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Freeze-all cycle for all normal responders?

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Abstract

Purpose

The purpose of this study is to evaluate the freeze-all strategy in subgroups of normal responders, to assess whether this strategy is beneficial regardless of ovarian response, and to evaluate the possibility of implementing an individualized embryo transfer (iET) based on ovarian response.

Methods

This was an observational, cohort study performed in a private IVF center. A total of 938 IVF cycles were included in this study. The patients were submitted to controlled ovarian stimulation (COS) with a gonadotropin-releasing hormone (GnRH) antagonist protocol and a cleavage-stage day 3 embryo transfer. We performed a comparison of outcomes between the fresh embryo transfer (n = 523) and the freeze-all cycles (n = 415). The analysis was performed in two subgroups of patients based on the number of retrieved oocytes: Group 1 (4–9 oocytes) and Group 2 (10–15 oocytes).

Result(s)

In Group 1 (4–9 retrieved oocytes), the implantation rates (IR) were 17.9 and 20.5% (P = 0.259) in the fresh and freeze-all group, respectively; the ongoing pregnancy rates (OPR) were 31 and 33% (P = 0.577) in the fresh and freeze-all group, respectively. In Group 2 (10–15 oocytes), the IR were 22.1 and 30.1% (P = 0.028) and the OPR were 34 and 47% (P = 0.021) in the fresh and freeze-all groups, respectively.

Conclusion(s)

Although the freeze-all policy may be related to better in vitro fertilization (IVF) outcomes in normal responders, these potential advantages decrease with worsening ovarian response. Patients with poorer ovarian response do not benefit from the freeze-all strategy.

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Fig. 1

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Acknowledgments

The English language editing of this manuscript was provided by the Journal Prep.

Author information

Correspondence to Matheus Roque.

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Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Capsule Although the freeze-all policy may be related to better IVF outcomes in normal responders, these potential advantages decrease with worsening ovarian response. Patients with poorer ovarian response do not benefit from the freeze-all strategy. The implementation of an individualized embryo transfer (iET) would ultimately benefit patients with respect to IVF outcomes.

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Roque, M., Valle, M., Guimarães, F. et al. Freeze-all cycle for all normal responders?. J Assist Reprod Genet 34, 179–185 (2017). https://doi.org/10.1007/s10815-016-0834-x

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Keywords

  • Freeze-all policy
  • Elective frozen-thawed embryo transfer
  • Delayed frozen-thawed embryo transfer
  • Embryo cryopreservation
  • IVF/ICSI