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. 2022 Sep 9;3(4):332-341.
doi: 10.1016/j.xfre.2022.09.002. eCollection 2022 Dec.

Factors associated with large-for-gestational-age infants born after frozen embryo transfer cycles

Anne J Roshong  1 , Carol E DeSantis  2   3 , Anthony K Yartel  2   3 , Ryan J Heitmann  4 , Dmitry M Kissin  2 , Bruce D Pier  1
Affiliations

Factors associated with large-for-gestational-age infants born after frozen embryo transfer cycles

Anne J Roshong et al. F S Rep. .

Abstract

Objective: To examine trends of frozen embryo transfer (FET) proportions and large-for-gestational-age (LGA) incidence and determine risk factors for LGA infants after FET.

Design: Retrospective cohort study.

Setting: Not applicable.

Patients: Frozen embryo transfer cycles.

Interventions: None.

Main outcome measures: Singleton LGA infant.

Results: The percentage of FETs increased from 20%-74% of transfers, whereas the rate of LGA among FET singleton births decreased from 18%-12% during 2004-2018. In a subanalysis of 127,525 FET-associated singleton live births during 2016-2018, patient factors associated with LGA were higher-than-normal maternal body mass index (body mass index [BMI], 25.0-29.9 kg/m2; adjusted relative risk [aRR], 1.31; 95% confidence interval [CI], 1.26-1.36; BMI, 30.0-34.9 kg/m2; aRR, 1.48; 95% CI, 1.41-1.55; and BMI, >35 Kg/m2; aRR, 1.68; 95% CI, 1.59-1.77) and ≥1 prior birth vs. none. Low maternal BMI (<18.5 vs. 18.5-24.9 kg/m2) and cycles involving patients who were non-Hispanic (NH) Asian/Native Hawaiian/Pacific Islander, NH Black, or Hispanic (compared with NH White) were at lower risk of LGA infants. Cycle factors associated with LGA included gestational carrier use (aRR, 1.25; 95% CI, 1.16-1.34) and donor sperm (aRR, 1.17; 95% CI, 1.10-1.25).

Conclusions: Although the number and proportion of FET cycles increased from 2004-2018, the rate of LGA after FET decreased. Maternal BMI, parity, and race/ethnicity were the strongest risk factors for LGA infants after FET.

Keywords: Frozen embryo transfer; in vitro fertilization; large-for-gestational-age; obstetric outcomes.

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Figures

FIGURE 1
FIGURE 1
(A) Trends in the percentages of all embryo transfer cycles that used fresh vs. frozen embryos, 2004–2018. (B) Trends in the percentages of singleton births that were large-for-gestational-age resulting from fresh embryo transfers vs. frozen embryo transfers, 2004–2018. FET = frozen embryo transfer.
See this image and copyright information in PMC

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