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PLoS One. 2018 Apr 9;13(4):e0194800. doi: 10.1371/journal.pone.0194800. eCollection 2018.

The deferred embryo transfer strategy improves cumulative pregnancy rates in endometriosis-related infertility: A retrospective matched cohort study.

Author information

1
Department of Gynecology Obstetrics II and Reproductive Medicine, Centre Hospitalier Universitaire (CHU) Cochin, Paris, France.
2
Department "Stress oxydant, prolifération cellulaire et inflammation", Institut Cochin, INSERM U1016, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.
3
Department "Development, Reproduction and Cancer", Institut Cochin, INSERM U1016, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.
4
Department of Histology-Embryology and Reproductive Biology, Centre Hospitalier Universitaire (CHU) Cochin, Paris, France.

Abstract

BACKGROUND:

Controlled ovarian stimulation in assisted reproduction technology (ART) may alters endometrial receptivity by an advancement of endometrial development. Recently, technical improvements in vitrification make deferred frozen-thawed embryo transfer (Def-ET) a feasible alternative to fresh embryo transfer (ET). In endometriosis-related infertility the eutopic endometrium is abnormal and its functional alterations are seen as likely to alter the quality of endometrial receptivity. One question in the endometriosis ART-management is to know whether Def-ET could restore optimal receptivity in endometriosis-affected women leading to increase in pregnancy rates.

OBJECTIVE:

To compare cumulative ART-outcomes between fresh versus Def-ET in endometriosis-infertile women.

MATERIALS AND METHODS:

This matched cohort study compared def-ET strategy to fresh ET strategy between 01/10/2012 and 31/12/2014. One hundred and thirty-five endometriosis-affected women with a scheduled def-ET cycle and 424 endometriosis-affected women with a scheduled fresh ET cycle were eligible for matching. Matching criteria were: age, number of prior ART cycles, and endometriosis phenotype. Statistical analyses were conducted using univariable and multivariable logistic regression models.

RESULTS:

135 in the fresh ET group and 135 in the def-ET group were included in the analysis. The cumulative clinical pregnancy rate was significantly increased in the def-ET group compared to the fresh ET group [58 (43%) vs. 40 (29.6%), p = 0.047]. The cumulative ongoing pregnancy rate was 34.8% (n = 47) and 17.8% (n = 24) respectively in the Def-ET and the fresh-ET groups (p = 0.005). After multivariable conditional logistic regression analysis, Def-ET was associated with a significant increase in the cumulative ongoing pregnancy rate as compared to fresh ET (OR = 1.76, CI95% 1.06-2.92, p = 0.028).

CONCLUSION:

Def-ET in endometriosis-affected women was associated with significantly higher cumulative ongoing pregnancy rates. Our preliminary results suggest that Def-ET for endometriosis-affected women is an attractive option that could increase their ART success rates. Future studies, with a randomized design, should be conducted to further confirm those results.

PMID:
29630610
PMCID:
PMC5890985
DOI:
10.1371/journal.pone.0194800
[Indexed for MEDLINE]
Free PMC Article

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