Objective: The purpose of this study was to compare fresh and frozen-thawed euploid blastocyst transfer protocols following preimplantation genetic screening (PGS) in cases of advanced maternal age. Methods: A total of 330 patients were examined retrospectively. PGS was performed on the embryos of 146 patients for whom fresh transfers were chosen. In contrast, frozen-thawed euploid single embryo transfer (ET) was selected after PGS for 184 patients, and their embryos were vitrified. The percentage of euploid embryos and rates of implantation, pregnancy, and pregnancy continuity, as well as clinical and biochemical abortion rates, were compared. Results: The numbers of retrieved oocytes, metaphase II oocytes, and fertilized ova were greater in the frozen-thawed group. The percentages of euploid embryos were comparable between the fresh and frozen-thawed groups (32% vs. 34.8%, respectively). The rates of implantation (46.6%vs. 62.5%), pregnancy (50% vs. 66.8%), ongoing pregnancy (38.4% vs. 53.8%), and live birth percentage (37.0% vs. 53.8%) were significantly higher in the frozen-thawed group. However, no significant differences were found in the clinical and biochemical abortion rates. Conclusion The use of frozen-thawed single euploid ET is associated with increased implantation and pregnancy rates compared to fresh single euploid ET with PGS.

INTRODUCTION: We investigated the awareness of palliative care (PC) services in advanced cancer patients and their family caregivers and whether negative perceptions was a possible barrier to PC utilisation in Singapore. MATERIALS AND METHODS: Patients with stage 4 solid cancer and their caregivers were interviewed between July 2016 and March 2018 at outpatient clinics located in the medical oncology departments of 2 major public hospitals in Singapore. Patients and caregivers were asked whether they were aware of PC services, how they first learned about them, who first recommended PC to the patient, whether the patient had received PC, and reasons for not receiving PC. RESULTS: Awareness of PC was lower in patients compared to caregivers (43% vs 53%; <0.01). The odds of being aware in patients was higher if they had higher education (odds ratio [OR] = 2.927; <0.001) and higher income (OR = 1.798; = 0.005). Compared to patients, more caregivers reported that a healthcare provider recommended PC to the patient (10% vs 20%; <0.012). Furthermore, 7% of patients and 15% of caregivers reported that the patient received PC ( = 0.031). The most common reasons for not receiving PC reported by patients and caregivers (respectively) were that the patient was still receiving treatment (68% and 78%), it is not time for PC (76% and 59%) and PC would not be of help (18% and 19%). CONCLUSION Less than half of patients indicated an awareness of PC. Our findings suggest that efforts should be made to increase awareness of PC and promote its acceptance in cancer patients and their family caregivers in Singapore.