Frozen thawed day 5 blastocyst transfer is associated with a lower risk of ectopic pregnancy than day 3 transfer and fresh transfer

Capsule:
Frozen-thawed day 5 blastocyst transfer is associated with a lower ectopic pregnancy rate than frozen- thawed day 3 transfer and fresh transfer in patients undergoing IVF-ET.

Authors:
Cong Fang, Ph.D., Rui Huang, Ph.D., Li-Na Wei, Ph.D., Lei Jia, M.M.

Volume 103, Issue 3, Pages 655-661

Abstract:

Objective:
To determine the ectopic pregnancy rate with fresh versus frozen-thawed embryo transfers, and factors associated with ectopic pregnancy in patients undergoing IVF-ET.

Design:
Retrospective analysis.

Setting:
Institutional IVF center.

Patient(s):
A total of 3,183 patients who received 3,340 blastocysts transfers: 1,994 fresh transfers and 1,346 frozen-thawed transfers.

Intervention(s):
Patients received fresh day 3 embryos (F-D3 group), fresh day 5 blastocysts (F-D5 group), frozen-thawed day 3 embryos (T-D3 group), or frozen-thawed day 5 or 6 blastocysts (T-D5 and T-D6 groups).

Main Outcome Measure(s):
Ectopic pregnancy rate.

Result(s):
The ectopic pregnant rates were 2.4% in the F-D3 group, 1.7% in F-D5, 1.9% in T-D3, 0.3% in T-D5, and 0.5% in T-D6. The ectopic pregnant rate of the T-D3 group was significantly greater than that of the T-D5 and T-D6 groups (1.9% vs. 0.3% and 0.5%). The ectopic pregnancy rate of the F-D5 group was significantly greater than that of the T-D5 group (1.7% vs. 0.3%).

Conclusion(s):
Frozen-thawed day 5 blastocyst transfer is associated with a lower ectopic pregnancy rate than frozen-thawed day 3 transfer and fresh transfer in patients undergoing IVF-ET.

  • Amanda N. Kallen

    Thanks to the authors for this study! My main question concerned the use of natural cycle FET and the generalizability of these results to all FET cycles. The authors postulate in their discussion that high E2 states might affect endometrial receptivity and interfere with embryo movement and potentially lead to ectopic pregnancy. Would they then postulate that the same study done with FET cycles primed with exogenous E+P (rather than natural cycle FET) might produce different results? Thanks again and look forward to hearing your thoughts.

  • Jason M. Franasiak

    Thank you for this interesting article. I particularly appreciate the way ectopic pregnancy was defined in a definitive and conservative fashion.

    Given the high rates of pelvic and fallopian-tube factors for infertility, were there any differences amongst groups in terms of prior ectopic pregnancies?

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