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• W1978256552 abstract "BACKGROUND: Two reasons for cryopreserving all embryos during in vitro fertilization (IVF) and deferring fresh embryo transfer (ET) is either the risk of ovarian hyperstimulation syndrome (OHSS) or inadequate endometrial thickness at time of peak follicular maturation. Some studies suggest that the frozen/thawed embryos derived from women who hyperstimulate produce normal pregnancy rates and others suggest an inferior pregnancy rate. Though using a graduated oral/vaginal estrogen regimen may increase the endometrial thickness, sometimes it does not and the embryo transfer occurs despite inferior endometrial thickness. Lower pregnancy rates are found with thin endometria in the late proliverative phase.OBJECTIVE(S): To evaluate the efficacy of a modified slow cool embryo freezing technique and at the same time evaluate the effect of deferring fresh embryo transfer (ET) and cryopreserving all embryos because of risk of OHSS vs. cryopreservation for inadequate endometrial thickness.MATERIALS AND METHOD(S): A modified slow cool cryopreservation technique was evaluated in which the programmable freezer was replaced by a rate controlled alcohol bath freezer. A simplified thawing procedure removed the cryoprotectant, 1,2 propanediol, in one step. Deferring fresh ET was for a serum estradiol >5000 pg/mL or >25 follicles of ≥12mm or endometrial thickness of ≤7mm, on the day of human chorionic gonadotropin. Women with endometrial synechiae were excluded.Tabled 1Deferred for OHSSDeferred for Poor LiningAge≤3536-39≤3536-39# transfers7461475235% pregnant/transfer (chemical)50.936.140.434.3% clinical/trans (ultrasound at 8 weeks)44.932.728.828.6% viable/transfer (12 weeks)40.829.325.025.7% delivered38.227.221.222.9Avg. # embryos transferred3.13.72.93.5Implantation rate (%)22.213.515.19.0 Open table in a new tab For women ≤39 the clinical pregnancy rate (PR) following frozen ET for those deferring for OHSS was 42.8% (389/893) vs. 28.7% (25/87) (p=0.01) for thin endometria. For inadequate endometrial thickness the live delivered PRs were 31.9% (285/893) vs. 21.8% (19/87) (p=0.07, chi-square analysis).CONCLUSION(S): The lower PR for those deferring fresh transfer for thin endometria vs. those deferring for risk of OHSS can be partially explained by still failing to attain adequate endometrial thickness despite a graduated estrogen regimen suggesting an important role for an unidentified endometrial factor.SUPPORT: None. BACKGROUND: Two reasons for cryopreserving all embryos during in vitro fertilization (IVF) and deferring fresh embryo transfer (ET) is either the risk of ovarian hyperstimulation syndrome (OHSS) or inadequate endometrial thickness at time of peak follicular maturation. Some studies suggest that the frozen/thawed embryos derived from women who hyperstimulate produce normal pregnancy rates and others suggest an inferior pregnancy rate. Though using a graduated oral/vaginal estrogen regimen may increase the endometrial thickness, sometimes it does not and the embryo transfer occurs despite inferior endometrial thickness. Lower pregnancy rates are found with thin endometria in the late proliverative phase. OBJECTIVE(S): To evaluate the efficacy of a modified slow cool embryo freezing technique and at the same time evaluate the effect of deferring fresh embryo transfer (ET) and cryopreserving all embryos because of risk of OHSS vs. cryopreservation for inadequate endometrial thickness. MATERIALS AND METHOD(S): A modified slow cool cryopreservation technique was evaluated in which the programmable freezer was replaced by a rate controlled alcohol bath freezer. A simplified thawing procedure removed the cryoprotectant, 1,2 propanediol, in one step. Deferring fresh ET was for a serum estradiol >5000 pg/mL or >25 follicles of ≥12mm or endometrial thickness of ≤7mm, on the day of human chorionic gonadotropin. Women with endometrial synechiae were excluded. For women ≤39 the clinical pregnancy rate (PR) following frozen ET for those deferring for OHSS was 42.8% (389/893) vs. 28.7% (25/87) (p=0.01) for thin endometria. For inadequate endometrial thickness the live delivered PRs were 31.9% (285/893) vs. 21.8% (19/87) (p=0.07, chi-square analysis). CONCLUSION(S): The lower PR for those deferring fresh transfer for thin endometria vs. those deferring for risk of OHSS can be partially explained by still failing to attain adequate endometrial thickness despite a graduated estrogen regimen suggesting an important role for an unidentified endometrial factor. SUPPORT: None." @default.
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• W1978256552 date "2011-03-01" @default.
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• W1978256552 title "A Comparison of Pregnancy Rates Following Frozen Embryo Transfer According to the Reason for Freezing: Risk of Ovarian Hyperstimulation vs. Inadequate Endometrial Thickness" @default.
• W1978256552 doi "https://doi.org/10.1016/j.fertnstert.2011.01.113" @default.
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