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Bodin E, Sainte-Rose R, Petit C, Cornuau M, Guérif F. [Clinical outcome after transfer of vitrified blastocysts in relation to freezing indication]. GYNECOLOGIE, OBSTETRIQUE, FERTILITE & SENOLOGIE 2024:S2468-7189(24)00249-6. [PMID: 38942237 DOI: 10.1016/j.gofs.2024.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 05/30/2024] [Accepted: 06/17/2024] [Indexed: 06/30/2024]
Abstract
OBJECTIVES In France, embryo thawing concern 45.8% of attempts at assisted reproductive technologies excluding artificial inseminations. This proportion is constantly increasing for various reasons. The main objective of this study is to compare the live birth rate following frozen blastocyst transfer (FBT) according to the initial indication for freezing. METHODS This is a retrospective study including patients who underwent FBT between 01/01/2020 and 06/30/2022 at the Regional University Hospital Center of Tours. The results were compared (univariate and multivariate analyses) between the three main indications for freezing: freezing of the complete cohort of blastocysts for risk of ovarian hyperstimulation (=OHS), freezing of supernumerary blastocysts after fresh blastocyst transfer (BT) with pregnancy (=second request) or without pregnancy (=BT failure). Results have also been described for other indications. RESULTS Among the 963 FBT cycles selected, 28% of live births by thawing were obtained, all indications of freezing combined. A significantly lower rate was identified in the FBT failure group compared to the OHS group. However, after adjustment, the results remained significant for the age of the patient on the freezing cycle but not for the indication for freezing. CONCLUSIONS The outcome of a FBT does not seem significantly impacted by the indication of freezing considering the confounding factors. The prospective analysis of more data from a multicenter study would be necessary to confirm these results.
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Affiliation(s)
- Emmanuelle Bodin
- Service de médecine et biologie de la reproduction, hôpital Bretonneau, 37044 Tours, France
| | - Romane Sainte-Rose
- Service de médecine et biologie de la reproduction, hôpital Bretonneau, 37044 Tours, France
| | - Claire Petit
- Service de médecine et biologie de la reproduction, hôpital Bretonneau, 37044 Tours, France
| | - Marion Cornuau
- Service de médecine et biologie de la reproduction, hôpital Bretonneau, 37044 Tours, France
| | - Fabrice Guérif
- Service de médecine et biologie de la reproduction, hôpital Bretonneau, 37044 Tours, France; PRC, CNRS, IFCE, Inrae, université de Tours, 37380 Nouzilly, France.
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Karavani G, Herzberg S, Schachter-Safrai N, Chill HH, Ben-Meir A, Simon A. Do vitrified frozen-thawed embryos generated from successful fresh cycles have higher potential for favorable outcome? Minerva Obstet Gynecol 2021; 73:632-637. [PMID: 34751530 DOI: 10.23736/s2724-606x.21.04759-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Many variables, including woman's age, embryo quality and endometrial receptivity, influence the success rate of either fresh embryo transfer (ET) or frozen-thawed ET (FT-ET) cycles. This study aims to examine whether the results of a fresh in-vitro fertilization (IVF) cycle correlate with its frozen-thawed embryos transfer outcomes. METHODS A retrospective cohort study conducted in a tertiary medical center single IVF unit between 2014-2017. The study population was comprised of women who underwent fresh ET with the remaining embryos frozen using vitrification and at least one consecutive FT-ET cycle. Comparison of FT-ET cycle's details and outcomes were assessed in relation to the outcome of preceding fresh ET cycle. RESULTS A total of 599 women underwent fresh ET and at least one consecutive FT-ET cycle. Significantly higher rates of successful FT-ET cycle outcomes were observed in the group of patients with a successful fresh cycle compared to the group with an unsuccessful fresh cycle (48.9% vs. 20.8%, P<0.001). Logistic regression demonstrated an adjusted OR of 5.02 for successful FT-ET after a successful fresh cycle. CONCLUSIONS Frozen-thawed embryos generated from successful fresh IVF cycles have higher potential to implant when compared to frozen-thawed embryos obtained in an unsuccessful fresh cycle.
