Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Jan;34(1):79-87.
doi: 10.1007/s10815-016-0825-y. Epub 2016 Nov 10.

Optimal embryo transfer strategy in poor response may include freeze-all

Murat Berkkanoglu  1 , Kevin Coetzee  2 , Hasan Bulut  2 , Kemal Ozgur  2
Affiliations

Optimal embryo transfer strategy in poor response may include freeze-all

Murat Berkkanoglu et al. J Assist Reprod Genet. 2017 Jan.

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.

Keywords: Blastocyst culture; Diminished ovarian reserve; Freeze-all; Poor response.

PubMed Disclaimer

Conflict of interest statement

Funding

This study received no financial support.

Conflict of interest

The authors declare that they have no conflict of interests.

Ethical approval

All participants in this study signed an informed consent (institutional Ethics committee form included).

Study data

The study data was partly presented at the 71st Annual Meeting of the ASRM, Baltimore, Maryland, USA, 17 to 21 October 2015.

References

    1. Garcia JE, Jones GS, Acosta AA, Wright G. HMG/hCG follicular maturation for oocytes aspiration: phase II, 1981. Fertil Steril. 1983;39:174–179. doi: 10.1016/S0015-0282(16)46815-9. - DOI - PubMed
    1. Ferraretti AP, la Marca A, Fauser BC, Tarlatzis B, Nargund G, Gianaroli L. ESHRE consensus on the definition of “poor response” to ovarian stimulation for in vitrofertilization: the Bologna criteria. Hum Reprod. 2011;26:1616–1624. doi: 10.1093/humrep/der092. - DOI - PubMed
    1. Cobo A, de Los Santos MJ, Castello D, Gamiz P, Campos P, Remobi J. Outcomes of vitrified early cleavage-stage and blastocyst-stage embryos in a cryopreservation program: evaluation of 3150 warming cycles. Fertil Steril. 2012;98:1138–1145. doi: 10.1016/j.fertnstert.2012.07.1107. - DOI - PubMed
    1. Gardner DK, Vella P, Lane M, et al. Culture and transfer of human blastocysts increases implantation rates and reduces the need for multiple embryo transfers. Fertil Steril. 1998;69:84–88. doi: 10.1016/S0015-0282(97)00438-X. - DOI - PubMed
    1. Gardner D. Blastocyst culture: toward single embryo transfer. Hum Fertil. 2000;3:229–237. doi: 10.1080/1464727002000199051. - DOI - PubMed

LinkOut - more resources