysis showed no detrimental impact of double cryoconservation on clinical and neonatal outcomes ( Hallamaa et al , 2021 ). The competence of biopsied euploid blastocysts after two rounds of cryopreservation has also been explored with contradictory results ( Taylor et al , 2014 ; Bradley et al , 2017 ; Cimadomo et al , 2018 ; Aluko et al , 2021 ).…”

Section: Introductionmentioning

confidence: 99%

Double vitrification and warming does not compromise the chance of live birth after single unbiopsied blastocyst transfer

Makieva,

Sachs,

Xie

et al. 2023

Human Reproduction Open

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STUDY QUESTION Does double vitrification and thawing of an embryo compromise the chance of live birth after a single blastocyst transfer? SUMMARY ANSWER The live birth rate obtained after double vitrification was comparable to that obtained after single vitrification. WHAT IS KNOWN ALREADY Double vitrification-warming (DVW) is commonly practiced to accommodate surplus viable embryos suitable for transfer, to allow retesting of inconclusively-diagnosed blastocysts in preimplantation genetic testing (PGT), and to circumvent limitations associated with national policies on embryo culture in certain countries. Despite its popularity, the evidence concerning the impact of DVW practice on ART outcomes is limited and lacking credibility. This is the first thorough investigation of clinical pregnancy and live birth rate following DVW in the case where the first round of vitrification occurred at the zygote stage and the second round occurred at the blastocyst stage in the absence of biopsy. STUDY DESIGN, SIZE, DURATION This is a retrospective observational analysis of n = 407 single blastocyst transfers whereby embryos created by IVF/ICSI were vitrified-warmed once (single vitrification-warming (SVW) n = 310) or twice (DVW, n = 97) between January 2017 and December 2021. PARTICIPANTS/MATERIALS, SETTING, METHODS In the SVW group, blastocysts were vitrified on day 5/6 and warmed on the day of embryo transfer (ET). In the DVW group, two pronuclear (2PN) zygotes were first vitrified-warmed and then re-vitrified on day 5/6 and warmed on the day of ET. Exclusion criteria were ETs from PGT and vitrified-warmed oocyte cycles. All of the ETS were single blastocyst transfers performed at the University Hospital Zurich in Switzerland following natural or artificial endometrial preparation. MAIN RESULTS AND THE ROLE OF CHANCE The biochemical pregnancy rate, clinical pregnancy rate (CPR) and live birth rate (LBR) were all comparable between the DVW and SVW groups. The CPR for DVW was 44.3% and for SVW it was 42.3% (p = 0.719). The LBR for DVW was 30.9% and for SVW it was 28.7% (p = 0.675). The miscarriage rate was additionally similar between the groups: 27.9% for DVW and 32.1% for SVW groups (p = 0.765). LIMITATIONS, REASONS FOR CAUTION The study is limited by its retrospective nature. Caution should be taken concerning interpretation of these findings in cases where double vitrification-warming occurs at different stages of embryo development. WIDER IMPLICATION OF THE FINDINGS The result of the present study on double vitrification-warming procedure provides a framework for counselling couples on their chance of clinical pregnancy per warming cycle. It additionally provides confidence and reassurance to laboratory professionals in certain countries where national policies limit embryo culture strategies making DVW inevitable. STUDY FUNDING/COMPETING INTERESTS This work was supported by the University Research Priority Program “Human Reproduction Reloaded” of the University of Zurich. The authors have no conflict of interest related to this study to declare. TRIAL REGISTRATION NUMBER N/A

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“…Frontiers in Cell and Developmental Biology frontiersin.org Also, double vitrification-warming has been described to allow retesting of inconclusively diagnosed blastocysts in PGT, to circumvent limitations associated with national policies on embryo culture in certain countries, and in the case of donor vitrified-warmed oocytes that following fertilization are cultured to the blastocyst stage and re-vitrified for future use. A recent retrospective study by Hallamaa and collaborators, investigated a cohort of vitrified and slow-frozen embryos and reported no detrimental impact of double cryopreservation on clinical and neonatal outcomes (Hallamaa et al, 2021). Another study published by Makieva and colleagues has investigated this aspect, comparing the clinical pregnancy rate (CPR) and LBR following double vitrification-warming in those cycles where vitrification was performed first at the zygote stage and the second procedure occurred at the blastocyst stage in the absence of biopsy (Makieva et al, 2023).…”

Section: Application Of Double Vitrification (Re-cryopreservation)mentioning

confidence: 99%

Vitrification of human blastocysts for couples undergoing assisted reproduction: an updated review

Sciorio,

Tramontano,

Campos

et al. 2024

Front. Cell Dev. Biol.

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Over the past 40 years there has been a worldwide critical change in the field of assisted reproduction technology (ART), leading to the increased application of single blastocyst transfer, which is extremely important to avoid the risks of multiple pregnancy and associated complications for both mother and babies. Indeed, advancements in ART over the last few decades have been obtained thanks to several improvements, including ovarian stimulation, embryo culture conditions and, of course, progress in cryopreservation methods, especially with the application of vitrification. The ability to cryopreserve human embryos has improved significantly with vitrification compared to the initially adopted slow-freezing procedures. Since the introduction of vitrification, it has become the gold standard method to effectively cryopreserve human blastocysts. However, some new protocols are now being explored, such as the short warming procedure and even shorter exposure to the equilibration solution before vitrification, which seem to provide optimal results. Therefore, the main aim of the current narrative review, will be to illustrate the benefit of vitrification as an effective method to cryopreserve the human blastocyst and to illustrate new protocols and variations which in future may increase the performance of vitrification protocols.

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Pregnancy potential and perinatal outcomes of embryos cryopreserved twice: a case–control study

Cited by 9 publications

References 26 publications

Effect of re‐cryopreservation on pregnancy and neonatal outcomes: Analysis using propensity score matching

Effect of re‐cryopreservation on pregnancy and neonatal outcomes: Analysis using propensity score matching

Double vitrification and warming does not compromise the chance of live birth after single unbiopsied blastocyst transfer

Vitrification of human blastocysts for couples undergoing assisted reproduction: an updated review

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