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Affiliation(s)
- Gilad Karavani
- Department of Obstetrics and Gynecology, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel -
| | - Shmuel Herzberg
- Department of Obstetrics and Gynecology, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Natali Schachter-Safrai
- Department of Obstetrics and Gynecology, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Henry H Chill
- Department of Obstetrics and Gynecology, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Assaf Ben-Meir
- Department of Obstetrics and Gynecology, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.,Unit of Infertility and IVF, Hadassah Hebrew University Hospital, Jerusalem, Israel
| | - Alex Simon
- Department of Obstetrics and Gynecology, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.,Unit of Infertility and IVF, Hadassah Hebrew University Hospital, Jerusalem, Israel
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Hershko Klement A, Tulandi T, Hasson J, Tannus S, Weitzner O, Weon-Young S, Wiser A, Shavit T. Does fresh single embryo transfer outcome predict the result of a subsequent vitrified-warmed blastocyst of the same cohort? HUM FERTIL 2020; 25:323-328. [PMID: 32686561 DOI: 10.1080/14647273.2020.1794061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Reflecting the current trends, the utilization of frozen-thawed transfer cycles has been steadily increasing worldwide; outcome predictors of these cycles are therefore a major research goal. Our aim was to investigate whether the outcome of a fresh single blastocyst transfer (SBT) can serve as a prognostic factor for the subsequent vitrified-warmed SBT originating from the same cohort. A retrospective cohort study was performed at a single unit. Non-donor fresh cycles were analyzed as predictors of the following vitrified-warmed cycle. Only SBTs were included. Cycles designated to a freeze-all policy and cycles involving pre-implantation genetic analysis were excluded. A total of 1127 vitrified-warmed single blastocyst cycles were included. The indications for artificial reproductive technologies were comparable across the study groups. Vitrified-warmed cycles following a live birth outcome in the fresh cycle were more likely to result in a clinical pregnancy than those following a fresh cycle, which failed to reach a live birth. The same trend was observed for live birth rate following vitrified-warmed transfer in the fresh cycle. After correcting for possible confounders, age and embryo quality were significantly correlated with the chance for a live birth, but the previous fresh cycle did not affect the results. We therefore conclude that after adjustment for age, embryo quality and number of previous oocyte retrieval cycles, the fresh cycle outcome was not a significant influential factor for the following vitrified-warmed cycle.
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Affiliation(s)
- Anat Hershko Klement
- Department of Obstetrics and Gynecology, IVF Unit, Hadassah Mount Scopus, Jerusalem, Israel
| | - Togas Tulandi
- Obstetrics and Gynecology Department, MUHC Reproductive Center, McGill University, Montreal, Canada
| | - Joseph Hasson
- Obstetrics and Gynecology Department, MUHC Reproductive Center, McGill University, Montreal, Canada.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Samer Tannus
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Omer Weitzner
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel
| | - Son Weon-Young
- Obstetrics and Gynecology Department, MUHC Reproductive Center, McGill University, Montreal, Canada
| | - Amir Wiser
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel
| | - Tal Shavit
- Obstetrics and Gynecology Department, MUHC Reproductive Center, McGill University, Montreal, Canada.,Department of Gynecology and IVF Unit, Assuta Ramat Hachayal, Tel Aviv-Yafo, Israel.,Department of Obstetrics and Gynecology, Ben-Gurion University, Beer-Sheave, Israel
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Zhang T, Li Z, Ren X, Huang B, Zhu G, Yang W, Jin L. Endometrial thickness as a predictor of the reproductive outcomes in fresh and frozen embryo transfer cycles: A retrospective cohort study of 1512 IVF cycles with morphologically good-quality blastocyst. Medicine (Baltimore) 2018; 97:e9689. [PMID: 29369190 PMCID: PMC5794374 DOI: 10.1097/md.0000000000009689] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
