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IVF Clinical

Clinical and laboratory parametersassociated with cycle outcomes in patientsundergoing euploid frozen blastocyst transfer

PUBLICATIONS
Accepted: May 19, 2023

ABSTRACT
Research question:
Which factors impact on clinical pregnancy rate (CPR) and live birth rates (LBR) in euploid frozen embryotransfer (eFET) cycles?Design:Retrospective observational study including 1660 eFET cycles with 2439 euploid blastocysts, from November 2016 toDecember 2020. The impact of clinical and laboratory parameters on CPR, biochemical miscarriage rate (BMR), clinicalmiscarriage rate (CMR) and LBR was evaluated.
Results:
CPR per transfer was 63.4%, LBR per transfer 51.6%. CPR and LBR were significantly higher when double embryotransfer (DET) was performed (71.6% versus 57.7%,P<0.001; 55.2% versus 49.1%,P= 0.016, respectively). However,pregnancy loss was significantly higher in the DET group (28.8% versus 22.8%,P= 0.02). When patients were classified by bodymass index (BMI), no differences were observed for CPR, but CMR was lower (P<0.001) and LBR higher (p= 0.031) for thenormal BMI group. The natural cycle protocol revealed lower CMR (P<0.001) and lower pregnancy loss (P<0.001);subsequently, higher LBR (57.6%, 48.8%, 45.0%,P=0.001) compared with hormonal replacement protocol and stimulatedcycle. Day of trophectoderm biopsy affected CPR (P<0.001) and LBR (P<0.001), yet no differences were observed for BMR,
CMR
or pregnancy loss. The multivariate analysis showed that day 6/7 embryos had lower probabilities for pregnancy;overweight and obesity had a negative impact on LBR, and natural cycle improved LBR (adjusted odds ratio 1.445, 95%confidence interval 0.5190.806).
Conclusions:
Day of biopsy affected CPR, while BMI and endometrial preparation protocol were associated with LBR in eFET.DET should be discouraged as it will increase the risk of pregnancy loss. Women with higher BMI should be aware of the higherrisk of pregnancy loss and lower LBR even though a euploid blastocyst is transferred.