Freeze-all policy: fresh vs. frozen-thawed embryo transfer.
OBJECTIVE
To compare in vitro fertilization (IVF) outcomes between fresh embryo transfer (ET) and frozen-thawed ET (the "freeze-all" policy), with fresh ET performed only in cases without progesterone (P) elevation.


METHODS
Prospective, observational, cohort study.


METHODS
Private IVF center.


METHODS
A total of 530 patients submitted to controlled ovarian stimulation (COS) with a gonadotropin-releasing hormone-antagonist protocol, and cleavage-stage, day-3 ET.


METHODS
None.


METHODS
Ongoing pregnancy rates.


RESULTS
A total of 530 cycles were included in the analysis: 351 in the fresh ET group (when P levels were ≤1.5 ng/mL on the trigger day); and 179 cycles in the freeze-all group (ET performed after endometrial priming with estradiol valerate, at 6 mg/d, taken orally). For the fresh ET group vs. the freeze-all group, respectively, the implantation rate was 19.9% and 26.5%; clinical pregnancy rate was 35.9% and 46.4%; and ongoing pregnancy rate was 31.1% and 39.7%.


CONCLUSIONS
The IVF outcomes were significantly better in the group using the freeze-all policy, compared with the group using fresh ET. These results suggest that even in a select group of patients that underwent fresh ET (P levels ≤1.5 ng/mL), endometrial receptivity may have been impaired by COS, and outcomes may be improved by using the freeze-all policy.
ORIGEN, Center for Reproductive Medicine, Rio de Janeiro, Brazil. Electronic address: matheusroque@hotmail.com.
Matheus
M
Roque
ORIGEN, Center for Reproductive Medicine, Rio de Janeiro, Brazil.
Marcello
M
Valle
ORIGEN, Center for Reproductive Medicine, Rio de Janeiro, Brazil.
Fernando
F
Guimarães
ORIGEN, Center for Reproductive Medicine, Belo Horizonte, Brazil.
Marcos
M
Sampaio
ORIGEN, Center for Reproductive Medicine, Belo Horizonte, Brazil; Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
Selmo
S
Geber
D000328:Adult; D015925:Cryopreservation; D010064:Embryo Implantation; D004624:Embryo Transfer; D005260:Female; D005300:Fertility Agents, Female / Q000008:administration & dosage; D005307:Fertilization in Vitro; D006801:Humans; D010062:Ovulation Induction; D011247:Pregnancy; D018873:Pregnancy Rate; D011446:Prospective Studies; D016896:Treatment Outcome
D005300:Fertility Agents, Female
Freeze-all; delayed frozen-thawed embryo transfer; embryo cryopreservation; frozen-thawed embryo transfer