Frozen-thawed embryo transfer is better than fresh embryo transfer in GnRH antagonist cycle in women with 3-10 oocytes retrieved: a retrospective cohort study

Purpose To compare the clinical outcome of fresh embryo transfer with frozen-thawed embryo transfer in subsequent cycle of GnRH antagonist protocol.

Totally, 1430 women were enrolled from the cases of our Assisted Reproduction Center from January 2015 to January 2019 for this retrospective cohort study. The inclusion criteria of the subjects included women with ages under 40 years, 3–10 oocytes retrieved, good embryo quality according to gardener score, GnRH antagonist protocol, underwent first cycle of fresh embryo transfer or freeze-all strategy and transferred in subsequent cycle. However, the patients with endometriosis, PGD/PGS cycles, history of recurrent pregnancy loss and uterine pathology were excluded. 495 women of group I underwent fresh embryo transfer in first cycle and 935 patients of group II received frozen-thawed transfer in subsequent cycle. The primary outcome was clinical pregnancy rate. A logistic regression analysis was performed to determine the variables that could be independently associated with clinical pregnancy rate. Models were adjusted for covariates including patients’ age, fertilization type, infertility type, infertility duration, the number of oocytes retrieved, the number of embryos transferred and type of embryo transferred.

Clinical pregnancy rate was significantly higher in frozen-thawed embryo transfer than in fresh embryo transfer (63.70% vs. 54.50%, p < 0.001). Miscarriage rate and ectopic pregnancy rate were comparable between two groups. Variables independently associated with clinical pregnancy rate were fresh/frozen embryo transfer, patients’ age and the number of embryos transferred. After adjusting for variables, the frozen embryo transfer [adjusted odds ratio (aOR) 0.75; 95% CI, 0.59–0.95, p = 0.016] was a predictive factor of clinical pregnancy rate.

Frozen embryo transfer is better than fresh embryo transfer in GnRH antagonist cycle in women with 3–10 oocytes retrieved. Similar content being viewed by others

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We thank the staff from Northwest Women’s and Children’s Hospital for their assistance with the data collection. We thank all participants in this study. Funding The study was funded by National Natural Science Foundation of China (No. 81771657 https://www.nsfc.gov.cn/) and General Projects of Social Development in Shaanxi Province (No. 2018SF-260). Author information Authors and Affiliations Contributions XTL: manuscript writing, HYB: data analysis, WHS: manuscript writing, JZS: protocol development. Corresponding author Ethics declarations Conflict of interest The authors declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. Ethical approval The approval of the Institutional Review Board of Northwest Women’s and Children’s Hospital was obtained for this retrospective cohort study (Number 2018002). All research was performed in accordance with relevant guidelines and regulations. Informed consent Informed consent was obtained from all individual participants included in the study. Additional information Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Rights and permissions About this article Cite this article Liu, X., Bai, H., Shi, W. et al. Frozen-thawed embryo transfer is better than fresh embryo transfer in GnRH antagonist cycle in women with 3–10 oocytes retrieved: a retrospective cohort study. Arch Gynecol Obstet 300, 1791–1796 (2019). https://doi.org/10.1007/s00404-019-05373-9 Received: Accepted: Published: Version of record: Issue date: DOI: https://doi.org/10.1007/s00404-019-05373-9