Comparison of clinical outcomes of different embryo transfer protocols in patients with repeated implantation failure in frozen-thawed cycles / 中国医师杂志

ABSTRACT

Objective The study compared the clinical outcomes among cleavage stage embryo transfer,two-step embryo transfer and blastocyst transfer in frozen-thawed cycles.To provide the clinical guidance for the patients with repeated implantation failure(RIF) to make a appropriate embryo transfer protocol.Methods In this retrospective study,a total of 252 patients with RIF were undergoing the frozenthawed embryo transfer (FET) treatment.They were divided into cleavage stage embryo transfer group (group A),two-step embryo transfer group (group B) and blastocyst transfer group (group C) according to the transfer protocols.Groups were compared including implantation rate,clinical pregnancy rate,live birth rate,miscarriage rate,multiple pregnancy rate and ectopic pregnancy rate.Results (1) There were no significant differences among three groups in age,infertility duration,infertility type,endometrial preparation protocols and embryo resuscitation rate.The rate of optimal embryo after resuscitation of group B was lower than that of group A (72.46％ vs 81.50％),showing significant differences (P'＜ 0.0125),but no significant difference were found between group B and C (72.46％ vs 77.42％),A and C (81.50％ vs 77.42％) (P'＞ 0.0125).(2) The implantation rate of embryos in group C was significantly higher than that in group A (38.46％ vs 21.61％) (P'＜0.0125),and there were no significant difference between group B and C (26.85％ vs 38.46％),A and B (21.61％ vs 26.85％).The clinical pregnancy rate of group B was significantly higher than that of group A (62.50％ vs 45.09％) (P'＜0.0125),and there were no significant differences between the others.No statistically differences existed in regard to the live birth rate among three groups,but the group B than the group A (50.00％ vs 35.71％),the group B than the group C (50.00％ vs 34.62％) showed an increasing trend.(3) No statistically differences existed in regard to abortion and multiple pregnancy rate among three groups (P ＞ 0.05).No case of ectopic pregnancy occurred in group B and group C,while in the group A,there were 7 cases of ectopic pregnancy.Conclusions For RIF patients,two-step embryo transfer and blastocyst transfer are relatively safe and effective transplants in frozen-thawed cycles compared to cleavage embryo transfer.