Dataset Information

Elective freezing of embryos versus fresh embryo transfer in IVF: a multicentre randomized controlled trial in the UK (E-Freeze).

ABSTRACT:

SUBMITTER: Maheshwari A

PROVIDER: S-EPMC9206534 | biostudies-literature | 2022 Mar

REPOSITORIES: biostudies-literature

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Elective freezing of embryos versus fresh embryo transfer in IVF: a multicentre randomized controlled trial in the UK (E-Freeze).

Maheshwari Abha A Bell Jennifer L JL Bhide Priya P Brison Daniel D Child Tim T Chong Huey Yi HY Cheong Ying Y Cole Christina C Coomarasamy Arri A Cutting Rachel R Hardy Pollyanna P Hamoda Haitham H Juszczak Edmund E Khalaf Yacoub Y Kurinczuk Jennifer J JJ Lavery Stuart S Linsell Louise L Macklon Nick N Mathur Raj R Pundir Jyotsna J Raine-Fenning Nick N Rajkohwa Madhurima M Scotland Graham G Stanbury Kayleigh K Troup Stephen S Bhattacharya Siladitya S

Human reproduction (Oxford, England) 20220301 3

<h4>Study question</h4>Does a policy of elective freezing of embryos, followed by frozen embryo transfer result in a higher healthy baby rate, after first embryo transfer, when compared with the current policy of transferring fresh embryos?<h4>Summary answer</h4>This study, although limited by sample size, provides no evidence to support the adoption of a routine policy of elective freeze in preference to fresh embryo transfer in order to improve IVF effectiveness in obtaining a healthy baby.<h4 ...[more]

PMID: 34999830

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Project description:ObjectiveTo evaluate the associations between homeostatic model assessment for insulin resistance (HOMA-IR) and pregnancy outcomes in non-dyslipidemic infertile women undergoing in vitro fertilization/intracytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET).Materials and methodsThis is a retrospective study involving 3,615 non-dyslipidemic infertile women who attend to the Reproductive Medicine Center of Xiangya Hospital, Central South University (CSU) between January 2014 and October 2021. Eligible participants were divided into three groups according to the quartiles of HOMA-IR: Group 1 (HOMA-IR <1.46), Group 2 (1.46 to <2.71) and Group 3 (HOMA-IR ≥2.71). Baseline data, clinical characteristics during the assisted reproductive technology (ART) procedure, pregnancy, and neonatal outcomes were compared among the three groups. Subgroup analysis based on presence or absence of the polycystic ovary syndrome (PCOS) status was also performed to analyze the effects of HOMA-IR among non-PCOS populations.ResultsThe late miscarriage rate and percentage of macrosomia increased with the HOMA-IR group (for late miscarriage rate: 2.23% vs. 3.04% vs. 7.35%, P<0.001; for macrosomia: 0.21% vs. 1.70% vs. 3.23%, P=0.002). Increased HOMA-IR (HOMA-IR≥2.71) was positively associated with late miscarriage (crude OR 3.50, 95% CI 1.64-7.47, P=0.001; adjusted OR 3.56, 95% CI 1.56-8.15, P=0.003). In the subgroup analysis, there were 3,165 participants in the non-PCOS group and 450 were assigned to the PCOS group. Late miscarriage rate increased with the HOMA-IR group among non-PCOS populations (2.20% vs. 3.03% vs. 7.67%, P<0.001). Late miscarriage rate of PCOS women were comparable among the three HOMA-IR groups (2.50% vs. 3.06% vs. 5.71%, P=0.634). Among non-PCOS women, increased HOMA-IR (HOMA-IR≥2.71) was positively associated with late miscarriage (crude OR 3.71, 95% CI 1.66-8.30, P=0.001; adjusted OR 3.82, 95% CI 1.59-9.17, P=0.003).ConclusionsLate miscarriage rate and prevalence of macrosomia increased with the HOMA-IR index. Preconception HOMA-IR is an independent risk factor for late miscarriage in normolipidemic women undergoing IVF/ICSI-ET. Controlling insulin resistance before ART might prevent the occurrence of late miscarriage and macrosomia.

Project description:ObjectiveThe aim of this study is to investigate whether the follicle-to-oocyte index [FOI: (number of retrieved oocytes/antral follicle count) × 100] was associated with clinical pregnancy after fresh cleavage transfer.DesignThe framework used to organize this study is retrospective cohort analysis.SettingThe study was performed in a single in vitro fertilization center in a public hospital.PatientsIn total, 4,323 fresh embryo transfer cycles from 1 August 2011 to 31 January 2022 were retrospectively analyzed. Data were designated into three groups according to FOI tertile values.InterventionsThere are no interventions in this study.Main outcome measureThe primary outcome measure is the clinical pregnancy rate (CPR).ResultsA total of 4,323 patients were included in the study. According to their FOI, patients were divided into low (FOI ≤ 0.70, n = 1,434), medium (FOI = 0.71-0.95, n = 1,070), and high (FOI = 0.96-1.00, n = 1,819) tertile groups. A significant statistical increase in the CPR from the lowest to the highest tertile FOI group was detected (47.28%, 51.78%, and 51.57%; P =0.026). After adjusted for potential confounders, multivariate logistic regression analysis revealed a positive association between FOI and CPR [odds ratio (OR) = 1.57; 95% confidence interval (CI): 1.18-2.11]. Each standard deviation increments in FOI (SD = 0.24) corresponded to a 20% increase in the CPR. Trend analysis also showed that FOI tertile groups were positively associated with CPR (P for trend = 0.010). Smooth curve fitting indicated the existence of a linear relationship across the entire range of FOI. No optimal cutoff value of FOI for prognosing CPR was found in smooth curve fitting analysis. Moreover, subgroup analyses suggested that the association was significantly stronger in the single cleavage transfer cycle (OR = 2.04; 95% CI: 1.14-3.65).ConclusionsFOI is an independent variable in prediction for CPR in fresh embryo transfer cycle, especially in the single cleavage transfer cycle.

Dataset Information

Elective freezing of embryos versus fresh embryo transfer in IVF: a multicentre randomized controlled trial in the UK (E-Freeze).

Publications

Elective freezing of embryos versus fresh embryo transfer in IVF: a multicentre randomized controlled trial in the UK (E-Freeze).

Similar Datasets

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