In Freeze-All Strategy, Cumulative Live Birth Rate (CLBR) Is Increasing According to the Number of Blastocysts Formed in Women <40 Undergoing Intracytoplasmic Sperm Injection (ICSI)
Background: Elective freezing of all embryos, followed by frozen-thawed ET cycles emerged to prevent risk of Ovarian Hyperstimulation Syndrome and to allow endometrium recovery after Controlled Ovarian Stimulation, leading to better IVF outcomes. Blastocyst Freeze-all policy can minimize the number...
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Frontiers Media S.A.
2019-07-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fendo.2019.00427/full |
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| author | Evangelos Papanikolaou Evangelos Papanikolaou Tatiana Chartomatsidou Evangelia Timotheou Petroula Tatsi Eleftheria Katsoula Christina Vlachou Irene Asouchidou Odysseas Zafeiratis Robert Najdecki |
| author_facet | Evangelos Papanikolaou Evangelos Papanikolaou Tatiana Chartomatsidou Evangelia Timotheou Petroula Tatsi Eleftheria Katsoula Christina Vlachou Irene Asouchidou Odysseas Zafeiratis Robert Najdecki |
| author_sort | Evangelos Papanikolaou |
| collection | DOAJ |
| description | Background: Elective freezing of all embryos, followed by frozen-thawed ET cycles emerged to prevent risk of Ovarian Hyperstimulation Syndrome and to allow endometrium recovery after Controlled Ovarian Stimulation, leading to better IVF outcomes. Blastocyst Freeze-all policy can minimize the number of abnormal embryos and consequently failed ETs, but its efficacy in terms of cumulative rates has not been studied yet.Methods: A prospective cohort observational study was carried out in Assisting Nature, Center of Assisted Reproduction and Genetics, in Thessaloniki, Greece from January 2014 until December 2017. 244 patients- normal or high responders- underwent COS with recFSH and Freeze-all policy with blastocyst culture. The included patients were 18-39 years and achieved clinical pregnancy and/or live birth or had all their vitrified blastocysts transferred in subsequent frozen-thawed cycles. Women were divided into four groups (group A: 1–2 blastocysts frozen; group B: 3–4; group C: 5–6; group D ≥7 blastocysts frozen) or seven groups (group I: 1–2 blastocysts frozen, group II: 3, group III: 4, group IV: 5, group V: 6, group VI: 7; group VII: ≥8 blastocysts frozen), according to the numerical range or to the absolute number of vitrified blastocysts, respectively.Results: The main outcome of the study was the CLBR achieved by frozen-thawed ETs, according to the number of the vitrified blastocysts. Higher CLBR are expected, when at least 3 blastocysts are formed (group B: 65.2%) and at least 2 frozen-thawed ETs are performed, reaching highest rates (88%) by group D (≥7 vitrified blastocysts). Similarly, CLBR is significantly increasing with the absolute number of the vitrified blastocysts, ranging from 20%, when 1–2 blastocysts are vitrified (group I) to 82.4% when ≥8 blastocysts are available.Conclusions: A higher number of vitrified blastocysts is associated with higher CLBR in women <40 years old- normal/high responders- following Freeze-all policy. Adopting Freeze-all strategy after blastocyst culture can contribute to improve delivery outcome after IVF, in terms of CLBR. The number of the total cryopreserved blastocysts produced might reflect the quality of the oocyte and can successfully predict the pregnancy outcome. The blastulation rate can be a robust criterion to segment or not an IVF cycle. |
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| last_indexed | 2024-12-13T08:21:01Z |
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| spelling | doaj.art-18861ef2ba5146bfaaea3032cf8807bd2022-12-21T23:54:01ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922019-07-011010.3389/fendo.2019.00427461592In Freeze-All Strategy, Cumulative Live Birth Rate (CLBR) Is Increasing According to the Number of Blastocysts Formed in Women <40 Undergoing Intracytoplasmic Sperm Injection (ICSI)Evangelos Papanikolaou0Evangelos Papanikolaou1Tatiana Chartomatsidou2Evangelia Timotheou3Petroula Tatsi4Eleftheria Katsoula5Christina Vlachou6Irene Asouchidou7Odysseas Zafeiratis8Robert Najdecki9Assisting Nature, Centre of Assisted Reproduction and Genetics, Thessaloniki, Greece3rd Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Thessaloniki, GreeceAssisting Nature, Centre of Assisted Reproduction and Genetics, Thessaloniki, GreeceAssisting Nature, Centre of Assisted Reproduction and Genetics, Thessaloniki, GreeceAssisting Nature, Centre of Assisted Reproduction and Genetics, Thessaloniki, GreeceAssisting Nature, Centre of Assisted Reproduction and Genetics, Thessaloniki, GreeceAssisting Nature, Centre of Assisted Reproduction