IVF/ICSI Outcomes After a Freeze-All Strategy: an Observational Cohort Study

In order to inform patients undergoing ART regarding their chances for motherhood, it seems useful to describe “freeze all” outcomes according to the different potential indications. The goal of this study was to examine the impact of a “freeze-all approach” on the cumulative live birth rate (cLBR) according to the indication. It is a cohort study including women who had undergone ovarian stimulation (OS) using an antagonist protocol with GnRH agonist triggering between 09.2016 and 09.2018 followed by a freeze-all cycle of blastocyst embryos. The ART outcomes were compared between the two main indications of the freeze-all strategy which were in our cohort: risk of ovarian hyperstimulation syndrome (OHSS) and endometriosis. The ART outcomes were also described for the others indications (inadequate endometrium and/or premature progesterone elevation at trigger day, two or more previous ART failures, and autoimmune disease and/or a high risk of thromboembolic disease (AI and/or TE risk)). In total, 658 women were included. The cLBR in the total population was 37.7% (248/658). The cLBR was significantly higher in the “OHSS risk” group (133/281, 47.3%) than in the “endometriosis” group (69/190, 36.3%) (p = 0.017). No significant differences were noted regarding perinatal outcomes, except a significantly higher risk of placenta praevia (PP) observed in the “endometriosis” group (10.1%) (p = 0.002). The “freeze-all approach” yielded good results in terms of the cLBR and especially in case of OHSS risk. These data should be taken into account when informing patients about the ART strategy and their chances of motherhood. Similar content being viewed by others Data Availability The data underlying this article will be shared on reasonable request to the corresponding author.

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The authors wish to thank staff members of our department for their expert assistance with data collection, particularly Valerie Blanchet, Julia Gonnot, Emmanuelle Laviron and Célie Cervantes. Funding This study was partially supported by a Finox Forward Research Grant. Author information Authors and Affiliations Corresponding author Ethics declarations Ethics Approval This study was approved by the Ethics Review Committee of Cochin University Hospital (CLEP)(n°AAA-2022–08012). Conflict of Interest The authors declare no competing interests. Additional information Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. The authors consider that the first two authors (Mathilde Bourdon and Asim Alwohaibi) should be regarded as joint first author. The authors consider that the last two authors (Charles Chapron and Pietro Santulli) should be regarded as joint last author. Supplementary Information Below is the link to the electronic supplementary material. Rights and permissions Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. About this article Cite this article Bourdon, M., Alwohaibi, A., Maignien, C. et al. IVF/ICSI Outcomes After a Freeze-All Strategy: an Observational Cohort Study. Reprod. Sci. 30, 2283–2291 (2023). https://doi.org/10.1007/s43032-023-01173-4 Received: Accepted: Published: Version of record: Issue date: DOI: https://doi.org/10.1007/s43032-023-01173-4