Vitrification of cleavage stage day 3 embryos results in higher live birth rates than conventional slow freezing: a RCT

Debrock, Sophie; Peeraer, Karen; Gallardo, Elia Fernandez; Neubourg, Diane De; Spiessens, Carl; D’Hooghe, Thomas

doi:10.1093/humrep/dev134

Cited by 66 publications

(61 citation statements)

References 19 publications

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“…The reasons may be that, for example, the equipment is already in place in many clinics, the method is not very operator-demanding, and the results for the developmental stages mentioned are reasonably good. With vitrification, however, much higher survival rates can be obtained [3,4].…”

Section: Introductionmentioning

confidence: 99%

Clinical evaluation of two formulations of slow-freezing solutions for cleavage stage embryos

Jin

et al. 2016

J Assist Reprod Genet

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Purpose The aim was to investigate if improved survival rates could be achieved using a new formulation of solutions for slow freezing of human cleavage stage embryos. Methods The evaluation was divided into two parts. The first part was a retrospective analysis of results obtained after freezing and thawing of day 3 embryos from 400 women using an old formulation of cryopreservation solutions compared to results from 108 women for which cryopreservation had been performed using new compositions of solutions. The second part was prospective, adding cycles until similar numbers of patients had been included in both groups. In total, 2274 embryos from 897 patients were thawed using the old formulation of solutions while 1273 embryos from 542 patients were frozen and thawed using the new solutions. The primary endpoint was survival rate. Results With the new solutions, the survival rate increased from 82.1 to 94.4 % and the complete embryo survival rate increased from 54.9 to 81.3 %. The implantation rate, clinical pregnancy rate per embryo transfer, and per cycle were 28.2, 45.2, and 43.7 %, respectively, using the old formulations of cryosolutions. With the new solutions, the results reached 33.7, 54.1, and 54.1 %, respectively. All differences in results were statistically significant. The number of cancelled embryo transfers due to no survived embryos was 18 with the old solutions and 0 using the new solutions.Conclusion With the new composition of solutions for slow freezing and thawing of embryos, significantly improved results were obtained. Additionally, the number of cancelled embryo transfers was reduced.

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Section: Introductionmentioning

confidence: 99%

Clinical evaluation of two formulations of slow-freezing solutions for cleavage stage embryos

Jin

et al. 2016

J Assist Reprod Genet

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“…Vitrification, or the rapid-freezing of embryos, has been implemented in many IVF centers and has been shown in comparative trials to be associated with higher rates of post-thaw survival and intact embryos than slow-freezing method (Debrock et al 2015). The risk for cycle cancellation due to cryopreservation damage was becoming extremely low.…”

Section: Discussionmentioning

confidence: 99%

Peer Review #2 of "The effect on twinning rate of transferring double vitrified-warmed embryos in women of advanced reproductive age: a retrospective study (v0.2)"

2020

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Twin pregnancies are associated with greater risk of neonatal morbidity and mortality than a singleton. This study was performed to investigate the twin pregnancy rate when two vitrified-warmed embryos are transferred in women of advanced reproductive age (≥ 35 years at the time of oocyte retrieval) and to evaluate the implications of findings in selecting candidates for elective single embryo transfer (eSET). A retrospective analysis of data which included 2038 women aged 35 to 45 years, who underwent vitrified-warmed double embryo transfer (DET), from January 2013 and December 2016 was undertaken. Pregnancy and twin rates were estimated after stratifying by prognostic profile. The twin pregnancy rate was lower in women with poor prognosis (12/96, 12.5%) as compared with that in women with favorable prognosis (102/374, 27.3%) and average prognosis (78/346, 22.5%) with significant differences (P<. 05). The twin rate for women with favorable prognosis were 29.2% (70/240) in the cycles of women aged 35-37 years, 26.8% (26/97) in the cycles of women aged 38-40 years, and 16.2% (6/37) in the cycles of women >40 years. The twin rate for women with average prognosis were 25.8% (51/198) in the cycles of women aged 35-37 years, 22.0% (22/100) in the cycles of women aged 38-40 years, and 10.4% (5/48) in the cycles of women >40 years. The twin rate for women with poor prognosis were 15.3% (9/59) in the cycles of women aged 35-37 years, 10.3% (3/29) in the cycles of women aged 38-40 years, and 0% (0/8) in the cycles of women >40 years. From these results, it was concluded that women with a favorable or average prognosis have a high risk of twin pregnancies. The finding can be used to guide future practice: i.e. performing eSET in women with favorable or average prognosis and DET in women with poor prognosis.

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“…9 Several studies have highlighted higher embryo survival rates following vitrification compared with slow freezing. 4,10 This translates into improved clinical outcomes, with a 2015 randomised controlled trial (RCT) 11 demonstrating a higher live-birth rate per embryo thawed after vitrification compared with slow freezing. Moreover, a cohort study of more than 30 000 FERs 12 demonstrated a higher live-birth rate per cycle started for vitrified versus slow frozen embryos, with meta-analysis data 13 supporting these findings.…”

Section: Improved Embryology Techniquesmentioning

confidence: 99%

The role of frozen–thawed embryo replacement cycles in assisted conception

Noble

Child

2019

The Obstetric & Gynaecologis

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Recent years have seen a dramatic rise in the number of frozenthawed embryo replacement (FER) cycles. Improved embryo cryopreservation techniques have resulted in outcomes for FER that are similar to fresh embryo transfer. FER maximises the cumulative live-birth rate of a fresh in vitro fertilisation (IVF) cycle by using excess embryos and encourages a policy of single embryo transfer; this has contributed to a fall in the multiple pregnancy rate associated with IVF. Freezing all suitable embryos in a fresh cycle reduces the risk of ovarian hyperstimulation syndrome. The endometrium is prepared for FER by a natural or medicated protocol; the optimum method is unknown. Learning objectives To appreciate the importance of FER in IVF practice. To understand the current debate surrounding fresh versus frozen IVF. To understand the indications for, and methods of, embryo cryopreservation. To understand the commonly used methods of endometrial preparation for FER. To be able to date an FER pregnancy. Ethical issues Funding from the National Health Service (NHS) for embryo storage and FER varies widely across the UK; where funding is limited, this can result in viable embryos being discarded. When an embryo is created by a couple, the consent of both partners is required before transferring the embryo.

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Vitrification of cleavage stage day 3 embryos results in higher live birth rates than conventional slow freezing: a RCT

Abstract: NCT02013024.

Cited by 66 publications

References 19 publications

Clinical evaluation of two formulations of slow-freezing solutions for cleavage stage embryos

Clinical evaluation of two formulations of slow-freezing solutions for cleavage stage embryos

Peer Review #2 of "The effect on twinning rate of transferring double vitrified-warmed embryos in women of advanced reproductive age: a retrospective study (v0.2)"

The role of frozen–thawed embryo replacement cycles in assisted conception

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