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Transfer of Fresh versus Frozen Embryos in Ovulatory Women.

Shi, Yuhua; Sun, Yun; Hao, Cuifang; Zhang, Heping; Wei, Daimin; Zhang, Yunshan; Zhu, Yimin; Deng, Xiaohui; Qi, Xiujuan; Li, Hong; Ma, Xiang; Ren, Haiqin; Wang, Yaqin; Zhang, Dan; Wang, Bo; Liu, Fenghua; Wu, Qiongfang; Wang, Ze; Bai, Haiyan; Li, Yuan; Zhou, Yi; Sun, Mei; Liu, Hong; Li, Jing; Zhang, Lin; Chen, Xiaoli; Zhang, Songying; Sun, Xiaoxi; Legro, Richard S; Chen, Zi-Jiang.
N Engl J Med; 378(2): 126-136, 2018 01 11.
Artigo em Inglês | MEDLINE | ID: mdl-29320646

BACKGROUND:

Elective frozen-embryo transfer has been shown to result in a higher live-birth rate than fresh-embryo transfer among anovulatory women with the polycystic ovary syndrome. It is uncertain whether frozen-embryo transfer increases live-birth rates among ovulatory women with infertility.

METHODS:

In this multicenter, randomized trial, we randomly assigned 2157 women who were undergoing their first in vitro fertilization cycle to undergo either fresh-embryo transfer or embryo cryopreservation followed by frozen-embryo transfer. Up to two cleavage-stage embryos were transferred in each participant. The primary outcome was a live birth after the first embryo transfer.

RESULTS:

The live-birth rate did not differ significantly between the frozen-embryo group and the fresh-embryo group (48.7% and 50.2%, respectively; relative risk, 0.97; 95% confidence interval [CI], 0.89 to 1.06; P=0.50). There were also no significant between-group differences in the rates of implantation, clinical pregnancy, overall pregnancy loss, and ongoing pregnancy. Frozen-embryo transfer resulted in a significantly lower risk of the ovarian hyperstimulation syndrome than fresh-embryo transfer (0.6% vs. 2.0%; relative risk, 0.32; 95% CI, 0.14 to 0.74; P=0.005). The risks of obstetrical and neonatal complications and other adverse outcomes did not differ significantly between the two groups.

CONCLUSIONS:

The live-birth rate did not differ significantly between fresh-embryo transfer and frozen-embryo transfer among ovulatory women with infertility, but frozen-embryo transfer resulted in a lower risk of the ovarian hyperstimulation syndrome. (Funded by the National Key Research and Development Program of China and the National Natural Science Foundation of China; Chinese Clinical Trial Registry number, ChiCTR-IOR-14005406 .).
Selo DaSilva