and Genetics, Thessaloniki, GreeceMedical Department, Aristotle University of Thessaloniki, Thessaloniki, GreeceAssisting Nature, Centre of Assisted Reproduction and Genetics, Thessaloniki, GreeceAssisting Nature, Centre of Assisted Reproduction and Genetics, Thessaloniki, GreeceBackground: Elective freezing of all embryos, followed by frozen-thawed ET cycles emerged to prevent risk of Ovarian Hyperstimulation Syndrome and to allow endometrium recovery after Controlled Ovarian Stimulation, leading to better IVF outcomes. Blastocyst Freeze-all policy can minimize the number of abnormal embryos and consequently failed ETs, but its efficacy in terms of cumulative rates has not been studied yet.Methods: A prospective cohort observational study was carried out in Assisting Nature, Center of Assisted Reproduction and Genetics, in Thessaloniki, Greece from January 2014 until December 2017. 244 patients- normal or high responders- underwent COS with recFSH and Freeze-all policy with blastocyst culture. The included patients were 18-39 years and achieved clinical pregnancy and/or live birth or had all their vitrified blastocysts transferred in subsequent frozen-thawed cycles. Women were divided into four groups (group A: 1–2 blastocysts frozen; group B: 3–4; group C: 5–6; group D ≥7 blastocysts frozen) or seven groups (group I: 1–2 blastocysts frozen, group II: 3, group III: 4, group IV: 5, group V: 6, group VI: 7; group VII: ≥8 blastocysts frozen), according to the numerical range or to the absolute number of vitrified blastocysts, respectively.Results: The main outcome of the study was the CLBR achieved by frozen-thawed ETs, according to the number of the vitrified blastocysts. Higher CLBR are expected, when at least 3 blastocysts are formed (group B: 65.2%) and at least 2 frozen-thawed ETs are performed, reaching highest rates (88%) by group D (≥7 vitrified blastocysts). Similarly, CLBR is significantly increasing with the absolute number of the vitrified blastocysts, ranging from 20%, when 1–2 blastocysts are vitrified (group I) to 82.4% when ≥8 blastocysts are available.Conclusions: A higher number of vitrified blastocysts is associated with higher CLBR in women <40 years old- normal/high responders- following Freeze-all policy. Adopting Freeze-all strategy after blastocyst culture can contribute to improve delivery outcome after IVF, in terms of CLBR. The number of the total cryopreserved blastocysts produced might reflect the quality of the oocyte and can successfully predict the pregnancy outcome. The blastulation rate can be a robust criterion to segment or not an IVF cycle.https://www.frontiersin.org/article/10.3389/fendo.2019.00427/fullfreeze-all policyblastulation rateblastocystcumulative live birth ratecumulative pregnancy rateIVF outcome |
| spellingShingle | Evangelos Papanikolaou Evangelos Papanikolaou Tatiana Chartomatsidou Evangelia Timotheou Petroula Tatsi Eleftheria Katsoula Christina Vlachou Irene Asouchidou Odysseas Zafeiratis Robert Najdecki In Freeze-All Strategy, Cumulative Live Birth Rate (CLBR) Is Increasing According to the Number of Blastocysts Formed in Women <40 Undergoing Intracytoplasmic Sperm Injection (ICSI) Frontiers in Endocrinology freeze-all policy blastulation rate blastocyst cumulative live birth rate cumulative pregnancy rate IVF outcome |
| title | In Freeze-All Strategy, Cumulative Live Birth Rate (CLBR) Is Increasing According to the Number of Blastocysts Formed in Women <40 Undergoing Intracytoplasmic Sperm Injection (ICSI) |
| title_full | In Freeze-All Strategy, Cumulative Live Birth Rate (CLBR) Is Increasing According to the Number of Blastocysts Formed in Women <40 Undergoing Intracytoplasmic Sperm Injection (ICSI) |
| title_fullStr | In Freeze-All Strategy, Cumulative Live Birth Rate (CLBR) Is Increasing According to the Number of Blastocysts Formed in Women <40 Undergoing Intracytoplasmic Sperm Injection (ICSI) |
| title_full_unstemmed | In Freeze-All Strategy, Cumulative Live Birth Rate (CLBR) Is Increasing According to the Number of Blastocysts Formed in Women <40 Undergoing Intracytoplasmic Sperm Injection (ICSI) |
| title_short | In Freeze-All Strategy, Cumulative Live Birth Rate (CLBR) Is Increasing According to the Number of Blastocysts Formed in Women <40 Undergoing Intracytoplasmic Sperm Injection (ICSI) |
| title_sort | in freeze all strategy cumulative live birth rate clbr is increasing according to the number of blastocysts formed in women 40 undergoing intracytoplasmic sperm injection icsi |
| topic | freeze-all policy blastulation rate blastocyst cumulative live birth rate cumulative pregnancy rate IVF outcome |
| url | https://www.frontiersin.org/article/10.3389/fendo.2019.00427/full |
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