1 Faculté de Médecine, Département de gynécologie, obstétrique II et médecine de la reproduction, Assistance Publique-Hôpitaux de Paris (AP-HP), Centre Hospitalier Universitaire (CHU) Cochin, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.
2 Institut Cochin, INSERM U1016, Laboratoire d'immunologie, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.
Reprod Sci. 2019 Sep;26(9):1210-1217. doi: 10.1177/1933719118811648. Epub 2018 Nov 20.
The aim of this study was to assess whether a deferred frozen-thawed embryo transfer (Def-ET) offers any benefits compared to a fresh ET strategy in women who have had 2 or more consecutive in vitro fertilization (IVF)/intracytoplasmic injection (ICSI) cycle failures.
An observational cohort study in a tertiary referral care center including 416 cycles from women with a previous history of 2 or more consecutive IVF/ICSI failures cycles. Both Def-ET and fresh ET strategies were compared using univariate and multivariate logistic regression models. The main outcome measured was the cumulative live birth rate (CLBR).
A total of 416 cycles were included in the analysis: 197 in the fresh ET group and 219 in the Def-ET group. The CLBR was not significantly different between the fresh and Def-ET groups (58/197 [29.4%] and 57/219 [26.0%], respectively, = .437). In addition, after the first ET, there was no significant difference in the live birth rate between the fresh ET and Def-ET groups (50/197 [25.4%] vs 44/219 [20.1%], respectively). Multivariate logistic regression analysis indicated that compared to the fresh strategy, the Def-ET strategy was not associated with a higher probability of live birth.
In cases with 2 or more consecutive prior IVF/ICSI cycle failures, a Def-ET strategy did not result in better ART outcomes than a fresh ET strategy.
本研究旨在评估对于曾经历过 2 次或以上连续体外受精（IVF）/卵胞浆内单精子注射（ICSI）周期失败的女性，延迟冷冻胚胎移植（Def-ET）是否优于新鲜胚胎移植（ET）策略。
这是一项在三级转诊中心进行的观察性队列研究，共纳入了 416 个周期，这些周期来自曾经历过 2 次或以上连续 IVF/ICSI 周期失败的女性。采用单变量和多变量逻辑回归模型比较 Def-ET 和新鲜 ET 策略。主要观察指标为累积活产率（CLBR）。
共纳入 416 个周期进行分析：新鲜 ET 组 197 个周期，Def-ET 组 219 个周期。新鲜 ET 组和 Def-ET 组的 CLBR 无显著差异（分别为 58/197[29.4%]和 57/219[26.0%]， =.437）。此外，首次 ET 后，新鲜 ET 组和 Def-ET 组的活产率无显著差异（分别为 50/197[25.4%]和 44/219[20.1%]）。多变量逻辑回归分析表明，与新鲜策略相比，Def-ET 策略与更高的活产率无关。
对于曾经历过 2 次或以上连续 IVF/ICSI 周期失败的患者，Def-ET 策略并不优于新鲜 ET 策略，无法获得更好的辅助生殖技术结局。
