Advertisement

To delay or not to delay a frozen embryo transfer after a failed fresh embryo transfer attempt?

      Objective

      To evaluate if increasing the interval between a failed fresh embryo transfer and a subsequent frozen embryo transfer (FET) cycle has any effect on clinical pregnancy rates (CPRs).

      Design

      Retrospective cohort study.

      Setting

      University-based tertiary referral center.

      Patient(s)

      Women who underwent at least one FET after ovarian stimulation for in vitro fertilization (IVF) and a failed fresh embryo transfer attempt from January 2010 to November 2014. We divided our sample according to the “timing” of the first FET (TF-FET), defined by the interval between oocyte retrieval and the FET cycle start date. The start of the FET was classified as either immediate (≤22 days after oocyte retrieval) or delayed (>22 days after oocyte retrieval).

      Intervention(s)

      None.

      Main Outcome Measure(s)

      CPR after the first FET.

      Result(s)

      A total of 1,183 FET cycles (performed in 1,087 women) were included in our study. No significant differences were found between the immediate and delayed FET groups regarding age, number of oocytes retrieved, number of good-quality embryos produced, embryo developmental stage at FET, and number of frozen embryos transferred. Most importantly, the CPRs of the first FET did not differ significantly according to the TF-FET (32.5% after immediate FET vs. 31.7% after delayed FET), even after adjusting for potential confounding with the use of multivariable logistic regression.

      Conclusion(s)

      FETs performed immediately after fresh IVF cycles had CPRs similar to those postponed to a later time. Therefore, deferring FETs may unnecessarily prolong time to pregnancy.

