Optimal Embryo Transfer Strategy in Poor Response May Include Freeze-all

Overview

Journal J Assist Reprod Genet

Publisher Springer

Specialties Genetics
Reproductive Medicine

Date 2016 Nov 11

PMID 27832397

Citations 11

Authors

Murat Berkkanoglu

Kevin Coetzee

Hasan Bulut

Kemal Ozgur

Affiliations

Soon will be listed here.

Abstract

Purpose: In this retrospective cohort study, we investigated the best embryo transfer strategy in ICSI cycles with ≤4 oocytes collected at oocyte retrieval.

Methods: Women who underwent antagonist co-treatment COS for ICSI treatment between January 2010 and December 2015 at a private ART clinic (N = 2263). Eight hundred seventy-nine women (group 1) had ≤4 oocytes collected at oocyte retrieval, of whom 645 (group A) had cleavage stage embryo transfer (ET), and 234 (group B) had blastocyst ET. One thousand three hundred eighty-four women (group 2) had 10-15 oocytes collected at oocyte retrieval, of whom 676 (group C) had cleavage stage ET, and 708 women (group D) had blastocyst ET. Blastocyst vitrification was performed using the Cryotop method and FET using artificial cycles.

Results: In group 1, the cancellation rate was significantly lower in group A (25.2 vs 38 %). The pregnancy rate (PR), clinical PR, implantation rate (IR), and live birth rate (LBR) per ET and per oocyte retrieval were all lower in group A. The clinical PR, IR, and LBR per ET of vitrified-warmed blastocyst ET were significantly the highest. In group 2, the cycle cancellation rate was significantly lower in group C (3.5 vs 13.4 %). The PR, clinical PR, and IR per ET and per oocyte retrieval were all lower in group C. The LBR per ET was significantly lower, but the LBR per oocyte retrieval was not significantly lower in group C. Again, the PR, clinical PR, and IR per ET of vitrified-warmed blastocyst ET were significantly the highest.

Conclusions: Day 5 ET strategy has been reserved for normal or high responders. The improved pregnancy outcomes from blastocyst culture and cryopreservation may challenge ART to extend this benefit to poor responders.

Citing Articles

Frozen versus fresh embryo transfer in women with low prognosis for in vitro fertilisation treatment: pragmatic, multicentre, randomised controlled trial.

Wei D, Sun Y, Zhao H, Yan J, Zhou H, Gong F BMJ. 2025; 388:e081474.

PMID: 39880462 PMC: 11778674. DOI: 10.1136/bmj-2024-081474.

Outcomes of different transfer strategies for in vitro fertilization/intracytoplasmic sperm injection with poor-quality embryos-Analysis of embryonic development, perinatal period, and neonatal outcomes.

Jin L, Li Z, Si K, Ma B, Ren X, Huang B Heliyon. 2024; 10(21):e40103.

PMID: 39559221 PMC: 11570467. DOI: 10.1016/j.heliyon.2024.e40103.

A deep learning model for predicting blastocyst formation from cleavage-stage human embryos using time-lapse images.

Kalyani K, Deshpande P Sci Rep. 2024; 14(1):28019.

PMID: 39543360 PMC: 11564556. DOI: 10.1038/s41598-024-79175-8.

Trade-off between double cleavage-stage embryos transfer and single blastocyst-stage embryo transfer in patients with few good quality embryos in antagonist cycles: a retrospective study using a propensity score matching analysis.

Han Y, Deng X, Cai J, Peng W, Duan C, Huang K BMC Pregnancy Childbirth. 2024; 24(1):339.

PMID: 38702596 PMC: 11067270. DOI: 10.1186/s12884-024-06537-5.

Efficacy of Artificial Oocyte Activation in Improving the Reproductive Outcome in Poor Responders: A Single Centre Cohort Study.

Kaur B, Malik S, Prakash V, Bhatia V, Gupta D J Family Reprod Health. 2023; 17(1):45-53.

PMID: 37538231 PMC: 10394489. DOI: 10.18502/jfrh.v17i1.11977.

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