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

  • Assisted Reproduction Technologies
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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.

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Authors and Affiliations

  1. Antalya IVF, Halide Edip Cd. No: 7, Kanal Mh, Antalya, 07080, Turkey

    Murat Berkkanoglu, Kevin Coetzee, Hasan Bulut & Kemal Ozgur

Authors
  1. Murat Berkkanoglu
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  2. Kevin Coetzee
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  3. Hasan Bulut
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  4. Kemal Ozgur
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Corresponding author

Correspondence to Murat Berkkanoglu.

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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.

Additional information

Capsule In a retrospective cohort study, day 5 blastocyst transfers were found to provide superior pregnancy rates compared to cleavage stage embryo transfers with further increases in pregnancy achieved through the transfer of vitrified-warmed blastocysts in frozen embryo transfers.

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Berkkanoglu, M., Coetzee, K., Bulut, H. et al. Optimal embryo transfer strategy in poor response may include freeze-all. J Assist Reprod Genet 34, 79–87 (2017). https://doi.org/10.1007/s10815-016-0825-y

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  • DOI: https://doi.org/10.1007/s10815-016-0825-y

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