Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre, Centre Hospitalier Universitaire (CHU) Cochin, Department of Gynaecology Obstetrics II and Reproductive Medicine, Paris, France.
Institut Cochin, Laboratoire d'immunologie, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.
PLoS One. 2018 Oct 19;13(10):e0206067. doi: 10.1371/journal.pone.0206067. eCollection 2018.
The 'Freeze all' strategy, which consists of cryopreservation of all embryos after the ovarian stimulation has undergone extensive development in the past decade. The time required for the endometrium to revert to a prestimulation state after ovarian stimulation and thus the optimal time to perform a deferred embryo transfer after the stimulation has not been determined yet.
To investigate the impact of the time from oocyte retrieval to frozen-thawed blastocyst transfer (FBT) on live birth rate (LBR), obstetrical and neonatal outcomes, in 'Freeze-all' cycle.
We conducted a large observational cohort study in a tertiary care university hospital including four hundred and seventy-four first autologous FBT performed after ovarian stimulation in 'freeze all' cycles. Reproductive outcomes were compared between FBT performed within the first menstrual cycle after the oocyte retrieval ('cycle 1' group) or delayed FBT ('cycle ≥ 2' group). The main Outcome Measure was the Live birth rate.
RESULT(S): A total of 188 FBT were included in the analysis in the 'cycle 1' group and 286 in the 'cycle ≥ 2' group. No significant differences were found between FBT performed within the first menstrual cycle after oocyte retrieval (the 'cycle 1' group) and delayed FBT (the 'cycle ≥ 2' group) in terms of the live birth rate [59/188 (31.38%) vs. 85/286 (29.72%); p = 0.696] and the miscarriage rate [20/82 (24.39%) vs. 37/125 (29.60%), respectively; p = 0.413]. The obstetrical and neonatal outcomes were also not significantly different between the two groups.
Our study did not detect statistically significant differences in the LBR for FBT performed within the first menstrual cycle after oocyte retrieval versus FBT following subsequent cycles. Embryo-endometrium interaction after a FBT does not appear to be impaired by potential adverse effects of COS whatever the number of cycle between oocyte retrieval and embryo transfer.
“冻存所有”策略是指在过去十年中,对卵巢刺激后广泛发育的所有胚胎进行冷冻保存。目前还不确定卵巢刺激后子宫内膜恢复到刺激前状态所需的时间,以及刺激后进行延迟胚胎移植的最佳时间。
研究卵母细胞采集后至冷冻-解冻囊胚移植(FBT)的时间对“冻存所有”周期活产率(LBR)、产科和新生儿结局的影响。
我们在一家三级保健大学医院进行了一项大型观察性队列研究,纳入了 474 例在“冻存所有”周期中进行的首次自体 FBT。比较了卵母细胞采集后第一个月经周期内进行的 FBT(“周期 1”组)或延迟 FBT(“周期≥2”组)的生殖结局。主要观察指标是活产率。
共有 188 例 FBT 纳入“周期 1”组分析,286 例纳入“周期≥2”组分析。在活产率方面,卵母细胞采集后第一个月经周期内进行的 FBT(“周期 1”组)与延迟 FBT(“周期≥2”组)之间无显著差异[59/188(31.38%)vs. 85/286(29.72%);p=0.696],流产率也无显著差异[20/82(24.39%)vs. 37/125(29.60%);p=0.413]。两组的产科和新生儿结局也无显著差异。
本研究未发现卵母细胞采集后第一个月经周期内进行的 FBT 与随后周期进行的 FBT 的活产率有统计学差异。无论卵母细胞采集和胚胎移植之间的周期数如何,FBT 后胚胎-子宫内膜的相互作用似乎不会因 COS 的潜在不良影响而受损。