To evaluate the relationship between endometrial thickness during fresh in vitro fertilization (IVF) cycles and the clinical outcomes of subsequent frozen embryo transfer (FET) cycles.FET cycles using at least one morphological good-quality blastocyst conducted between 2012 and 2013 at a university-based reproductive center were reviewed retrospectively. Endometrial ultrasonographic characteristics were recorded both on the oocyte retrieval day and on the day of progesterone supplementation in FET cycles. Clinical pregnancy rate, spontaneous abortion rate, and live birth rate were analyzed.One thousand five hundred twelve FET cycles was included. The results showed that significant difference in endometrial thickness on day of oocyte retrieval (P = .03) was observed between the live birth group (n = 844) and no live birth group (n = 668), while no significant difference in FET endometrial thickness was found (P = .261) between the live birth group and no live birth group. For endometrial thickness on oocyte retrieval day, clinical pregnancy rate ranged from 50.0% among patients with an endometrial thickness of ≤6 mm to 84.2% among patients with an endometrial thickness of >16 mm, with live birth rate from 33.3% to 63.2%. Multiple logistic regression analysis of factors related to live birth indicated endometrial thickness on oocyte retrieval day was associated with improved live birth rate (OR was 1.069, 95% CI: 1.011-1.130, P = .019), while FET endometrial thickness did not contribute significantly to pregnancy outcomes following FET cycles. The ROC curves revealed the cut-off points of endometrial thickness on oocyte retrieval day was 8.75 mm for live birth.Endometrial thickness during fresh IVF cycles was a better predictor of endometrial receptivity in subsequent FET cycles than FET cycle endometrial thickness. For those females with thin endometrium in fresh cycles, additional estradiol stimulation might be helpful for adequate endometrial development.
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Outcome of cryotransfer of embryos developed from vitrified oocytes: double vitrification has no impact on delivery rates. Fertil Steril 2013; 99:1623-30. [DOI: 10.1016/j.fertnstert.2013.01.106] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2012] [Revised: 01/14/2013] [Accepted: 01/15/2013] [Indexed: 01/26/2023]
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Shi W, Zhang S, Zhao W, Xia X, Wang M, Wang H, Bai H, Shi J. Factors related to clinical pregnancy after vitrified-warmed embryo transfer: a retrospective and multivariate logistic regression analysis of 2313 transfer cycles. Hum Reprod 2013; 28:1768-75. [PMID: 23599130 DOI: 10.1093/humrep/det094] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
STUDY QUESTION What factors does multivariate logistic regression show to be significantly associated with the likelihood of clinical pregnancy in vitrified-warmed embryo transfer (VET) cycles? SUMMARY ANSWER Assisted hatching (AH) and if the reason to freeze embryos was to avoid the risk of ovarian hyperstimulation syndrome (OHSS) were significantly positively associated with a greater likelihood of clinical pregnancy. WHAT IS KNOWN ALREADY Single factor analysis has shown AH, number of embryos transferred and the reason of freezing for OHSS to be positively and damaged blastomere to be negatively significantly associated with the chance of clinical pregnancy after VET. It remains unclear what factors would be significant after multivariate analysis. STUDY DESIGN, SIZE, DURATION The study was a retrospective analysis of 2313 VET cycles from 1481 patients performed between January 2008 and April 2012. A multivariate logistic regression analysis was performed to identify the factors to affect clinical pregnancy outcome of VET. PARTICIPANTS/MATERIALS, SETTING, METHODS There were 22 candidate variables selected based on clinical experiences and the literature. With the thresholds of α entry = α removal= 0.05 for both variable entry and variable removal, eight variables were chosen to contribute the multivariable model by the bootstrap stepwise variable selection algorithm (n = 1000). Eight variables were age at controlled ovarian hyperstimulation (COH), reason for freezing, AH, endometrial thickness, damaged blastomere, number of embryos transferred, number of good-quality embryos, and blood presence on transfer catheter. A descriptive comparison of the relative importance was accomplished by the proportion of explained variation (PEV). MAIN RESULTS AND THE ROLE OF CHANCE Among the reasons for freezing, the OHSS group showed a higher OR than the surplus embryo group when compared with other reasons for VET groups (OHSS versus Other, OR: 2.145; CI: 1.4-3.286; Surplus embryos versus Other, OR: 1.152; CI: 0.761-1.743) and high PEV (marginal 2.77%, P = 0.2911; partial 1.68%; CI of area under receptor operator characteristic curve (ROC): 0.5576-0.6000). AH also showed a high OR (OR: 2.105, CI: 1.554-2.85) and high PEV (marginal 1.97%; partial 1.02%; CI of area under ROC: 0.5344-0.5647). The number of good-quality embryos showed the highest marginal PEV and partial PEV (marginal 3.91%, partial 2.28%; CI of area under ROC: 0.5886-0.6343). LIMITATIONS, REASONS FOR CAUTION This was a retrospective multivariate analysis of the data obtained in 5 years from a single IVF center. Repeated cycles in the same woman were treated as independent observations, which could introduce bias. Results are based on clinical pregnancy and not live births. Prospective analysis of a larger data set from a multicenter study based on live births is necessary to confirm the findings. WIDER IMPLICATIONS OF THE FINDINGS Paying attention to the quality of embryos, the number of good embryos, AH and the reasons for freezing that are associated with clinical pregnancy after VET will assist the improvement of success rates.
