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Replacing single frozen-thawed euploid embryos in a natural cycle in ovulatory women may increase live birth rates compared to medicated cycles in anovulatory women

  • Assisted Reproduction Technologies
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Abstract

Purpose

The goal of this study was to compare pregnancy outcomes between natural frozen embryo transfer (FET) cycles in ovulatory women and programmed FET cycles in anovulatory women after undergoing in vitro fertilization with preimplantation genetic screening (IVF-PGS).

Methods

This was a retrospective cohort study performed at an academic medical center. Patients undergoing single FET IVF-PGS cycles between October 2011 and December 2014 were included. Patients were stratified by type of endometrial replacement: programmed cycles with estrogen/progesterone replacement and natural cycles. IVF-PGS with 24-chromosome screening was performed on all included patients. Those patients with euploid embryos had single embryo transfer in a subsequent FET. The primary study outcome was live birth/ongoing pregnancy rate. Secondary outcomes included implantation, biochemical pregnancy, and miscarriage rates.

Results

One hundred thirteen cycles met inclusion criteria: 65 natural cycles and 48 programmed cycles. The programmed FET group was younger (35.9 ± 4.5 vs. 37.5 ± 3.7, P = 0.03) and had a higher AMH (3.95 ± 4.2 vs. 2.37 ± 2.4, P = 0.045). The groups were similar for BMI, gravidity, parity, history of uterine surgery, and incidence of Asherman’s syndrome. There was also no difference in embryo grade at biopsy or transfer, and proportion of day 5 and day 6 transfers. Implantation rates were higher in the natural FET group (0.66 ± 0.48 vs. 0.44 ± 0.50, P = 0.02). There was no difference in the rates of biochemical pregnancy or miscarriage. After controlling for age, live birth/ongoing pregnancy rate was higher in natural FETs with an adjusted odds ratio of 2.68 (95% CI 1.22–5.87).

Conclusions

Natural FET in ovulatory women after IVF-PGS is associated with increased implantation and live birth rates compared to programmed FET in anovulatory women. Further investigation is needed to determine whether these findings hold true in other patient cohorts.

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Authors and Affiliations

  1. The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medical College, 1305 York Avenue, 6th Floor, New York, NY, 10021, USA

    Alexis P Melnick, Robert Setton, Logan D. Stone, Nigel Pereira, Kangpu Xu, Zev Rosenwaks & Steven D. Spandorfer

Authors
  1. Alexis P Melnick
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  2. Robert Setton
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  3. Logan D. Stone
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  4. Nigel Pereira
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  5. Kangpu Xu
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  6. Zev Rosenwaks
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  7. Steven D. Spandorfer
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Corresponding author

Correspondence to Alexis P Melnick.

Ethics declarations

The current study was approved by the Weill Cornell Medical College Institutional Review Board. All FETs performed at The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine between October 2011 and December 2014 were reviewed for inclusion.

Conflict of interest

The authors declare that they have no conflict of interest.

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Melnick, A.P., Setton, R., Stone, L.D. et al. Replacing single frozen-thawed euploid embryos in a natural cycle in ovulatory women may increase live birth rates compared to medicated cycles in anovulatory women. J Assist Reprod Genet 34, 1325–1331 (2017). https://doi.org/10.1007/s10815-017-0983-6

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  • DOI: https://doi.org/10.1007/s10815-017-0983-6

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