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. 2020 Jul 22;18(7):491-500.
doi: 10.18502/ijrm.v13i7.7366. eCollection 2020 Jul.

Reduced live birth rates in frozen versus fresh single cleavage stage embryo transfer cycles: A cross -sectional study

Wan Tinn Teh  1   2   3 , Alex Polyakov  2   3 , Claire Garrett  3 , David Edgar  3 , John Mcbain  1   2   3 , Peter Adrian Walton Rogers  1
Affiliations

Reduced live birth rates in frozen versus fresh single cleavage stage embryo transfer cycles: A cross -sectional study

Wan Tinn Teh et al. Int J Reprod Biomed. .

Abstract

Background: Studies have suggested that embryo-endometrial developmental asynchrony caused by slow-growing embryos can be corrected by freezing the embryo and transferring it back in a subsequent cycle. Therefore, we hypothesized that live birth rates (LBR) would be higher in frozen embryo transfer (FET) compared with fresh embryo transfers.

Objective: To compare LBR between fresh and FET cycles.

Materials and methods: A cross-sectional analysis of 10,744 single autologous embryo transfer cycles that used a single cleavage stage embryo was performed. Multivariate analysis was performed to compare LBR between FET and fresh cycles, after correcting for various confounding factors. Sub-analysis was also performed in cycles using slow embryos.

Results: Both LBR (19.13% vs 14.13%) and clinical pregnancy (22.48% vs 16.25%) rates (CPR) were higher in the fresh cycle group (p < 0.00). Multivariate analysis for confounding factors also confirmed that women receiving a frozen-thawed embryo had a significantly lower LBR rate compared to those receiving a fresh embryo (OR 0.76, 95% CI 0.68-0.86, p < 0.00). In the sub-analysis of 1,154 cycles using slow embryos, there was no statistical difference in LBR (6.40% vs 6.26%, p = 0.92) or CPR (8.10% vs 7.22%, p = 0.58) between the two groups.

Conclusion: This study shows a lower LBR in FET cycles when compared to fresh cycles. Our results suggest that any potential gains in LBR due to improved embryo-endometrial synchrony following FET are lost, presumably due to freeze-thaw process-related embryo damage.

Keywords: Embryo; Frozen embryo transfer; Transfer.; Fresh; Live birth.

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Conflict of interest statement

None declared.

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