Risk of placenta accreta spectrum in fresh versus natural, stimulated and programmed cycle frozen-thawed embryo transfer

IF 3.5 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Reproductive biomedicine online Pub Date : 2026-05-01 Epub Date: 2025-11-15 DOI:10.1016/j.rbmo.2025.105410

Tomoyuki Fujita , Toshiyuki Yoshizato , Kenta Murotani , Hitoshi Obara , Naotake Tsuda

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Abstract

Research question: How does the risk of placenta accreta spectrum (PAS) in pregnancies from natural cycle (NC-FET), stimulated cycle (SC-FET) and programmed cycle (PC-FET) frozen-thawed embryo transfers compare with that in fresh embryo transfer?

Design: A total of 174,591 embryo transfer cycles resulting in singleton live births were obtained from the Japanese assisted reproductive technology (ART) registry from 2017 to 2020. A multivariate logistic regression model compared the risk of PAS across different embryo transfer methods. Adjusted factors were maternal age at embryo transfer, indication for ART, number and stage of embryos transferred, use of assisted hatching, presence of placenta praevia and mode of delivery.

Results: The incidence of PAS was 0.16% (39/23,827), 0.17% (66/37,787), 0.14% (11/8,143) and 1.48% (1,549/104,834) for fresh embryo transfer, NC-FET, SC-FET and PC-FET, respectively. PC-FET carried a higher risk of PAS versus fresh embryo transfer (adjusted odds ratio [aOR] 9.12, 95% confidence interval [CI] 6.54–12.73), whereas there was no significantly increased risk with NC-FET and SC-FET. Subgroup analyses revealed that, for single cleavage-stage embryo transfer, PC-FET was associated with a higher risk of PAS versus fresh embryo transfer (aOR 11.19, 95% CI 6.55–19.11). NC-FET and SC-FET showed no significantly increased risk. For single-blastocyst transfer, PC-FET carried a higher risk of PAS versus fresh embryo transfer (aOR 5.44, 95% CI 3.26–9.09), whereas NC-FET and SC-FET had a similar risk to fresh embryo transfer.

Conclusions: PC-FET carried a higher risk of PAS than fresh embryo transfer, while NC-FET and SC-FET did not. When planning embryo transfer reproductive physicians should recognize that PC-FET is a potential risk factor for PAS.

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新鲜与自然、刺激和程序化周期冻融胚胎移植中胎盘增生谱的风险。

研究问题：自然周期（NC-FET）、刺激周期（SC-FET）和程序化周期（PC-FET）冷冻解冻胚胎移植与新鲜胚胎移植中妊娠胎盘增生谱（PAS）的风险如何比较？设计：从2017年至2020年，从日本辅助生殖技术（ART）登记处共获得174,591个导致单胎活产的胚胎移植周期。一个多变量逻辑回归模型比较了不同胚胎移植方法中PAS的风险。调整后的因素为胚胎移植时母亲的年龄、ART的适应证、移植胚胎的数量和阶段、辅助孵化的使用、是否存在前置胎盘和分娩方式。结果：新鲜胚胎移植、NC-FET、SC-FET和PC-FET的PAS发生率分别为0.16%（39/23,827）、0.17%（66/37,787）、0.14%（11/8,143）和1.48%（1,549/104,834）。与新鲜胚胎移植相比，PC-FET发生PAS的风险更高（调整优势比[aOR] 9.12, 95%可信区间[CI] 6.54-12.73），而NC-FET和SC-FET的风险没有显著增加。亚组分析显示，对于单卵裂期胚胎移植，PC-FET与新鲜胚胎移植相比，PAS的风险更高（aOR 11.19, 95% CI 6.55-19.11）。NC-FET和SC-FET的风险没有明显增加。对于单个囊胚移植，PC-FET比新鲜胚胎移植具有更高的PAS风险（aOR 5.44, 95% CI 3.26-9.09），而NC-FET和SC-FET与新鲜胚胎移植具有相似的风险。结论：PC-FET比新鲜胚胎移植有更高的PAS风险，而NC-FET和SC-FET没有。当计划胚胎移植时，生殖医生应该认识到PC-FET是PAS的潜在危险因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Reproductive biomedicine online 医学-妇产科学

CiteScore

7.20

自引率

7.50%

发文量

391

审稿时长

50 days

期刊介绍： Reproductive BioMedicine Online covers the formation, growth and differentiation of the human embryo. It is intended to bring to public attention new research on biological and clinical research on human reproduction and the human embryo including relevant studies on animals. It is published by a group of scientists and clinicians working in these fields of study. Its audience comprises researchers, clinicians, practitioners, academics and patients. Context: The period of human embryonic growth covered is between the formation of the primordial germ cells in the fetus until mid-pregnancy. High quality research on lower animals is included if it helps to clarify the human situation. Studies progressing to birth and later are published if they have a direct bearing on events in the earlier stages of pregnancy.