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Affiliation(s)
- Wenhao Shi
- Assisted Reproduction Center, Maternal & Child Health Care Hospital of Shaanxi Province, Hou Zai Men 73# Xin Cheng District, Xi'an, China
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Weissman A, Levin D, Ravhon A, Eran H, Golan A, Levran D. What is the preferred method for timing natural cycle frozen–thawed embryo transfer? Reprod Biomed Online 2009; 19:66-71. [DOI: 10.1016/s1472-6483(10)60048-x] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Ovarian hyperstimulation syndrome and prophylactic human embryo cryopreservation: analysis of reproductive outcome following thawed embryo transfer. J Ovarian Res 2008; 1:7. [PMID: 19014420 PMCID: PMC2585559 DOI: 10.1186/1757-2215-1-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2008] [Accepted: 11/06/2008] [Indexed: 11/10/2022] Open
Abstract
Objective To review utilisation of elective embryo cryopreservation in the expectant management of patients at risk for developing ovarian hyperstimulation syndrome (OHSS), and report on reproductive outcome following transfer of thawed embryos. Materials and methods Medical records were reviewed for patients undergoing IVF from 2000–2008 to identify cases at risk for OHSS where cryopreservation was electively performed on all embryos at the 2 pn stage. Patient age, total number of oocytes retrieved, number of 2 pn embryos cryopreserved, interval between retrieval and thaw/transfer, number (and developmental stage) of embryos transferred (ET), and delivery rate after IVF were recorded for all patients. Results From a total of 2892 IVF cycles undertaken during the study period, 51 IVF cases (1.8%) were noted where follicle number exceeded 20 and pelvic fluid collection was present. Elective embryo freeze was performed as OHSS prophylaxis in each instance. Mean (± SD) age of these patients was 32 ± 3.8 yrs. Average number of oocytes retrieved in this group was 23 ± 8.7, which after fertilisation yielded an average of 14 ± 5.7 embryos cryopreserved per patient. Thaw and ET was performed an average of 115 ± 65 d (range 30–377 d) after oocyte retrieval with a mean of 2 ± 0.6 embryos transferred. Grow-out to blastocyst stage was achieved in 88.2% of cases. Delivery/livebirth rate was 33.3% per initiated cycle and 43.6% per transfer. Non-transferred blastocysts remained in cryostorage for 24 of 51 patients (46.1%) after ET, with an average of 3 ± 3 blastocysts refrozen per patient. Conclusion OHSS prophylaxis was used in 1.8% of IVF cycles at this institution; no serious OHSS complications were encountered during the study period. Management based on elective 2 pn embryo cryopreservation with subsequent thaw and grow-out to blastocyst stage for transfer did not appear to compromise embryo viability or overall reproductive outcome. For these patients, immediate elective embryo cryopreservation and delay of ET by as little as 30 d allowed for satisfactory conclusion of the IVF sequence, yielding a livebirth-delivery rate (per ET) >40%.
