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The interval transfer of a frozen‐thawed embryo is more successful than a fresh embryo transfer for women undergoing IVF with recurrent implantation failure after cleavage stage embryo biopsy
Author(s) -
Pontré Jennifer C.,
Ryan John P.,
Tan Andy,
Hart Roger J.
Publication year - 2019
Publication title -
australian and new zealand journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.734
H-Index - 65
eISSN - 1479-828X
pISSN - 0004-8666
DOI - 10.1111/ajo.12798
Subject(s) - embryo transfer , embryo , blastomere , biopsy , blastocyst , andrology , gynecology , pregnancy rate , live birth , medicine , cryopreservation , pregnancy , biology , embryogenesis , genetics
Background Recurrent implantation failure ( RIF ) is repeated unsuccessful embryo transfers ( ET s). Aims To identify predictive embryonic markers of implantation in RIF , following pre‐implantation genetic screening ( PGS ) of cleavage stage embryos, after accounting for male and female factors. Materials and Methods Retrospective analysis of RIF patients undergoing PGS after correction of modifiable causes. Results Eighty‐four patients underwent 140 in vitro ferilisation cycles. Forty‐one cycles were excluded: 12 (no embryo for transfer), four (double ET s) and 25 (no biopsy). Sixty‐three patients underwent 99 single euploid ETs (48 fresh, 51 frozen) resulting in 11 biochemical pregnancies, 36 clinical pregnancies ( CP ), and six miscarriages and 30 live births ( LB ). Frozen ET was more successful than fresh; respective live birth rate ( LBR ) and clinical pregnancy rate ( CPR ), 39.2% versus 20.8%, ( P = 0.02), 45.1% versus 27.1% ( P = 0.04). LBR and CPR were lower when 5–6 blastomeres were present at embryo biopsy, compared to embryos with ≥7 blastomeres: 15.4% versus 32.6% ( P = 0.185) and 15.4% versus 39.5% ( P = 0.074) respectively. Serum β human chorionic gonadotropin (βh CG) concentration was greater when a more developed embryo was biopsied ( r = 0.448, P = 0.017 and r = 0.476, P = 0.118, fresh and frozen transfers, respectively). Embryo morphokinetic analysis demonstrated faster development to blastocyst stage when more cells were present at biopsy: mean 103.3, 102.2 and 96.0 h for biopsy at the 5–6, 7–8 or ≥9 cell stage respectively ( P = 0.040 for difference between 7–8 cells vs ≥9). Conclusions After cleavage stage biopsy, frozen ET was more successful than fresh ET . Chance of conception and serum βh CG concentration correlated with number of cells present at time of biopsy.