Pregnancy and Perinatal Outcomes After Fresh Versus Frozen Embryo Transfer Cycles in Women of Advanced Age
10.13471/j.cnki.j.sun.yat-sen.univ（med.sci）.2022.0514
- VernacularTitle:高龄女性新鲜与冷冻胚胎移植后妊娠及围产结局
- Author:
Hui-tian WANG
1
;
Xiao-xia ZHANG
1
;
Jie-ru ZHU
1
;
Tao LI
1
Author Information
1. Center for Reproductive Medicine，The Third Affiliated Hospital of Sun Yat-sen University，Guangzhou 510630，China
- Publication Type:Journal Article
- Keywords:
advanced age;
embryo transfer;
pregnancy outcome;
perinatal outcomes;
pregnancy complication
- From:
Journal of Sun Yat-sen University(Medical Sciences)
2022;43(5):795-806
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveThe objective of the present study was to compare the pregnancy and perinatal outcomes in women of advanced age between autologous fresh ET and FET cycles. MethodsA retrospective cohort study was conducted， which included 1 622 transfer cycles of 1 622 patients with ≥35 years of age. Patients who received their first embryo transfer cycle （IVF/ICSI treatment） between October 2015 and May 2020 in the center of reproductive medicine of the Third Affiliated Hospital of Sun Yat-sen University were included. Among them， 903 patients had 903 fresh ET cycles， and 719 freeze-all patients received 719 FET cycles. The baseline characteristics， pregnancy outcomes， complication rates， and perinatal outcomes were compared between the two groups. Logistic regression was performed to adjusted for confounding factors. ResultsWomen with advanced age and fresh embryo transfer had significantly higher clinical pregnancy rate ［40.2% vs. 36.6%，OR 95%CI：1.66 （1.323，2.078），P＜0.001］， live birth rate ［29.7% vs. 23.8%，OR 95%CI：1.93 （1.505，2.484），P＜0.001］， and multiple pregnancy rate ［25.1% vs. 12.2%，OR 95%CI：1.89 （1.114，3.190），P＝0.018］ than those with FET cycles. Fresh embryo transfer had significantly decreased miscarriage rate ［25.1% vs. 33.5%，OR 95%CI：0.53 （0.356，0.794），P＝0.002］， Caesarean delivery rate ［70.5% vs. 76.6%，OR 95%CI：0.60 （0.362，0.987），P＝0.044］， and hypertensive disorders of pregnancy ［2.2% vs. 4.6%，OR 95%CI：0.35 （0.128，0.947），P＝0.039］ than those of FET group. There were no significant differences in the rate of ectopic pregnancy， preterm delivery rate， gestational diabetes mellitus. and preterm premature rupture between the two groups （P＞0.05）. FET group had significantly higher mean new born birth weight ［（3 133 ± 612） g vs. （2 977 ± 609） g，P=0.006］. Further age-stratified analysis showed that the clinical pregnancy rate of fresh transfer was significantly higher than that of frozen embryo transfer in patients aged 35-37 years ［47.8% vs. 45.4%，OR 95%CI：1.68 （1.176，2.391），P =0.004］. The live birth rate of fresh embryo transfer in patients aged 35-37 years and 38-39 years was higher than that of frozen embryo transfer ［39.3% vs. 32.9%，OR 95%CI： 1.79 （1.239，2.581），P =0.002］， ［35.5% vs. 30.4%，OR 95%CI： 1.70 （1.023，2.809），P =0.040］ . ConclusionsPatients with advanced age obtain better pregnancy and neonatal outcomes by fresh embryo transfer than by frozen embryo transfer. Patients without contraindications should preferentially choose fresh embryo transfer to improve their pregnancy outcome， reduce the waiting time for embryo transfer， and to avoid the adverse outcomes which increase over time with advanced age.
