Maternal and perinatal outcomes in programmed versus natural vitrified–warmed blastocyst transfer cycles
| Autor: | Chantal Bartels, Alison Bartolucci, Claudio Benadiva, Lawrence Engmann, Daniel Grow, Reeva Makhijani, Prachi N. Godiwala, John Nulsen |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
0301 basic medicine medicine.medical_specialty Pregnancy Rate First line Natural cycle media_common.quotation_subject medicine.medical_treatment Fertility Fertilization in Vitro Andrology 03 medical and health sciences 0302 clinical medicine Pregnancy medicine Humans Retrospective Studies media_common Cryopreservation 030219 obstetrics & reproductive medicine In vitro fertilisation Obstetrics Singleton business.industry Blastocyst Transfer Infant Newborn Pregnancy Outcome Obstetrics and Gynecology Retrospective cohort study General Medicine Embryo Transfer Vitrification Embryo transfer Pregnancy Complications 030104 developmental biology Reproductive Medicine Female Live birth business Live Birth Developmental Biology |
| Zdroj: | Reproductive BioMedicine Online. 41:300-308 |
| ISSN: | 1472-6483 |
| DOI: | 10.1016/j.rbmo.2020.03.009 |
| Popis: | Do maternal and perinatal outcomes differ between natural and programmed frozen embryo transfer (FET) cycles?Retrospective cohort study at a university-affiliated fertility centre including 775 patients who underwent programmed or natural FET cycles resulting in a singleton live birth using blastocysts vitrified between 2013 and 2018.A total of 384 natural and 391 programmed FET singleton pregnancies were analysed. Programmed FET resulted in higher overall maternal complications (32.2% [126/391] versus 18.8% [72/384]; P0.01), including higher probability of hypertensive disorders of pregnancy (HDP) (15.3% [60/391] versus 6.3% [24/384]; P0.01), preterm premature rupture of membranes (2.6% [10/391] versus 0.3% [1/384]; P = 0.02) and caesarean delivery (53.2% [206/387] versus 42.8% [163/381]; P = 0.03) compared with natural FET. After controlling for potential confounders, including age, body mass index, parity, smoking status, history of diabetes or chronic hypertension, infertility diagnosis, number of embryos transferred and use of preimplantation genetic testing, the adjusted odds ratio for HDP was 2.39 (95% CI 1.37 to 4.17) and for overall maternal complications was 2.21 (95% CI 1.51 to 3.22) comparing programmed with natural FET groups. The groups did not significantly differ for any perinatal outcomes analysed, including birth weight (3357.9 ± 671.6 g versus 3318.4 ± 616.2 g; P = 0.40) or rate of birth defects (1.5% [6/391] versus 2.1% [8/384]; P = 0.57), respectively.Vitrified-warmed blastocyst transfer in a programmed cycle resulted in a twofold higher probability of HDP compared with transfer in a natural cycle. Natural FET cycle should, therefore, be recommended as first line for all eligible patients undergoing FET to reduce the risk of HDP. |
| Databáze: | OpenAIRE |
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