      Key Words

      To read this article in full you will need to make a payment

      References

        • Doody K.J.
        Cryopreservation and delayed embryo transfer–assisted reproductive technology registry and reporting implications.
        Fertil. 2014; 102: 27-31
        • Kalra S.K.
        • Ratcliffe S.J.
        • Coutifaris C.
        • Molinaro T.
        • Barnhart K.T.
        Ovarian stimulation and low birth weight in newborns conceived through in vitro fertilization.
        Obstet Gynecol. 2011; 118: 863-871
        • Ishihara O.
        • Araki R.
        • Kuwahara A.
        • Itakura A.
        • Saito H.
        • Adamson G.D.
        Impact of frozen-thawed single-blastocyst transfer on maternal and neonatal outcome: an analysis of 277,042 single-embryo transfer cycles from 2008 to 2010 in Japan.
        Fertil Steril. 2014; 101: 128-133
        • Pelkonen S.
        • Koivunen R.
        • Gissler M.
        • Nuojua-Huttunen S.
        • Suikkari A.M.
        • Hyden-Granskog C.
        • et al.
        Perinatal outcome of children born after frozen and fresh embryo transfer: the Finnish cohort study 1995–2006.
        Hum Reprod. 2010; 25: 914-923
        • Shih W.
        • Rushford D.D.
        • Bourne H.
        • Garrett C.
        • McBain J.C.
        • Healy D.L.
        • et al.
        Factors affecting low birthweight after assisted reproduction technology: difference between transfer of fresh and cryopreserved embryos suggests an adverse effect of oocyte collection.
        Hum Reprod. 2008; 23: 1644-1653
        • Maheshwari A.
        • Pandey S.
        • Shetty A.
        • Hamilton M.
        • Bhattacharya S.
        Obstetric and perinatal outcomes in singleton pregnancies resulting from the transfer of frozen thawed versus fresh embryos generated through in vitro fertilization treatment: a systematic review and meta-analysis.
        Fertil Steril. 2012; 98 (e1–9): 368-377
        • Clayton H.B.
        • Schieve L.A.
        • Peterson H.B.
        • Jamieson D.J.
        • Reynolds M.A.
        • Wright V.C.
        Ectopic pregnancy risk with assisted reproductive technology procedures.
        Obstet Gynecol. 2006; 107: 595-604
        • Huang B.
        • Hu D.
        • Qian K.
        • Ai J.
        • Li Y.
        • Jin L.
        • et al.
        Is frozen embryo transfer cycle associated with a significantly lower incidence of ectopic pregnancy? An analysis of more than 30,000 cycles.
        Fertil Steril. 2014; 102: 1345-1349
        • Ishihara O.
        • Kuwahara A.
        • Saitoh H.
        Frozen-thawed blastocyst transfer reduces ectopic pregnancy risk: an analysis of single embryo transfer cycles in Japan.
        Fertil Steril. 2011; 95: 1966-1969
        • Shapiro B.S.
        • Daneshmand S.T.
        • De Leon L.
        • Garner F.C.
        • Aguirre M.
        • Hudson C.
        Frozen-thawed embryo transfer is associated with a significantly reduced incidence of ectopic pregnancy.
        Fertil Steril. 2012; 98: 1490-1494
        • Wennerholm U.B.
        • Henningsen A.K.
        • Romundstad L.B.
        • Bergh C.
        • Pinborg A.
        • Skjaerven R.
        • et al.
        Perinatal outcomes of children born after frozen-thawed embryo transfer: a Nordic cohort study from the CONARTAS group.
        Hum Reprod. 2013; 28: 2545-2553
        • Devroey P.
        • Polyzos N.P.
        • Blockeel C.
        An OHSS-free clinic by segmentation of IVF treatment.
        Hum Reprod. 2011; 26: 2593-2597
        • Weinerman R.
        • Mainigi M.
        Why we should transfer frozen instead of fresh embryos: the translational rationale.
        Fertil Steril. 2014;
        • Wong K.M.
        • Mastenbroek S.
        • Repping S.
        Cryopreservation of human embryos and its contribution to in vitro fertilization success rates.
        Fertil Steril. 2014; 102: 19-26
        • Roque M.
        Freeze-all policy: is it time for that?.
        J Assist Reprod Genet. 2015; 32: 171-176
        • Reichman D.E.
        • Chung P.
        • Meyer L.
        • Greenwood E.
        • Davis O.
        • Rosenwaks Z.
        Consecutive gonadotropin-releasing hormone–antagonist in vitro fertilization cycles: does the elapsed time interval between successive treatments affect outcomes?.
        Fertil Steril. 2013; 99: 1277-1282
        • Maas K.H.
        • Baker V.L.
        • Westphal L.M.
        • Lathi R.B.
        Optimal timing of frozen embryo transfer after failed IVF attempt.
        Fertil Steril. 2008; 90: S285
        • Hu X.L.
        • Feng C.
        • Lin X.H.
        • Zhong Z.X.
        • Zhu Y.M.
        • Lv P.P.
        • et al.
        High maternal serum estradiol environment in the first trimester is associated with the increased risk of small-for-gestational-age birth.
        J Clin Endocrinol Metab. 2014; 99: 2217-2224
        • Diamond M.P.
        • Kruger M.
        • Santoro N.
        • Zhang H.
        • Casson P.
        • Schlaff W.
        • et al.
        Endometrial shedding effect on conception and live birth in women with polycystic ovary syndrome.
        Obstet Gynecol. 2012; 119: 902-908
        • Griesinger G.
        • Diedrich K.
        • Devroey P.
        • Kolibianakis E.M.
        GnRH agonist for triggering final oocyte maturation in the GnRH antagonist ovarian hyperstimulation protocol: a systematic review and meta-analysis.
        Hum Reprod Update. 2006; 12: 159-168
        • Shapiro B.S.
        • Daneshmand S.T.
        • Garner F.C.
        • Aguirre M.
        • Thomas S.
        Gonadotropin-releasing hormone agonist combined with a reduced dose of human chorionic gonadotropin for final oocyte maturation in fresh autologous cycles of in vitro fertilization.
        Fertil Steril. 2008; 90: 231-233
        • Blockeel C.
        • de Vos M.
        • Verpoest W.
        • Stoop D.
        • Haentjens P.
        • Devroey P.
        Can 200 IU of hCG replace recombinant FSH in the late follicular phase in a GnRH-antagonist cycle? A pilot study.
        Hum Reprod. 2009; 24: 2910-2916
        • van der Linden M.
        • Buckingham K.
        • Farquhar C.
        • Kremer J.A.
        • Metwally M.
        Luteal phase support for assisted reproduction cycles.
        Cochrane Database Syst Rev. 2015; : CD009154
        • Schoolcraft W.B.
        • Gardner D.K.
        • Lane M.
        • Schlenker T.
        • Hamilton F.
        • Meldrum D.R.
        Blastocyst culture and transfer: analysis of results and parameters affecting outcome in two in vitro fertilization programs.
        Fertil Steril. 1999; 72: 604-609
        • Van Landuyt L.
        • van de Velde H.
        • de Vos A.
        • Haentjens P.
        • Blockeel C.
        • Tournaye H.
        • et al.
        Influence of cell loss after vitrification or slow-freezing on further in vitro development and implantation of human day 3 embryos.
        Hum Reprod. 2013; 28: 2943-2949
        • van de Vijver A.
        • Polyzos N.P.
        • van Landuyt L.
        • de Vos M.
        • Camus M.
        • Stoop D.
        • et al.
        Cryopreserved embryo transfer in an artificial cycle: is GnRH agonist down-regulation necessary?.
        Reprod Biomed Online. 2014; 29: 588-594
        • de Neubourg D.
        • Bogaerts K.
        • Wyns C.
        • Albert A.
        • Camus M.
        • Candeur M.
        • et al.
        The history of Belgian assisted reproduction technology cycle registration and control: a case study in reducing the incidence of multiple pregnancy.
        Hum Reprod. 2013; 28: 2709-2719
        • Zegers-Hochschild F.
        • Adamson G.D.
        • de Mouzon J.
        • Ishihara O.
        • Mansour R.
        • Nygren K.
        • et al.
        The International Committee for Monitoring Assisted Reproductive Technology (ICMART) and the World Health Organization (WHO) revised glossary on ART terminology, 2009.
        Hum Reprod. 2009; 24: 2683-2687
        • Lancastle D.
        • Boivin J.
        A feasibility study of a brief coping intervention (PRCI) for the waiting period before a pregnancy test during fertility treatment.
        Hum Reprod. 2008; 23: 2299-2307
        • Gameiro S.
        • Boivin J.
        • Domar A.
        Optimal in vitro fertilization in 2020 should reduce treatment burden and enhance care delivery for patients and staff.
        Fertil Steril. 2013; 100: 302-309
        • Riggs R.
        • Mayer J.
        • Dowling-Lacey D.
        • Chi T.F.
        • Jones E.
        • Oehninger S.
        Does storage time influence postthaw survival and pregnancy outcome? An analysis of 11,768 cryopreserved human embryos.
        Fertil Steril. 2010; 93: 109-115
        • Remohi J.
        • Gartner B.
        • Gallardo E.
        • Yalil S.
        • Simon C.
        • Pellicer A.
        Pregnancy and birth rates after oocyte donation.
        Fertil Steril. 1997; 67: 717-723
        • Simon C.
        • Oberye J.
        • Bellver J.
        • Vidal C.
        • Bosch E.
        • Horcajadas J.A.
        • et al.
        Similar endometrial development in oocyte donors treated with either high- or standard-dose GnRH antagonist compared to treatment with a GnRH agonist or in natural cycles.
        Hum Reprod. 2005; 20: 3318-3327