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Increased pregnancy complications following frozen-thawed embryo transfer during an artificial cycle

  • Assisted Reproduction Technologies
  • Published:
Journal of Assisted Reproduction and Genetics Aims and scope Submit manuscript

Abstract

Purpose

This study aimed to clarify the risks of adverse pregnancy outcomes in patients and their offspring after frozen embryo transfer (FET) during an artificial cycle (AC).

Methods

We conducted a retrospective cohort study that included all FET cycles and subsequent deliveries in a single centre between August 2013 and March 2016. Pregnancy, obstetric and neonatal outcomes were compared among patients treated during an AC or a natural cycle with luteal phase support (NC-LPS). Multivariate logistic regression was performed to evaluate the relationship between endometrial preparation schemes and pregnancy, obstetric and neonatal outcomes.

Results

AC-FET was not a significant risk factor for clinical pregnancy rate, multiple birth rate or miscarriage rate after adjusting for potential confounders. However, AC-FET was a significant risk factor for ectopic pregnancy rate (adjusted odds ratio (AOR), 1.738; 95% confidence interval (CI), 1.086–2.781) and live birth rate (AOR, 0.709; 95% CI, 0.626–0.802). Regarding obstetric outcomes, AC-FET was found to be associated with an increased risk for hypertension disorder (AOR, 1.780; 95% CI, 1.262–2.510) and caesarean section (AOR, 1.507; 95% CI, 1.195–1.900). In multiples, birth weight (2550 g (2150–2900 g) in AC-FET vs. 2600 g (2350–2900 g) in NC-LPS; P = 0.023), gestational age (36.6 weeks (35.3–37.6 weeks) vs. 37.1 weeks (36.1–37.9 weeks); P < 0.001), and z-score (− 0.5 (− 1.1, − 0.0) vs. − 0.4 (− 1.0, 0.2); P = 0.009) were higher in the NC-LPS group than in the AC-FET group, although there were no differences in these variables among singletons.

Conclusion

Compared with NC-LPS, AC-FET seemed to have a negative effect on obstetric outcomes.

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Acknowledgements

The authors wish to thank the information engineer in the research group at the Reproductive Center of Citic-Xiangya Hospital for their work in assembling the data for this study.

Funding

Supported by the National Basic Research Program of China (2016YFC1000206 to G.L.). This funding source had no influence on the content of this study.

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Authors and Affiliations

  1. Institute of Reproduction and Stem Cell Engineering, School of Basic Medicine, Central South University, Changsha, China

    Shuang Jing, Xiao feng Li, Shuoping Zhang, Fei Gong, Guangxiu Lu & Ge Lin

  2. Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, People’s Republic of China

    Xiao feng Li, Fei Gong, Guangxiu Lu & Ge Lin

  3. Key Laboratory of Reproductive and Stem Cell Engineering, National Health and Family Planning Commission, Changsha, People’s Republic of China

    Shuoping Zhang, Fei Gong, Guangxiu Lu & Ge Lin

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  1. Shuang Jing
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Contributions

GL, GL and FG conceptualised the project. SJ and XL oversaw data collection, analysed the data and drafted the manuscript. SZ provided substantive edits to the manuscript. S.J. and X.L. should be considered co-first authors.

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Correspondence to Ge Lin.

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Jing, S., Li, X.f., Zhang, S. et al. Increased pregnancy complications following frozen-thawed embryo transfer during an artificial cycle. J Assist Reprod Genet 36, 925–933 (2019). https://doi.org/10.1007/s10815-019-01420-1

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  • DOI: https://doi.org/10.1007/s10815-019-01420-1

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