Improving reproductive outcomes in frozen embryo transfer over fresh embryo transfer in women with endometrioma: A historical cohort study

Parisa Pirooznia, Pirooznia P, Mehri Mashayekhi, Mashayekhi M, Ghaffari F, Firouzeh Ghaffari, Nadia Jahangiri, Jahangiri N, Zolfaghari Z, Zahra Zolfaghari, Firoozeh Ahmadi, Ahmadi F, Fateme Hasani, Hasani F, Narimani N, Nima Narimani
International journal of reproductive biomedicine · 2025 · vol. 22(11) , pp. 857–870 · doi:10.18502/ijrm.v22i11.17819 · PMID:39866586 · PMC11757671 · W4406336828
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-08 ⓘ

This historical cohort study found that frozen embryo transfer resulted in a significantly higher live birth rate compared to fresh embryo transfer in women with endometrioma-related infertility.

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⚙ AI-generated deep summary by claude@2026-07, 2026-07-11 · read from full text ⓘ

This historical cohort study compared frozen embryo transfer (FET) versus fresh embryo transfer (ET) in 200 infertile women aged 18–39 with ultrasound-confirmed endometrioma, using medical records from the Royan Institute (Tehran, March 2016–2021). After exclusions, 121 underwent FET and 79 underwent fresh ET, with outcomes including live birth rate (primary), clinical pregnancy, miscarriage, and implantation rate, alongside neonatal outcomes; ovarian stimulation and endometrial preparation protocols varied, and factors like stimulation type and embryo preparation showed no effect on live birth in univariate logistic regression. Live birth rate per ET cycle was significantly higher with FET (OR 1.937, p = 0.044), while neonatal outcomes (e.g., gestational age, preterm birth, birth weight measures, delivery type) were similar between groups, and the paper’s limitations include its retrospective design and reliance on available record information. This paper is centrally about endometriosis—specifically endometrioma-associated infertility—comparing pregnancy and neonatal outcomes between frozen and fresh embryo transfer strategies.

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Abstract

BACKGROUND: Endometrioma, a common manifestation of endometriosis, often indicates the severity of the disease. In vitro fertilization and embryo transfer (ET) are key therapeutic strategies for infertility associated with endometriosis. However, the optimal type of ET (frozen or fresh) and its impact on pregnancy success rates remain debated, with limited studies available. OBJECTIVE: This historical cohort study aimed to compare fertility and neonatal outcomes, focusing on live birth rate (LBR), clinical pregnancy, and implantation rates in women with endometrioma-associated infertility, between fresh and frozen embryo transfer (FET). MATERIALS AND METHODS: In this historical cohort study, the medical records (files) of 289 women diagnosed with endometrioma-related infertility, who underwent in vitro fertilization/intracytoplasmic sperm injection treatment at Royan Institute, Tehran, Iran between March 2016-2021 were reviewed. Ultimately, 200 files that met the established criteria were selected for review. The extracted data was then compared between groups: FET (n = 121) and fresh ET (n = 79). RESULTS: No significant differences were observed between the groups in terms of demographic characteristics and endometrioma size. The only significant difference in fertility outcomes was the LBR, which was 36.4% for the FET group compared to 22.8% for the fresh ET group (p = 0.04). No significant differences were observed in neonatal outcomes between the groups. Overall, our study suggests that FET may lead to higher LBRs in women diagnosed with endometrioma. CONCLUSION: Our study suggests that FET may lead to higher LBRs in women diagnosed with endometrioma.
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This research was not financially supported by any organization. The authors utilized the Artificial Intelligence tool Microsoft Copilot-GPT4 to assist with language editing and improving the readability of the manuscript.

Coi Statement

The authors declare no conflict of interest.

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Condition tags

endometriosisendometriomainfertility

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Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

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