Katie White, Jessica Cheung, Prachi Godiwala, Reeva Makhijani, Allison Bartolucci, Claudio Benadiva, Lawrence Engmann, Daniel Grow
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引用次数: 0
Abstract
Purpose: Optimal endometrial preparation is essential for the transfer of a euploid embryo. Recent works have shown advantages of ovulatory cycle frozen-thawed embryo transfer (Ovu-FET) for simplicity, implantation rate, and reduction of hypertensive disorders of pregnancy; however, few women over age 40 years were included in these studies. This study compared pregnancy outcomes in patients aged 40-45 years between Ovu-FET and programmed cycle FET (PC-FET).
Methods: Retrospective cohort study in a university-affiliated fertility center. Two hundred eighty-seven FET cycles with euploid embryo transfer between 2015 and 2022 were included, with 116 cycles utilizing the PC-FET and 171 the Ovu-FET protocol. The use of letrozole was permitted for patients with irregular cycles. The primary outcome was ongoing pregnancy rate with secondary outcomes including pregnancy rate, clinical pregnancy rate, biochemical rate, and clinical loss rate. Multivariate regression was utilized to adjust for potential covariates.
Results: The ongoing pregnancy rates were similar between the Ovu-FET versus PC-FET groups (62.6% vs. 58.6%, P = 0.50). Pregnancy rates (77.2% vs. 82.8%, P = 0.25) and clinical pregnancy rates (69.5% vs. 68.1%, P = 0.79) were also similar. Clinical loss rates were similar between the two groups (7.0% vs. 9.5%, P = 0.41). Biochemical loss rates were slightly lower for the Ovu-FET versus PC-FET groups (7.6% vs. 14.7%, P = 0.06) without reaching statistical significance.
Conclusion: Our study supports the use of Ovu-FET in women aged 40 years and older undergoing euploid embryo transfers. The results should strengthen confidence in the use of Ovu-FET for older patients.
目的：最佳子宫内膜准备是整倍体胚胎移植的必要条件。最近的研究表明，排卵周期冷冻解冻胚胎移植（Ovu-FET）在操作简单、着床率高、减少妊娠高血压疾病等方面具有优势；然而，很少有40岁以上的女性被纳入这些研究。本研究比较了40-45岁患者的妊娠结局，分别采用卵形FET和程序周期FET （PC-FET）。方法：在某大学附属生育中心进行回顾性队列研究。在2015年至2022年期间，包括整倍体胚胎移植的287个FET周期，其中116个周期使用PC-FET， 171个使用Ovu-FET方案。月经周期不规律的患者允许使用来曲唑。主要转归为持续妊娠率，次要转归包括妊娠率、临床妊娠率、生化率和临床损失率。采用多元回归对潜在协变量进行校正。结果：Ovu-FET组与PC-FET组的持续妊娠率相似（62.6% vs. 58.6%, P = 0.50）。妊娠率（77.2% vs. 82.8%, P = 0.25）和临床妊娠率（69.5% vs. 68.1%, P = 0.79）也相似。两组的临床损失率相似（7.0% vs 9.5%, P = 0.41）。与PC-FET组相比，Ovu-FET组的生化损失率略低（7.6%比14.7%,P = 0.06），但没有达到统计学意义。结论：我们的研究支持在40岁及以上接受整倍体胚胎移植的女性中使用Ovu-FET。该结果应加强对老年患者使用Ovu-FET的信心。
期刊介绍：
The Journal of Assisted Reproduction and Genetics publishes cellular, molecular, genetic, and epigenetic discoveries advancing our understanding of the biology and underlying mechanisms from gametogenesis to offspring health. Special emphasis is placed on the practice and evolution of assisted reproduction technologies (ARTs) with reference to the diagnosis and management of diseases affecting fertility. Our goal is to educate our readership in the translation of basic and clinical discoveries made from human or relevant animal models to the safe and efficacious practice of human ARTs. The scientific rigor and ethical standards embraced by the JARG editorial team ensures a broad international base of expertise guiding the marriage of contemporary clinical research paradigms with basic science discovery. JARG publishes original papers, minireviews, case reports, and opinion pieces often combined into special topic issues that will educate clinicians and scientists with interests in the mechanisms of human development that bear on the treatment of infertility and emerging innovations in human ARTs. The guiding principles of male and female reproductive health impacting pre- and post-conceptional viability and developmental potential are emphasized within the purview of human reproductive health in current and future generations of our species.
The journal is published in cooperation with the American Society for Reproductive Medicine, an organization of more than 8,000 physicians, researchers, nurses, technicians and other professionals dedicated to advancing knowledge and expertise in reproductive biology.
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