Comparison Of Endometrial Receptivity And Pregnancy Rate Between Fresh Embryo Transfer (ET) And Frozen-Thawed ET After Gonadotrophin-Releasing Hormone (Gnrh) Antagonist Protocol In Normal Ovarian Responders
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Abstract
Background: Gonadotrophin-releasing hormone (GnRH) antagonist protocol has grown in popularity in the in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) treatment.
Purpose: The goal of this study was to assess endometrial receptivity by means of uterine, endometrial, and subendometrial blood flows using transvaginal colour Doppler power ultrasound. It also compared rates of pregnancies between fresh and frozen-thawed ET following GnRH antagonist protocol in normal ovarian responders.
Methods: This retrospective cohort study involved a total of (450) patients divided into two groups; Fresh ET group (n=230) and frozen hawed ET (n=220).
Results: The uterine artery RI and endometrial thickness were significantly lower in the frozen-thawed ET group. The frozen-thawed ET group had a substantially greater clinical pregnancy rate (57.27% vs. 33.04%) (p=0.033); implantation rate (33.11% vs. 23.11%) (p=0.025), ongoing pregnancy rate (55.0% vs. 30.0%) (p=0.013) and live birth rate (45.9% vs. 23.47%) (p=0.02) than the fresh ET group after the GnRH antagonist protocol
Conclusions: Frozen-thawed transfer cycles have been identified to be associated in higher live birth rates and clinical pregnancy rates than fresh embryo transfers. The findings could offer medical professionals with useful information for practice in the clinic.
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References
1. Aflatoonian, A., Mansoori-Torshizi, M., Farid Mojtahedi, M., Aflatoonian, B., Khalili, M. A., Amir-Arjmand, M. H., Soleimani, M., Aflatoonian, N., Oskouian, H., Tabibnejad, N., & Humaidan, P. (2018). Fresh versus frozen embryo transfer after gonadotropin-releasing hormone agonist trigger in gonadotropin-releasing hormone antagonist cycles among high responder women: A randomized, multi-center study. International journal of reproductive biomedicine, 16(1), 9–18.
2. Al-Inany, H. G., Youssef, M. A., Ayeleke, R. O., Brown, J., Lam, W. S., & Broekmans, F. J. (2016). Gonadotrophin-releasing hormone antagonists for assisted reproductive technology. The Cochrane database of systematic reviews, 4(4), CD001750. https://doi.org/10.1002/14651858.CD001750.pub4
3. Fan, L., Tang, N., Yao, C., Wei, X., Tang, Y., Li, J., & Huang, W. (2022). Association Between Fresh Embryo Transfers and Frozen-Thawed Embryo Transfers Regarding Live Birth Rates Among Women Undergoing Long Gonadotropin-Releasing Hormone Antagonist Protocols. Frontiers in cell and developmental biology, 10, 884677. https://doi.org/10.3389/fcell.2022.884677
4. Ginström Ernstad, E., Wennerholm, U. B., Khatibi, A., Petzold, M., Bergh, C. (2019). Neonatal and Maternal Outcome after Frozen Embryo Transfer: Increased Risks in Programmed Cycles. Am. J. Obstet. Gynecol. 221 (2), 126–e18. 10.1016/j.ajog.2019.03.010
5. Law, Y. J., Zhang, N., Venetis, C. A., Chambers, G. M., Harris, K. (2019). The Number of Oocytes Associated with Maximum Cumulative Live Birth Rates Per Aspiration Depends on Female Age: a Population Study of 221 221 Treatment Cycles. Hum. Reprod. 34 (9), 1778–1787. 10.1093/humrep/dez100
6. Liu, X., Bai, H., Shi, W., & Shi, J. (2019). 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. Archives of gynecology and obstetrics, 300(6), 1791–1796. https://doi.org/10.1007/s00404-019-05373-9
7. Polyzos, N. P., Drakopoulos, P., Parra, J., Pellicer, A., Santos-Ribeiro, S., Tournaye, H., et al. (2018). Cumulative Live Birth Rates According to the Number of Oocytes Retrieved after the First Ovarian Stimulation for In Vitro Fertilization/intracytoplasmic Sperm Injection: a Multicenter Multinational Analysis Including ∼15,000 Women. Fertil. Sterility 110 (4), 661–670. 10.1016/j.fertnstert.2018.04.039
8. Prasad, S., Goyal, R., Kumar, Y., Nayar, P., Hajela, S., Kumaran, A., Vairagi, R., & Chauhan, S. (2017). The Relationship Between Uterine Artery Two-dimensional Color Doppler Measurement and Pregnancy Outcome: A Prospective Observational Study. Journal of reproduction & infertility, 18(2), 251–256.
9. Roque, M., Lattes, K., Serra, S., Solà, I., Geber, S., Carreras, R., & Checa, M. A. (2013). Fresh embryo transfer versus frozen embryo transfer in in vitro fertilization cycles: a systematic review and meta-analysis. Fertility and sterility, 99(1), 156–162. https://doi.org/10.1016/j.fertnstert.2012.09.003
10. Talaulikar, V. S., Arulkumaran S. (2013). Maternal, Perinatal and Long-Term Outcomes after Assisted Reproductive Techniques (ART): Implications for Clinical Practice. Eur. J. Obstet. Gynecol. Reprod. Biol. 170 (1), 13–19. 10.1016/j.ejogrb.2013.04.014
11. Trounson, A., and Mohr L. (1983). Human Pregnancy Following Cryopreservation, Thawing and Transfer of an Eight-Cell Embryo. Nature 305 (5936), 707–709. 10.1038/305707a0
12. Wang, C.H. and Hu, X.Q., (2021). A systematic review of clinical efficacy of frozen-thawed embryos and fresh embryos in in-vitro fertilization cycles. Cryobiology, 100, 19–25
13. Weinerman, R. & Mainigi, M. (2014). Why We Should Transfer Frozen Instead of Fresh Embryos: The Translational Rationale. Fertil. Sterility 102 (1), 10–18. 10.1016/j.fertnstert.2014.05.019
14. Wong, K. M., Mastenbroek, S., & Repping, S. (2014). Cryopreservation of human embryos and its contribution to in vitro fertilization success rates. Fertility and sterility, 102(1), 19–26. https://doi.org/10. 1016 /j.fertnstert.2014.05.027
15. Xia, M., & Zheng, J. (2021). Comparison of clinical outcomes between the depot gonadotrophin-releasing hormone agonist protocol and gonadotrophin-releasing hormone antagonist protocol in normal ovarian responders. BMC pregnancy and childbirth, 21(1), 372. https://doi.org/10.1186/s12884-021-03849-8
16. Zhang, W., Xiao, X., Zhang, J., Wang, W., Wu, J., Peng, L., & Wang, X. (2018). Clinical outcomes of frozen embryo versus fresh embryo transfer following in vitro fertilization: a meta-analysis of randomized controlled trials. Archives of gynecology and obstetrics, 298(2), 259–272. https://doi.org/10.1007/s00404-018-4786-5