Objective:To explore the effect of pregnancy outcome of the first in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) and embryo transfer cycle on the next frozen-thawed embryo transfer cycle. Methods:A retrospective cohort study was designed by collecting data from 6658 infertile patients in Department of Reproductive Endocrinology, Women's Hospital of Zhejiang University from January 2010 to December 2019. Two groups were included, the fresh embryo-frozen embryo group ( n=4310) and the frozen embryo-frozen embryo group ( n=2348), and each group was divided into four subgroups according to the pregnancy outcome of the first transfer cycle: non-pregnancy subgroup, biochemical pregnancy subgroup, pregnancy loss subgroup, and live birth subgroup. In each group, the live birth rate (LBR) of the second transfer cycle was compared among the four subgroups. Results:In the second transfer cycle of the fresh embryo-frozen embryo group, LBR in each subgroup was 31.3% (972/3109), 33.7% (92/273), 33.3% (169/507), and 39.2% (165/421), respectively. Compared with non-pregnancy subgroup, the difference of LBR in the live birth subgroup was statistically significant [after adjustment, a P<0.001, a OR(95% CI)=1.555(1.245-1.942)]. In the second transfer cycle of the frozen embryo-frozen embryo group, LBR in each subgroup was 37.3% (655/1754), 47.0% (79/168), 45.4% (122/269), and 44.6% (70/157), respectively. Compared with non-pregnancy subgroup, the differences of LBR in biochemical pregnancy subgroup, pregnancy loss subgroup and live birth subgroup were statistically significant [after adjustment, a P=0.018, a OR(95% CI)=1.471(1.069-2.026); a P=0.014, a OR(95% CI)=1.388 (1.069-1.802); a P=0.035, a OR(95% CI)=1.452(1.026-2.054)]. Conclusion:In the fresh embryo-frozen embryo group, live birth in the first transfer cycle is associated with increased LBR in the subsequent cycles, while in the frozen embryo-frozen embryo group, biochemical pregnancy, pregnancy loss, or live birth in the first transfer cycle are associated with increased LBR in the following cycles.

Objective:To explore the effect of pregnancy outcome of the first in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) and embryo transfer cycle on the next frozen-thawed embryo transfer cycle. Methods:A retrospective cohort study was designed by collecting data from 6658 infertile patients in Department of Reproductive Endocrinology, Women's Hospital of Zhejiang University from January 2010 to December 2019. Two groups were included, the fresh embryo-frozen embryo group ( n=4310) and the frozen embryo-frozen embryo group ( n=2348), and each group was divided into four subgroups according to the pregnancy outcome of the first transfer cycle: non-pregnancy subgroup, biochemical pregnancy subgroup, pregnancy loss subgroup, and live birth subgroup. In each group, the live birth rate (LBR) of the second transfer cycle was compared among the four subgroups. Results:In the second transfer cycle of the fresh embryo-frozen embryo group, LBR in each subgroup was 31.3% (972/3109), 33.7% (92/273), 33.3% (169/507), and 39.2% (165/421), respectively. Compared with non-pregnancy subgroup, the difference of LBR in the live birth subgroup was statistically significant [after adjustment, a P<0.001, a OR(95% CI)=1.555(1.245-1.942)]. In the second transfer cycle of the frozen embryo-frozen embryo group, LBR in each subgroup was 37.3% (655/1754), 47.0% (79/168), 45.4% (122/269), and 44.6% (70/157), respectively. Compared with non-pregnancy subgroup, the differences of LBR in biochemical pregnancy subgroup, pregnancy loss subgroup and live birth subgroup were statistically significant [after adjustment, a P=0.018, a OR(95% CI)=1.471(1.069-2.026); a P=0.014, a OR(95% CI)=1.388 (1.069-1.802); a P=0.035, a OR(95% CI)=1.452(1.026-2.054)]. Conclusion:In the fresh embryo-frozen embryo group, live birth in the first transfer cycle is associated with increased LBR in the subsequent cycles, while in the frozen embryo-frozen embryo group, biochemical pregnancy, pregnancy loss, or live birth in the first transfer cycle are associated with increased LBR in the following cycles.

fertilization and embryo transplantation (IVF-ET) technology is one of the main treatments for infertility. But IVF-ET is expensive and has not be covered by health insurance in most developing countries. Therefore, how to obtain the maximum success rate with the minimum cost is a common concern of clinicians and patients. At present, the economic studies on IVF-ET mainly focus on different ovulation stimulating drugs, different ovulation stimulating protocols, different transplantation methods and the number of transplants. But the process of IVF-ET is complex, the relevant methods of economic study are diverse, and there are no unified standard for outcome indicators, so there is no unified conclusion for more economical and effective protocol by now. Therefore, to analyze the economic studies of IVF-ET, and to explore appropriate evaluation methods and cost-effective protocols will be helpful for reasonable allocation of medical resources and guidance of clinical selection. It would provide policy reference to include the costs of IVF-ET treatment in health insurance in the future.
Economics, Medical ; trends ; Embryo Transfer ; economics ; statistics & numerical data ; Female ; Fertilization in Vitro ; economics ; statistics & numerical data ; Humans ; Infertility ; economics ; Insurance, Health ; economics ; statistics & numerical data ; Ovulation Induction