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International Journal of Reproductive BioMedicine
Research and Clinical Center for Infertility, Shahid Sadoughi University of Medical Sciences of Yazd
ISSN: 1680-6433 EISSN: 1680-6433
Vol. 18, No. 7, 2020, pp. 491-500
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Bioline Code: rm20053
Full paper language: English
Document type: Research Article
Document available free of charge
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International Journal of Reproductive BioMedicine, Vol. 18, No. 7, 2020, pp. 491-500
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Reduced live birth rates in frozen versus fresh single cleavage stage embryo transfer cycles: A cross -sectional study
Teh, Wan Tinn; Polyakov, Alex; Garrett, Claire; Edgar, David; Mcbain, John & Rogers, Peter Adrian Walton
Abstract
Background: Studies have suggested that embryo-endometrial developmental
asynchrony caused by slow-growing embryos can be corrected by freezing the embryo
and transferring it back in a subsequent cycle. Therefore, we hypothesized that live
birth rates (LBR) would be higher in frozen embryo transfer (FET) compared with fresh
embryo transfers.
Objective: To compare LBR between fresh and FET cycles.
Materials and Methods: A cross-sectional analysis of 10,744 single autologous embryo
transfer cycles that used a single cleavage stage embryo was performed. Multivariate
analysis was performed to compare LBR between FET and fresh cycles, after correcting
for various confounding factors. Sub-analysis was also performed in cycles using slow
embryos.
Results: Both LBR (19.13% vs 14.13%) and clinical pregnancy (22.48% vs 16.25%)
rates (CPR) were higher in the fresh cycle group (p < 0.00). Multivariate analysis for
confounding factors also confirmed that women receiving a frozen-thawed embryo had
a significantly lower LBR rate compared to those receiving a fresh embryo (OR 0.76,
95% CI 0.68-0.86, p < 0.00). In the sub-analysis of 1,154 cycles using slow embryos,
there was no statistical difference in LBR (6.40% vs 6.26%, p = 0.92) or CPR (8.10% vs
7.22%, p = 0.58) between the two groups.
Conclusion: This study shows a lower LBR in FET cycles when compared to fresh
cycles. Our results suggest that any potential gains in LBR due to improved embryoendometrial
synchrony following FET are lost, presumably due to freeze-thaw process-related
embryo damage.
Keywords
Fresh; Frozen embryo transfer; Live birth; Embryo; Transfer.
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