Freezing of all embryos in in vitro fertilization is beneficial in high responders, but not intermediate and low responders: an analysis of 82,935 cycles from the Society for Assisted Reproductive Technology registry.

Published

Journal Article

OBJECTIVE:To assess in vitro fertilization (IVF) and pregnancy outcomes in patients having their first frozen embryo transfer (FET) after a freeze-all cycle versus similar patients having their first fresh embryo transfer (ET). DESIGN:Retrospective cohort study. SETTING:None. PATIENT(S):Registry data on 82,935 patient cycles from the Society for Assisted Reproductive Technology (SART). INTERVENTION(S):All first fresh autologous IVF cycles were analyzed and compared to first FET cycles after a freeze-all first IVF stimulation. The cycles were subdivided into cohorts based upon the number of oocytes retrieved (OR): 1-5 (low), 6-14 (intermediate), and 15+ (high responders). Univariate analyses were performed on cycle characteristics, and multivariable regression analyses were performed on outcome data. MAIN OUTCOME MEASURE(S):Clinical pregnancy rate (CPR) and live-birth rate (LBR). RESULTS:Of the 82,935 cycles analyzed, 69,102 patients had their first fresh transfer, and 13,833 had a first FET. High responders were found to have a higher CPR and LBR in the FET cycles compared with the fresh ET cycles (61.5 vs. 57.4%; 52.0 vs. 48.9%). In intermediate responders, both CPR and LBR were higher after fresh ET compared with FET (49.6% vs. 44.2%; 41.2 vs. 35.3%). Similarly, in low responders, CPR and LBR were higher after fresh compared with FET (33.2% vs. 15.9%; 25.9% vs. 11.5%). CONCLUSION(S):A freeze-all strategy is beneficial in high responders but not in intermediate or low responders, thus refuting the idea that freeze-all cycles are preferable for all patients.

Full Text

Duke Authors

Cited Authors

  • Acharya, KS; Acharya, CR; Bishop, K; Harris, B; Raburn, D; Muasher, SJ

Published Date

  • October 2018

Published In

Volume / Issue

  • 110 / 5

Start / End Page

  • 880 - 887

PubMed ID

  • 30139718

Pubmed Central ID

  • 30139718

Electronic International Standard Serial Number (EISSN)

  • 1556-5653

International Standard Serial Number (ISSN)

  • 0015-0282

Digital Object Identifier (DOI)

  • 10.1016/j.fertnstert.2018.05.024

Language

  • eng