經PGD確認染色體正常之囊胚全冷凍再解凍植入活產率較新鮮植入高(77 vs 59%)

Fertil Steril. 2017 Jan 27. pii: S0015-0282(16)63094-7. doi: 10.1016/j.fertnstert.2016.12.022. [Epub ahead of print]

Optimal euploid embryo transfer strategy, fresh versus frozen, after preimplantation genetic screening with next generation sequencing: a randomized controlled trial.

Coates A1, Kung A2, Mounts E3, Hesla J3, Bankowski B3, Barbieri E3, Ata B4, Cohen J5, Munné S5.

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Abstract

OBJECTIVE:

To compare two commonly used protocols (fresh vs. vitrified) used to transfer euploid blastocysts after IVF with preimplantation genetic screening.

DESIGN:

Randomized controlled trial.

SETTING:

Private assisted reproduction center.

PATIENT(S):

A total of 179 patients undergoing IVF treatment using preimplantation genetic screening.

INTERVENTION(S):

Patients were randomized at the time of hCG administration to either a freeze-all cycle or a fresh day 6 ET during the stimulated cycle.

MAIN OUTCOME MEASURE(S):

Implantation rates (sac/embryo transferred), ongoing pregnancy rates (PRs) (beyond 8 weeks), and live birth rate per ET in the primary transfer cycle.

RESULT(S):

Implantation rate per embryo transferred showed an improvement in the frozen group compared with the fresh group, but not significantly (75% vs. 67%). The ongoing PR (80% vs. 61%) and live birth rates (77% vs. 59%) were significantly higher in the frozen group compared with the fresh group.

CONCLUSION(S):

Either treatment protocol investigated in the present study can be a reasonable option for patients. Freezing all embryos allows for inclusion of all blastocysts in the cohort of embryos available for transfer, which also results in a higher proportion of patients reaching ET. These findings suggest a trend toward favoring the freeze-all option as a preferred transfer strategy when using known euploid embryos.