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Polotsky AJ, Daif JL, Jindal S, Lieman HJ, Santoro N, Pal L. Serum progesterone on the day of human chorionic gonadotropin administration predicts clinical pregnancy of sibling frozen embryos. Fertil Steril 2008; 92:1880-5. [PMID: 18851847 DOI: 10.1016/j.fertnstert.2008.09.017] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2008] [Revised: 09/02/2008] [Accepted: 09/04/2008] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To evaluate patient characteristics and fresh in vitro fertilization (IVF) cycle parameters that influence success of sibling frozen-thawed embryo transfer (FET) cycles. DESIGN Retrospective study. SETTING Academic infertility practice. PATIENT(S) Infertile women undergoing FET cycles using embryos cryopreserved on day 3 after insemination after an initial fresh IVF cycle. INTERVENTION(S) 90 FET cycles. MAIN OUTCOME MEASURE(S) Clinical pregnancy (CP). RESULT(S) The likelihood of CP after FET was statistically significantly higher in women who had achieved CP in the preceding fresh IVF cycle (71.4% vs. 40.6%). Multivariable logistic regression analysis confirmed that patients achieving CP after the fresh IVF cycle were more likely to achieve CP after FET (OR 5.5; 95% CI, 1.2-25.3) after adjusting for age, number, and cleavage status of embryos transferred. Additionally, higher serum levels of progesterone on the day of human chorionic gonadotropin administration emerged as predictive of CP after FET at a statistically significant level. CONCLUSION(S) The outcome of the fresh embryo transfer cycle is the foremost predictor of CP after FET of the sibling embryos. The relationship between serum progesterone on the day of human chorionic gonadotropin administration in the fresh cycle and the outcome of subsequent FET is noteworthy and merits further investigation.
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Affiliation(s)
- Alex J Polotsky
- Department of Obstetrics and Gynecology and Women's Health, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York 10461, USA.
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Prades M, Golmard JL, Vauthier D, Lefèbvre G, Poirot C. Can cumulative pregnancy rates be increased by freezing and thawing single embryos? Fertil Steril 2008; 91:395-400. [PMID: 18295209 DOI: 10.1016/j.fertnstert.2007.11.074] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2007] [Revised: 11/20/2007] [Accepted: 11/20/2007] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To evaluate the extent to which transfers of frozen single embryos increase cumulative pregnancy rates. DESIGN Retrospective analysis. SETTING IVF unit of a university hospital. PATIENT(S) Patients undergoing IVF cycles that were carried out from 2001 to 2005 (n = 1758). Patients were assigned to three groups according to the number of embryos frozen: group A, no cryopreservation; group B, a single embryo frozen; group C, several embryos frozen. INTERVENTION(S) Analysis of fresh ETs as a function of the number of embryos frozen and comparison outcomes for the thawing of a single embryo between subgroups B* (only one embryo frozen and thawed) and C* (last embryo of the cohort thawed). MAIN OUTCOME MEASURE(S) Implantation and pregnancy rates after fresh ETs and embryo survival and pregnancy rates after the transfer of a single thawed embryo. RESULT(S) The pregnancy rate per fresh ET increased significantly with the number of embryos frozen: 16.2% in group A, 21.4% in group B, and 26.5% in group C. For single thawed embryos, survival was higher in group C* (91.7%) than in group B* (72.6%). The pregnancy rate was also significantly higher in group C* (19.4% vs. 0%). CONCLUSION(S) The freezing of single embryos is of no benefit in cumulative pregnancy rates. ET strategies should therefore be reviewed.
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Affiliation(s)
- Marie Prades
- Reproductive Biology Unit, University Hospital, Hôpital Pitié-Salpêtrière, Paris, France.
