Comparable Pregnancy Loss and Neonatal Birthweights in Frozen Embryo Transfer Cycles Using Vitrified Embryos from Progestin-Primed Ovarian Stimulation and GnRH Analogue Protocols: A Retrospective Cohort Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Study Population and Data
2.3. Outcomes
2.4. Statistical Analysis
3. Results
3.1. Study Population and Baseline Characteristics
3.2. Incidence of Pregnancy Loss
3.3. Neonatal Birthweights in Singleton and Twin Births
3.4. The Incidence of Pregnancy Loss Stratified by Maternal Age and Oocyte Yields
3.5. Sensitivity Analysis
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Characteristics | GnRH Analogue (n = 1913) | PPOS (n = 3831) | p Value |
---|---|---|---|
Maternal age (yrs) | 31.64 ± 3.44 | 31.67 ± 3.82 | 0.76 |
23–29 | 517 (27.0%) | 1210 (31.6%) | |
30–34 | 981 (51.3%) | 1688 (44.1%) | |
35–37 | 336 (17.6%) | 640 (16.7%) | |
38–42 | 79 (4.1%) | 293 (7.6%) | |
Paternal age (yrs) n = 14,059 | 33.70 ± 4.65 | 33.67 ± 4.97 | 0.81 |
20–34 | 1161 (60.7%) | 2351 (61.4%) | |
35–44 | 615 (32.1%) | 1132 (29.5%) | |
45–55 | 137 (7.2%) | 348 (9.1%) | |
BMI (kg/m2) | 0.81 | ||
<18.5 | 238 (12.4%) | 493 (12.9%) | |
18.5–22.9 | 1175 (61.4%) | 2375 (62.0%) | |
23–27.4 | 450 (23.0%) | 859 (22.4%) | |
>=27.5 | 50 (2.8%) | 104 (2.7%) | |
Infertility duration (yrs) | 0.69 | ||
1–3 | 1181 (61.7%) | 2344 (61.2%) | |
>=4 | 732 (38.3%) | 1487 (38.8%) | |
Gravidity | 0.64 | ||
0 | 1014 (53.0%) | 2032 (53.0%) | |
1 | 492 (25.7%) | 950 (24.8%) | |
>=2 | 407 (21.3%) | 849 (22.2%) | |
No. of miscarriages n = 12,144 | 0.50 | ||
0 | 590 (83.8%) | 3064 (85.5%) | |
1 | 92 (13.1%) | 417 (11.6%) | |
>=2 | 22 (3.1%) | 101 (2.8%) | |
No. of induced abortions n = 12,144 | 0.80 | ||
0 | 554 (78.7%) | 2815 (78.6%) | |
1–2 | 139 (19.7%) | 698 (19.5%) | |
>=3 | 11 (1.6%) | 69 (1.90%) | |
Parity | 0.39 | ||
0 | 1775 (92.8%) | 3530 (92.1%) | |
>=1 | 138 (7.2%) | 301 (7.9%) | |
Previous IVF attempts | 0.08 | ||
0 | 1445 (75.6%) | 2918 (76.2%) | |
1–2 | 300 (15.7%) | 530 (13.8%) | |
>=3 | 168 (8.8%) | 383 (10.0%) | |
Infertility indications | 0.37 | ||
Tubal | 827 (43.2%) | 1670 (43.6%) | |
Male | 285 (14.9%) | 556 (14.5%) | |
Endometriosis | 93 (4.9%) | 171 (4.5%) | |
Dysfunctional ovulation | 72 (3.8%) | 160 (4.2%) | |
Uterine | 84 (4.4%) | 216 (5.6%) | |
Unknown | 171 (8.9%) | 305 (8.0%) | |
Combined | 381 (19.9%) | 753 (19.7%) | |
Basic FSH value (mIU/mL) | 5.55 ± 1.57 | 5.56 ± 1.54 | 0.84 |
Oocyte yields | 0.40 | ||
1–5 | 303 (15.8%) | 646 (16.9%) | |
6–15 | 1140 (59.6%) | 2296 (59.9%) | |
16–35 | 470 (24.6%) | 889 (23.2%) | |
Fertilization methods | 0.12 | ||
IVF | 1186 (62.0%) | 2454 (64.1%) | |
ICSI | 482 (25.2%) | 953 (24.9%) | |
IVF + ICSI | 245 (12.8%) | 424 (11.1%) | |
Endometrium preparation | <0.01 | ||
Natural cycle | 590 (30.8%) | 978 (25.5%) | |
Mild stimulation | 918 (48.0%) | 1823 (47.6%) | |
HRT | 405 (21.2%) | 1030 (26.9%) | |
Endometrium thickness (mm) n = 14,231 | 0.37 | ||
