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• W2509130300 abstract "Single thawed euploid embryo transfer (STEET) decreases the risk of maternal and neonatal morbidity associated with multiple gestation. [1] If transfer of a euploid embryo fails to progress to a clinical pregnancy, we sought to determine if there are identifiable risk factors for a failed second STEET. Retrospective case-control. All single thawed transfers of embryos designated as euploid by Next Generation Sequencing (NGS) were identified between April 2015 and February 2016 (n=263 transfers, 232 patients). Only patients with a first failed STEET and a subsequent second attempt at elective STEET were included (n=25 patients). Cycle characteristics were compared between those with and without a successful second transfer. Analyses were performed using t-tests and chi square analyses. Clinical pregnancy (fetal heart rate) after NGS diagnosis with STEET is 62.3% in our patient population. After one failed STEET, clinical pregnancy occurred in 56% of patients in the second STEET cycle (p=0.54). Endometrial thickness was significantly increased in patients that achieved clinical pregnancy on the second transfer as compared to those that did not (p=0.01). A lower average age at transfer and higher number of euploid blastocysts remaining was seen in the group achieving pregnancy, but statistical significance was not reached (Table 1).Tabled 1Patients with a second STEET after one failed STEET with diagnosis via NGS from 4/2015 to 2/2016.No Clinical Pregnancy with Second STEET (n=11 patients)Achieved Clinical Pregnancy with Second STEET (n=14 patients)p valueMaternal age at transfer (years)39.2 (+5.1)37.0 (+3.9)0.09Age at vitrification (years)33.1 (+5.0)36.1 (+4.4)0.03Number of days post-retrieval (n)80.7 (+52.8)86.0 (+49.3)0.71Number of euploid blastocysts remaining (n)1.5 (+1.1)2.2 (+1.5)0.07Endometrial echo on cycleday 14 (cm)7.5 (+0.9)8.5 (+1.4)0.01Progesterone level on day of transfer (ng/ml)17.1 (+6.5)18.0 (+5.9)0.87Estradiol level on day of transfer (pg/ml)622.1 (+539.1)492.9 (+573.6)0.43Most common embryo quality (%)3-5Bb (59.1%)3-5 Bb (60.7%)0.91Description of embryo as “fully expanded” on day of transfer (%)31.8%50%0.12 Open table in a new tab Lower pregnancy rates might be expected after an initial failed transfer cycle, as the number of good quality blastocysts available is reduced. However, clinical pregnancy rate with a second STEET following an initial failed cycle was similar to the pregnancy rate seen for all first transfers in our population, providing hope for couples. A thicker endometrial echo and younger maternal age at transfer were associated with increased ability to achieve clinical pregnancy in a second STEET after previous failure, indicating a possible underlying uterine or embryologic factor. Further research is needed to identify other potential contributions to pregnancy failure with STEET in order to increase utilization of single embryo transfer." @default.
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• W2509130300 date "2016-09-01" @default.
• W2509130300 modified "2023-10-14" @default.
• W2509130300 title "Why does a euploid embryo fail to implant? lessons from patients who get a second transfer" @default.
• W2509130300 doi "https://doi.org/10.1016/j.fertnstert.2016.07.594" @default.
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