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Reproductive outcome is optimized by genomic embryo screening, vitrification, and subsequent transfer into a prepared synchronous endometrium

  • Assisted Reproduction Technologies
  • Published:
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Abstract

Purpose

The aim of this study is to compare implantation and live birth rates (LBR) between fresh euploid embryo transfers versus cryo-all cycles with a subsequent embryo transfer into a prepared endometrium.

Material and Methods

This is a retrospective cohort study. Patients who underwent an IVF cycle with PGS with trophectoderm biopsy from January 2011 to July 2015 were included. Patients were divided into three groups: “Fresh Only,” “Frozen Embryo Transfer ('FET) Only,” and “Fresh ET then FET.” For “Fresh Only” group (n = 345), PGS results were received within 24 h. For “FET Only” group (n = 514), results were expected after 24 h, and embryos were cryopreserved after biopsy; only FET was performed in this group (no fresh transfer). For “FET with a previous fresh ET” (n = 139) group, patients underwent a fresh ET with a subsequent FET, in which the same cohort of embryos was utilized. The main outcome measures were pregnancy rate (PR), clinical PR, implantation rate (IR), LBR, and early pregnancy loss rate.

Results

IRs were statistically higher in the “FET Only” group when compared to the “Fresh Only” group (59.5 vs. 50.6 %, p < 0.01) and the “FET with a previous fresh ET” (59.5 vs. 50.6 %, p < 0.05). LBR was statistically significant in the “FET Only” group when compared to the “Fresh Only” group (57.6 vs. 46.5 %, p < 0.005) but not when compared to “FET with a previous fresh ET” group (57.6 vs. 47.7 %, p = 0.07).

Conclusions

This analysis suggests euploid embryos to be more likely to implant and achieve a LBR in a synthetic FET cycle than in a fresh cycle.

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Authors and Affiliations

  1. Reproductive Medicine Associates of New York, 635 Madison Ave 10th Floor, New York City, NY, 10022, USA

    Jorge Rodriguez-Purata, Joseph Lee, Michael Whitehouse, Marlena Duke, Lawrence Grunfeld, Benjamin Sandler, Alan Copperman & Tanmoy Mukherjee

  2. Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, Klingenstein Pavilion 1176 Fifth Avenue 9th Floor, New York City, NY, 10029, USA

    Lawrence Grunfeld, Benjamin Sandler, Alan Copperman & Tanmoy Mukherjee

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  1. Jorge Rodriguez-Purata
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  2. Joseph Lee
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Correspondence to Jorge Rodriguez-Purata.

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Additional information

Capsule This analysis suggests euploid embryos to be more likely to implant and achieve a LBR in a synthetic FET cycle than in a fresh cycle.

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ESM 1

Demographic characteristics of Only IVF vs. Only FET. Histogram of the distribution with overlaid normal and kernel densities of all demographic variables. Boxplot comparing the distribution of each demographic variable. Q-q plot of the quantiles of the Only IVF set against the quantiles of the Only FET data set testing the normality of each group (DOCX 1029 kb)

ESM 2

Laboratory outcomes of Only IVF vs. Only FET. Histogram of the distribution with overlaid normal and kernel densities of all demographic variables. Boxplot comparing the distribution of each demographic variable. Q-q plot of the quantiles of the Only IVF set against the quantiles of the Only FET data set testing the normality of each group (DOCX 780 kb)

ESM 3

Demographic characteristics of Only FET vs. Fresh then FET. Histogram of the distribution with overlaid normal and kernel densities of all demographic variables. Boxplot comparing the distribution of each demographic variable. Q-q plot of the quantiles of the Only FET set against the quantiles of the Fresh then FET data set testing the normality of each group (DOCX 855 kb)

ESM 4

Laboratory outcomes of Only FET vs. Fresh then FET. Histogram of the distribution with overlaid normal and kernel densities of all demographic variables. Boxplot comparing the distribution of each demographic variable. Q-q plot of the quantiles of the Only FET set against the quantiles of the Fresh then FET data set testing the normality of each group (DOCX 756 kb)

ESM 5

Demographic characteristics of patient s in the Fresh then FET group segregated according if they fresh cycle was successful (pregnant vs. non-pregnant). Histogram of the distribution with overlaid normal and kernel densities of all demographic variables. Boxplot comparing the distribution of each demographic variable. Q-q plot of the quantiles of the Pregnant set against the quantiles of the Non-Pregnant data set testing the normality of each group (DOCX 412 kb)

ESM 6

Laboratory outcomes of patient s in the Fresh then FET group segregated according if they fresh cycle was successful (pregnant vs. non-pregnant). Histogram of the distribution with overlaid normal and kernel densities of all demographic variables. Boxplot comparing the distribution of each demographic variable. Q-q plot of the quantiles of the Pregnant set against the quantiles of the Non-Pregnant data set testing the normality of each group (DOCX 401 kb)

ESM 7

Comparison of patients in the ‘Fresh ET then FET’ segregated according if they fresh cycle was successful (pregnant vs. non-pregnant). Results are expressed as mean ± standard deviation with 95 % confidence intervals (CI). Significance established at p < 0.05. For each group, pregnancy rates, clinical pregnancy rates, early pregnancy loss rates, multiple pregnancy rates, and live birth rates were calculated. Adjusted odds ratios (OR) and their 95 % CI by Clopper-Pearson method for implantation rate, PR, clinical PR, and early pregnancy loss rate were calculated to evaluate the relative odds of each event compared with the reference group (Fresh Only) (DOCX 18 kb)

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Rodriguez-Purata, J., Lee, J., Whitehouse, M. et al. Reproductive outcome is optimized by genomic embryo screening, vitrification, and subsequent transfer into a prepared synchronous endometrium. J Assist Reprod Genet 33, 401–412 (2016). https://doi.org/10.1007/s10815-016-0647-y

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  • DOI: https://doi.org/10.1007/s10815-016-0647-y

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