Reproductive outcomes in women with advanced endometriosis in fresh versus frozen embryo transfer cycles.
This study compared reproductive outcomes in women with advanced endometriosis undergoing fresh versus frozen embryo transfer, finding higher implantation and ongoing pregnancy rates with frozen embryo transfers.
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This retrospective cohort study compared reproductive outcomes between fresh embryo transfer and freeze-all, deferred frozen embryo transfer after ICSI in women aged 18–37 with laparoscopy-diagnosed advanced endometriosis (r-ASRM stage III/IV) recruited from two IVF centers in Alexandria, Egypt. After excluding women with uterine lesions including adenomyosis and other factors, 211 matched participants (103 fresh; 108 frozen) were analyzed for ongoing pregnancy, implantation, clinical pregnancy, and miscarriage rates. Ongoing pregnancy, implantation, and clinical pregnancy rates were significantly higher in the frozen embryo transfer group, while miscarriage rate was numerically higher after fresh transfer but not statistically significant. The paper’s main limitation is its retrospective design and reliance on medical record review, and it does not report randomized allocation or control for all potential confounders. This paper is centrally about endometriosis — it evaluates how a freeze-all strategy vs fresh embryo transfer affects implantation and ongoing pregnancy outcomes in women with advanced endometriosis.
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