Freeze-all embryo strategy in poor ovarian responders undergoing ovarian stimulation for in vitro fertilization

Abstract

This retrospective study determined the efficacy of the ‘freeze-all’ embryo strategy in poor ovarian responders undergoing ovarian stimulation for in vitro fertilization (IVF). A total of 559 poor responders who met Bologna criteria between January 2012 and December 2014 were included in this study: 256 in the fresh embryo transfer group and 303 in the freeze-all group. Vitrification and warming of day 3 embryos were performed using the Cryotop method. The poor responders treated with fresh embryo transfer and those treated with freeze-all strategy showed similar live birth rates per cycle (12.1% vs. 16.2%, p = .172) and per transfer (15.9% vs. 20.9%, p = .182). Multivariate logistic regression analysis showed that maternal age at retrieval (odds ratio, 0.919; 95% confidence interval, 0.865–0.977; p = .006) and number of good-quality embryos transferred (odds ratio, 1.953; 95% confidence interval, 1.346–2.835; p < .001) were significantly associated with the live birth rate. Freeze-all cycle is an acceptable treatment in poor ovarian responders, and it should be suggested by physicians as an alternative to cycle cancelation in case in which a fresh transfer would not be advantageous.

Chinese abstract

卵巢低反应(POR)不育患者在刺激卵巢体外受精后采取选择性全胚胎冷冻

摘要

这项回顾性研究对卵巢低反应(POR)不育患者通过促排卵体外受精(IVF)后采取“选择性全胚胎冷冻”的有效性进行了分析。2012年1月至2014年12月, 共559名符合博洛尼亚标准的卵巢低反应不育患者被纳入本研究：其中256名患者为新鲜胚胎移植组, 303名为冻结胚胎移植组。第3天胚胎使用Cryotop方法进行了玻璃化冷冻及复温。新鲜胚胎移植组以及冻结胚胎移植组每个周期（12.1％和16.2％, p = .172）以及每次移植（15.9％对20.9％, p = .182）表现出相似的活产率。多因素logistic回归分析显示, 年龄（比值比, 0.919,95％置信区间, 0.865-0.977; P = .006 ）和移植的优质胚胎数量（优势比1.953,95％置信区间1.346-2.835; p <.001）与活产率显著相关, 对于卵巢低反应育患者来说选择性全胚胎冷冻技术是一种可选择的治疗方法, 且对于周期取消后不适合采取新鲜胚胎移植的患者, 医生可建议其选择“选择性全胚胎冷冻”技术作为替代方案。

Keywords:

• Freeze-all
• poor response
• in vitro fertilization
• ovarian stimulation
• cryopreservation

Additional information

Funding

This study was supported by Natural Science Foundation of Zhejiang Province [No. LY17H040002] and Science and Technology Department of Zhejiang Province [No. 2018C37126].