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Balaban B, Yakin K, Isiklar A, Urman B. Utilization of high-security straws for embryo freezing in an in vitro fertilization program: a prospective, randomized study. Fertil Steril 2007; 87:691-6. [PMID: 17173906 DOI: 10.1016/j.fertnstert.2006.07.1504] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2006] [Revised: 07/20/2006] [Accepted: 07/20/2006] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To compare the outcome of frozen-thawed ET cycles where embryos had been stored in conventional versus ionomeric resin-based, high-security straws (HSSs). DESIGN Prospective, randomized study. SETTING Private assisted-reproduction unit. PATIENT(S) Three hundred and six freeze cycles, and 197 thaw cycles. INTERVENTION(S) Day 3 embryos (n = 1,268) were frozen, and 517 were thawed using HSSs. Alternately, day 3 embryos (n = 1,228) were frozen, and 505 were thawed using conventional straws. MAIN OUTCOME MEASURE(S) Cryosurvival, cleavage and morulae formation rates, and clinical pregnancy, implantation, and multiple pregnancy rates. RESULT(S) Although cycle characteristics did not show any differences, the cryosurvival rate was higher in the HSS group (94.7%) than in the conventional straw group (86%), as was the morulae formation rate (58.7% versus 42.7%). Despite a similar number of embryos being transferred, the clinical pregnancy rate (PR) was higher in the HSS group, but the difference lacked statistical significance (42.5% versus 31.2). Implantation rates (19.4% versus 11.4%) and multiple PRs (41.8% versus 16.6%) were significantly higher in the HSS group than in the conventional straw group. CONCLUSION(S) High-security straws are high effective in human embryo cryopreservation, because they provide higher cryosurvival and implantation rates, as well as a lower risk of cross-contamination compared to conventional straws.
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Affiliation(s)
- Basak Balaban
- Assisted Reproduction Unit, Vehbi Koc Vakfi American Hospital, Istanbul, Turkey
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Urman B, Balaban B, Yakin K. Impact of fresh-cycle variables on the implantation potential of cryopreserved-thawed human embryos. Fertil Steril 2007; 87:310-5. [DOI: 10.1016/j.fertnstert.2006.06.034] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2006] [Revised: 06/10/2006] [Accepted: 06/10/2006] [Indexed: 11/30/2022]
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Lahav-Baratz S, Koifman M, Shiloh H, Ishai D, Wiener-Megnazi Z, Dirnfeld M. Analyzing factors affecting the success rate of frozen-thawed embryos. J Assist Reprod Genet 2004; 20:444-8. [PMID: 14714822 PMCID: PMC3455644 DOI: 10.1023/b:jarg.0000006705.46147.a2] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE In recent years the infertile population applying for IVF treatments was changed and so the indications for performing intracellular sperm injection (ICSI). The aim of this study was to analyze predicting factors of our thawing cycles. METHODS From December 1998 to July 2001, 440 consecutive thawing cycles were performed. Patient characteristics were examined. The number of cryopreserved embryos, number of transferred embryos, the timing of cryopreservation (48 h vs. 72 h), and embryo survival rate were analyzed as a possible predictor for pregnancies achievement. RESULTS Conventional IVF patient's characteristic was significantly different from ICSI population and analysis has been performed for every population separately. In the IVF population the women age, the number of transferred embryos, and timing of cryopreservation were factors significantly influencing the pregnancy rate. Interestingly, in the ICSI population only the number of transferred embryos was found to be a predictive factor. CONCLUSION ICSI and IVF cycles should be analyzed separately. Not all the factors influencing the success rate in the conventional IVF population are valid in the ICSI population.
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Affiliation(s)
- S Lahav-Baratz
- Department of Obstetric and Gynecology, IVF unit, Carmel Medical Center, Haifa, Israel.
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Kolibianakis EM, Zikopoulos K, Devroey P. Implantation Potential and Clinical Impact of Cryopreservation—A Review. Placenta 2003; 24 Suppl B:S27-33. [PMID: 14559027 DOI: 10.1016/s0143-4004(03)00133-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The ability of human embryos to survive the freezing and thawing process is reflected in their implantation potential. Although cryopreservation appears to affect adversely the capacity of human embryos to implant, it has also been shown to enhance consistently IVF outcome. Moreover, despite the reduced implantation potential of cryopreserved embryos as compared to fresh embryos, multiple pregnancies are frequent in frozen embryo transfer (FRET) cycles. There is no conclusive evidence that the stage of development at the time of freezing provides a clear advantage for the outcome of a FRET cycle. On the other hand, a decreased chance for pregnancy achievement appears to exist with advanced maternal age. Neither the mode of endometrium preparation nor the length of cryostorage appears to affect the outcome of FRET cycles which is positively associated to the achievement of pregnancy in the corresponding fresh cycle. Available evidence suggests that there are no adverse consequences in the babies born after embryo cryopreservation, although larger studies are necessary to allow solid conclusions.