<8 mm | 125 (6.5%) | 227 (5.9%) | |
>=8 mm | 1788 (93.5%) | 3604 (94.1%) | |
Embryo stage n = 3739 | 0.01 | ||
Cleavage | 550 (81.7%) | 2628 (85.7%) | |
Blastocyst | 123 (18.3%) | 438 (14.3%) | |
Embryos transferred | 0.71 | ||
1 | 245 (12.8%) | 504 (13.2%) | |
2 | 1668 (87.2%) | 3327 (86.8%) |
GnRH Analogue (n = 1913) | PPOS (n = 3831) | OR (95%CI) | p Value | |
---|---|---|---|---|
Pregnancy loss | 352 (18.4%) | 734 (19.2%) | 1.02 (0.97, 1.06) | 0.49 |
Biochemical pregnancy loss | 44 (2.3%) | 148 (3.9%) | ||
Ectopic pregnancy | 34 (1.8%) | 115 (3.0%) | ||
Early miscarriage (6–11 weeks) | 227 (11.9%) | 333 (8.7%) | ||
Late miscarriage (12–24 weeks) | 46 (2.4%) | 134 (3.5%) | ||
Stillbirth (≥24 weeks) | 1 (0.1%) | 4 (0.1%) | ||
Live birth | 1561 (81.6%) | 3097 (80.8%) | 0.97 (0.88, 1.06) | 0.49 |
Gestational weeks at delivery (weeks) n = 4204 | 0.50 | |||
<=32 | 28 (2.8%) | 89 (3.0%) | ||
33–36 | 180 (14.9%) | 450 (15.0%) | ||
>=37 | 1000 (82.8%) | 2457 (82.0%) | ||
Birth weight (g) n = 4617 | ||||
Single n (%) | 1183 (76.6%) | 2262 (73.5%) | ||
Newborn weight (g) | 3346.0± 515.5 | 3337.0 ± 494.4 | 0.62 | |
Twins | 360 (23.4%) | 812 (26.5%) | ||
Newborn weight (g) | 2533.2 ± 424.2 | 2496.8 ± 429.2 | 0.18 | |
Sex of neonates n = 4424 | 0.33 | |||
Male | 682 (52.9%) | 1606 (51.2%) | ||
Female | 608 (47.1%) | 1528 (48.8%) | ||
Mode of delivery n = 4593 | 0.15 | |||
Vaginal | 318 (20.5%) | 681 (22.4%) | ||
Cesarean section | 1232 (79.5%) | 2362 (77.6%) | ||
Low birthweight (<2500 g) | 196 (12.6%) | 415 (13.5%) | 1.07 (0.89, 1.29) | 0.46 |
High birthweight (>4000 g) | 106 (6.9%) | 176 (5.7%) | 0.82 (0.64, 1.06) | 0.12 |
Neonatal events | 85 (5.5%) | 155 (5.0%) | 0.92 (0.70, 1.20) | 0.53 |
Congenital anomalies | 29 (1.9%) | 79 (2.6%) | 1.38 (0.90, 2.12) | 0.14 |
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Chai, W.; Liao, M.; Feng, G.; Wei, M.; Shi, W.; Wang, Y.; Chen, Q. Comparable Pregnancy Loss and Neonatal Birthweights in Frozen Embryo Transfer Cycles Using Vitrified Embryos from Progestin-Primed Ovarian Stimulation and GnRH Analogue Protocols: A Retrospective Cohort Study. J. Clin. Med. 2022, 11, 6151. https://doi.org/10.3390/jcm11206151
Chai W, Liao M, Feng G, Wei M, Shi W, Wang Y, Chen Q. Comparable Pregnancy Loss and Neonatal Birthweights in Frozen Embryo Transfer Cycles Using Vitrified Embryos from Progestin-Primed Ovarian Stimulation and GnRH Analogue Protocols: A Retrospective Cohort Study. Journal of Clinical Medicine. 2022; 11(20):6151. https://doi.org/10.3390/jcm11206151
Chicago/Turabian StyleChai, Weiran, Maokun Liao, Guang’en Feng, Mengjie Wei, Wentao Shi, Yun Wang, and Qiuju Chen. 2022. "Comparable Pregnancy Loss and Neonatal Birthweights in Frozen Embryo Transfer Cycles Using Vitrified Embryos from Progestin-Primed Ovarian Stimulation and GnRH Analogue Protocols: A Retrospective Cohort Study" Journal of Clinical Medicine 11, no. 20: 6151. https://doi.org/10.3390/jcm11206151