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Retrospective comparison of pregnancy outcomes of fresh and frozen-warmed single blastocyst transfer: a 5-year single-center experience

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

Abstract

Purpose

To assess whether live birth rates (LBR) and maternal/neonatal complications differed following single fresh and frozen-warmed blastocyst transfer.

Methods

The present retrospective observational study analyzed 4,613 single embryo transfers (SET) (646 fresh and 3,967 frozen) from January 1, 2014, to December 31, 2018. Fresh embryo transfer at blastocyst stage was considered according to the age of the patient and her prognosis. In case of the risk of ovarian hyperstimulation syndrome, premature progesterone rise, non-optimal endometrial growth, or supernumerary embryos, cryopreservation with subsequent frozen embryo transfer (FET) was indicated.

Results

No differences in LBR were recorded. Fresh embryo transfers yielded an increase both in neonatal complications OR 2.15 (95% CI 1.20–3.86, p 0.010), with a higher prevalence of singletons weighting below the 5th percentile (p 0.013) and of intrauterine growth retardation (p 0.015), as well as maternal complications, with a higher placenta previa occurrence OR 3.58 (95% CI 1.54–8.28, p 0.003), compared to FET.

Conclusion

LBR appears not to be affected by the transfer procedure preferred. Fresh embryo transfer is associated with higher risk of neonatal complications (specifically a higher prevalence of singletons weighting below the 5th percentile and of intrauterine growth retardation) and placenta previa. Reflecting on the increased practice of ART procedures, it is imperative to understand whether a transfer procedure yields less complications than the other and if it is time to switch to a “freeze-all” procedure as standard practice.

Trial registration: Clinical Trial Registration Number: NCT04310761. Date of registration: March 17, 2020, retrospectively registered.

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Data availability

Data and supplementary materials are available under request.

Code availability

Only under request.

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Acknowledgements

The authors thank all the embryologists and gynecologists working in Humanitas Fertility Center, Rozzano, Milan, Italy.

Author information

Authors and Affiliations

  1. Division of Gynecology and Reproductive Medicine, Department of Gynecology, Fertility Center, Humanitas Research Hospital, IRCCS, Via Manzoni 56, 20089, Rozzano, Milan, Italy

    Federico Cirillo, Camilla Ronchetti, Andrea Busnelli & Paolo Emanuele Levi-Setti

  2. Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4Pieve Emanuele, 20090, Milan, Italy

    Leonora Grilli, Camilla Ronchetti, Ilaria Paladino, Andrea Busnelli & Paolo Emanuele Levi-Setti

  3. Biostatistics Unit, Humanitas Research Hospital, IRCCS, 20089, Rozzano, Milan, Italy

    Emanuela Morenghi

Authors
  1. Federico Cirillo
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  2. Leonora Grilli
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  3. Camilla Ronchetti
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  4. Ilaria Paladino
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  5. Emanuela Morenghi
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  7. Paolo Emanuele Levi-Setti
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Contributions

FC and PELS were involved in the study concept and design. LG, IP, and EM contributed to the acquisition of data. FC and EM analyzed data. LG and FC wrote the manuscript and had a primary responsibility for final content. FC and EM supervised the analysis. CR and AB contributed to bibliography updating and critically revised the manuscript and helped for data analysis. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Paolo Emanuele Levi-Setti.

Ethics declarations

Ethics approval

Internal Ethical Committee approved the study design on April 7, 2020. The procedures used in this study adhere to the tenets of the Declaration of Helsinki.

Consent to participate and for publication

Patients who underwent ART cycles had consented in writing that their medical records could be used for research purposes and publication if their anonymity was ensured and protected.

Competing interests

The authors declare no competing interests.

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Cirillo, F., Grilli, L., Ronchetti, C. et al. Retrospective comparison of pregnancy outcomes of fresh and frozen-warmed single blastocyst transfer: a 5-year single-center experience. J Assist Reprod Genet 39, 201–209 (2022). https://doi.org/10.1007/s10815-021-02362-3

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  • DOI: https://doi.org/10.1007/s10815-021-02362-3

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