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Affiliation(s)
- E M Kolibianakis
- Centre for Reproductive Medicine, Dutch-Speaking Brussels Free University, Laarbeeklaan 101, 1090 Brussels, Belgium.
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Abstract
Since the first reported pregnancy in a human being after a frozen/thawed eight cell stage preembryo, cryopreservation of preembryos has been integrated as an important element of assisted reproductive technologies (ART). The cryopreservation technique has brought several advantages to ART. It allows the transfer of a limited number of embryos in the collection cycle, thereby reducing the risk of multiple pregnancies, and the patients have a reservoir of excess embryos for additional transfers. This maximises the number of embryo transfers per oocyte retrieval, while at the same time increasing the cumulative pregnancy rate from a given treatment cycle. Also, the ability to freeze all the embryos obtained and transfer at a subsequent cycle is useful in the avoidance of hyperstimulation syndrome, or when factors that may jeopardize implantation are apparent. Freezing of oocytes in a pronuclear stage has a valuable role in the management of infertility. Supernumerary zygotes can be cryopreserved safely for future transfer, avoiding additional inconvenience for the patients. The freezing thawing technique does not have any adverse effects on oocytes fertilized microsurgically. Pronuclear stage oocytes eventually survive the cryopreservation procedure better, yielding after culture cleaved embryos appropriate for transfer, which could increase the implantation rate. We believe that the cryopreservation of cleaved embryos, which is problematic, can be safely replaced by this procedure. This is not only an advantage for society as a whole, but also for the people involved in the process, as there should be no ethical or moral conflict for the patients or for the laboratory staff about discarding this material.
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Affiliation(s)
- N Nikolettos
- Democritus University of Thrace, Faculty of Medicine, Alexanrdroupolis, Greece
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Damario MA, Hammitt DG, Session DR, Dumesic DA. Embryo cryopreservation at the pronuclear stage and efficient embryo use optimizes the chance for a liveborn infant from a single oocyte retrieval. Fertil Steril 2000; 73:767-73. [PMID: 10731539 DOI: 10.1016/s0015-0282(99)00638-x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To estimate the potential for a liveborn in our program achieved through either fresh or frozen embryos derived from a single oocyte retrieval. DESIGN Retrospective analysis. SETTING A tertiary referral reproductive medicine unit. PATIENT(S) All consecutive patients undergoing oocyte retrieval from January 1, 1996, to June 30, 1997. INTERVENTION(S) All couples undergoing IVF-ET at our center are counseled about a specific embryo transfer number after oocyte retrieval based on demographic and historical factors. Only this specified number of embryos is retained in culture. All normally fertilized (2PN) oocytes exceeding this number are immediately cryopreserved at the pronuclear stage. For couples who do not conceive after fresh embryo transfers, frozen embryo transfers are subsequently performed by usually thawing only the number of embryos intended for transfer, thereby conserving remaining embryos for further potential frozen embryo cycles. MAIN OUTCOME MEASURE(S) Liveborn delivery per oocyte retrieval.39.0 years were 61.2%, 59.7%, and 18.5%, respectively. CONCLUSION(S) For women <39 years of age, the efficient use of embryo cryopreservation at the pronuclear stage and economical embryo utilization policies results in cumulative chances for a liveborn exceeding 60%.
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Ben-Ozer S, Vermesh M. Full term delivery following cryopreservation of human embryos for 7. 5 years. Hum Reprod 1999; 14:1650-2. [PMID: 10357994 DOI: 10.1093/humrep/14.6.1650] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Successful pregnancy in a 44 year old woman is described following the transfer of embryos which were cryopreserved for 7.5 years. The embryos were obtained during a gamete intra-Fallopian transfer (GIFT) procedure in 1989. To our knowledge this is one of the longest published periods of cryopreservation of embryos which has resulted in a healthy baby. This report illustrates the previously presumed viability and normality of human embryos undergoing long-term cryopreservation. Additionally, it emphasizes the importance for advanced reproductive technique programmes and patients to review and update their embryo status.
