PLoS ONE (Jan 2020)

Impact of elective frozen vs. fresh embryo transfer strategies on cumulative live birth: Do deleterious effects still exist in normal & hyper responders?

  • Fazilet Kubra Boynukalin,
  • Niyazi Emre Turgut,
  • Meral Gultomruk,
  • Selen Ecemis,
  • Zalihe Yarkiner,
  • Necati Findikli,
  • Mustafa Bahceci

DOI
https://doi.org/10.1371/journal.pone.0234481
Journal volume & issue
Vol. 15, no. 6
p. e0234481

Abstract

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BackgroundIs freeze-all strategy effective in terms of cumulative live birth rates (CLBRs) in all patients?MethodsThis retrospective single-center study analyzed the CLBRs of 2523 patients undergoing fresh or electively frozen blastocyst transfer cycles. In 1047, cycles, the fresh embryo transfer (ET) strategy was applied for the 1st ET, whereas electively frozen ET (e-FET) was performed in 1476 cycles. Female age ≤ 37 and blastocysts frozen via vitrification were included. The patients in each arm were further stratified into four subgroups according to the number of oocytes retrieved as follows: Group A: 1-5, group B: 6-10, group C: 11-15 and group D: 16-25 oocytes retrieved. The primary endpoint was the CLBR. The secondary endpoints were the ovarian hyperstimulation syndrome (OHSS) rate and the live birth rates (LBRs) following fresh ETs and e-FETs for the first transfers.Result(s)The CLBR was similar between the fresh ET and e-FET arms in group A (35/76 (46.1%) vs 29/67 (43.3%), p = 0.74) and group B (165/275 (60%) vs 216/324 (66.7%), p = 0.091), whereas significantly higher rates were detected in favor of the e-FET arm within group C (328/460 (71.3%) vs 201/348 (57.8%), pConclusionCompared with a fresh-transfer strategy, the e-FET strategy resulted in a higher CLBR among patients with >10 oocytes retrieved during stimulated cycles.