title: Freeze-all can be a superior therapy to another fresh cycle in patients with prior fresh blastocyst implantation failure.
abstract: Implantation failure has various causes, including impaired uterine receptivity following ovarian stimulation. This retrospective cohort study compared outcomes in patients with prior implantation failure who elected to undergo another fresh cycle versus those who opted for embryo cohort cryopreservation (freeze-all) and subsequent thaw. There were 269 patients with implantation failure following fresh autologous blastocyst transfer opting to undergo a subsequent cycle, with 163 choosing another fresh cycle and 106 electing freeze-all and subsequent thaw. Multiple logistic regression analysis indicated that cohort cryopreservation was associated with greater chance of live birth when compared with another fresh cycle (P < 0.0001). The odds ratio for live birth with freeze-all relative to a fresh cycle was 3.8 (95% CI 2.1-7.2). A second analysis was then performed using cumulative live birth rate as the outcome measure. Multiple logistic regression indicated freeze-all was associated with greater cumulative live birth rate than was a fresh cycle (OR 1.9, 95% CI 1.1-3.3, P = 0.0287). These findings suggest that, following implantation failure with fresh blastocysts, patients have a significantly greater chance of live birth with freeze-all and subsequent thaw than with another fresh cycle.
authors.affiliation: Fertility Center of Las Vegas, Las Vegas, NV, USA; Department of Obstetrics and Gynecology, School of Medicine, University of Nevada, Las Vegas, NV, USA. Electronic address: bsshapiro@aol.com.
authors.forename: Bruce S
authors.initials: BS
authors.lastname: Shapiro
authors.affiliation: Fertility Center of Las Vegas, Las Vegas, NV, USA; Department of Obstetrics and Gynecology, School of Medicine, University of Nevada, Las Vegas, NV, USA.
authors.forename: Said T
authors.initials: ST
authors.lastname: Daneshmand
authors.affiliation: Fertility Center of Las Vegas, Las Vegas, NV, USA; Department of Obstetrics and Gynecology, School of Medicine, University of Nevada, Las Vegas, NV, USA.
authors.forename: Forest C
authors.initials: FC
authors.lastname: Garner
authors.affiliation: Fertility Center of Las Vegas, Las Vegas, NV, USA.
authors.forename: Martha
authors.initials: M
authors.lastname: Aguirre
authors.affiliation: Fertility Center of Las Vegas, Las Vegas, NV, USA.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Hudson
mesh_terms: D000328:Adult; D015925:Cryopreservation; D010064:Embryo Implantation; D004624:Embryo Transfer / Q000379:methods*; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D011247:Pregnancy; D018873:Pregnancy Rate; D012189:Retrospective Studies; D055815:Young Adult
keywords: IVF; embryo cryopreservation; endometrial receptivity; implantation failure; ovarian stimulation