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Affiliation(s)
- S Ben-Ozer
- Center for Human Reproduction, Los Angeles, California, 18370 Burbank Blvd, Suite 301, Tarzana, CA 91356, USA
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Simon A, Holzer H, Hurwitz A, Revel A, Zentner BS, Lossos F, Laufer N. Comparison of cryopreservation outcome following intracytoplasmic sperm injection and conventional in vitro fertilization. J Assist Reprod Genet 1998; 15:431-7. [PMID: 9717119 PMCID: PMC3454802 DOI: 10.1007/bf02744937] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
PURPOSE Our purpose was to compare the success rate of transferring frozen-thawed embryos generated from either intracytoplasmic sperm injection (ICSI) or conventional in vitro fertilization (IVF). METHODS A retrospective review of all frozen-thawed embryo transfer (ET) cycles between January 1995 and April 1997 was performed. There were 83 and 204 transfer cycles of frozen-thawed multicellular embryos generated from conventional IVF (group A) and ICSI (group B), respectively. The survival rate of frozen-thawed embryos and the outcome following ET in both groups were assessed. RESULTS The groups did not differ in age (31.7 +/- 4.6 and 30.6 +/- 6.0; mean +/- SD) or number of embryos transferred (3.5 +/- 1.1 and 3.8 +/- 1.3 for groups A and B, respectively). An acceptable pregnancy rate per ET was achieved in both groups, but the rate was significantly higher (P = 0.04) for group A than group B, 32.5 and 20%, respectively. Group A included frozen embryos of a higher quality than those of group B, but the proportion of embryos surviving after thawing was significantly higher for group B than group A (92.5 and 85.6%, respectively; P = 0.0004). The abortion rate did not differ between the two groups: 22 and 26.8% for groups A and B, respectively. CONCLUSIONS Although an overall high pregnancy rate was achieved following frozen-thawed ET, it was lower for cycles in which embryos had been generated from ICSI. This difference may be attributed to a lower prefreezing embryo quality in the ICSI group. Embryos originating from ICSI were not vulnerable to cryopreservation and, when implanted, resulted in a comparable abortion rate to thawed embryos of conventional IVF.
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Affiliation(s)
- A Simon
- Department of Obstetrics and Gynecology, Hadassah University Hospital, Mount Scopus, Jerusalem, Israel
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van der Weiden RM. "Nothing succeeds like success". Fertil Steril 1995; 64:1046. [PMID: 7589628 DOI: 10.1016/s0015-0282(16)57929-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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Tucker MJ, Kort HI, Toledo AA, Morton PC, Wright G, Ingargiola PE, Sweitzer CL. Effect of coculture on subsequent survival and implantation of cryopreserved human embryos. J Assist Reprod Genet 1995; 12:689-92. [PMID: 8624424 DOI: 10.1007/bf02212894] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
PURPOSE This retrospective analysis was designed to assess the performance of human embryos following cryopreservation based on whether they were originally developed in standard culture medium (65 cycles, 223 embryos) or cocultured on partial monolayers of bovine oviductal epithelial cells (63 cycles, 198 embryos). Embryo cryosurvival and implantation were compared between the study group and the contemporaneously match controls. RESULTS During a 2-year period when no factors of the cryopreservation program were altered, 63 transfers of 159 surviving thawed control cleavage-stage embryos (71.3% survival) that were 54% intact gave rise to 11 viable pregnancies (17.5%/ET), to yield an implantation rate of 6.9% per embryo. Sixty-three transfers of 147 thawed cocultured embryos (74.2% survival) that were 61% intact gave an implantation rate of 13.6% per embryo that was significantly higher than the control group (P < 0.05). CONCLUSION Coculture of embryos prior to cryopreservation does not appear to improve cryosurvival; however, it does improve implantation postthaw compared with embryos following standard culture prior to cryopreservation.
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Affiliation(s)
- M J Tucker
- Reproductive Biology Associates, Atlanta, Georgia 30342, USA
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