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Research paper

INVESTIGATING FACTORS INFLUENCING CLINICAL PREGNANCY RATES IN HORMONE REPLACEMENT THERAPY FROZEN-THAWED EMBRYO TRANSFER CYCLES: A CROSS-SECTIONAL STUDY

By
Sepideh Peivandi Orcid logo ,
Sepideh Peivandi
Samaneh Aghajanpour Orcid logo ,
Samaneh Aghajanpour
Mohammad Khademloo Orcid logo ,
Mohammad Khademloo
Keshvar Samadaee Gelehkolaee Orcid logo ,
Keshvar Samadaee Gelehkolaee
Marzieh Zamaniyan Orcid logo
Marzieh Zamaniyan

Abstract

Approximately 50% of embryo transfer cycles are performed as frozen embryo transfer (FET) cycles; however, research on the factors influencing pregnancy rates in these cycles is limited in northern Iran. The aim of this study was to identify the factors influencing the clinical pregnancy rate in hormone replacement therapy (HRT) FET cycles among infertile women. This descriptive-analytical observational study analyzed HRT FET cycles of 429 infertile couples whose embryos were obtained by microinjection at two in vitro fertilization (IVF) centers in Sari, northern Iran, from April 2015 to March 2019. Data were analyzed using SPSS software, version 22, with a significance level set at p < 0.05. The mean ± SD age of women and men was 32 ± 2.52 and 36 ± 1.62 years, respectively. The mean ± SD age of women at the time of oocyte collection was 31.06 ± 5.3 years. Among the 429 patients, 171 cases (39.9%) achieved chemical pregnancy and 156 cases (36.3%) achieved clinical pregnancy. Multivariate regression analysis revealed significant differences between the clinically pregnant and non-pregnant groups (p < 0.05) in factors such as the woman's age at oocyte retrieval, duration of infertility, occupation, body mass index (BMI), developmental stage of the transferred embryo, type of catheter used for transfer, and embryo grade. The study concluded that younger maternal age at oocyte retrieval, shorter duration of infertility, optimal BMI, higher embryo grade, and appropriate selection of transfer techniques are key determinants of achieving clinical pregnancy in HRT-FET cycles. These findings can guide specialists in optimizing FET protocols to improve pregnancy outcomes.

References

1.
Graham ME, Jelin A, Hoon AH, Wilms Floet AM, Levey E, Graham EM. Assisted reproductive technology: Short‐ and long‐term outcomes. Developmental Medicine &amp; Child Neurology. 2022;65(1):38–49.
2.
Hsueh YW, Huang CC, Hung SW, Chang CW, Hsu HC, Yang TC, et al. Finding of the optimal preparation and timing of endometrium in frozen-thawed embryo transfer: a literature review of clinical evidence. Frontiers in Endocrinology. 2023;14.
3.
Muhaidat N, Karam A, Nabhan M, Dabbah T, Odeh B, Eid M, et al. Factors Affecting the Outcomes of First in vitro Fertilization and Embryo Transfer: A Retrospective Investigation. International Journal of Women’s Health. 2023;Volume 15:1537–45.
4.
Hayashi N, Enatsu N, Iwasaki T, Otsuki J, Matsumoto Y, Kokeguchi S, et al. Predictive factors influencing pregnancy rate in frozen embryo transfer. Reproductive Medicine and Biology. 2020;19(2):182–8.
5.
Grebe TA, Khushf G, Greally JM, Turley P, Foyouzi N, Rabin-Havt S, et al. Clinical utility of polygenic risk scores for embryo selection: A points to consider statement of the American College of Medical Genetics and Genomics (ACMG). Genetics in Medicine. 2024;26(4):101052.
6.
Rezaeiyeh D, Mehrara R, A, Ali Pour M, A. Impact of Various Parameters as Predictors of The Success Rate of In Vitro Fertilization. Int J Fertil Steril. 2022;(2):76–84.
7.
Eftekhar M, Rahmani E, Pourmasumi S. Evaluation of clinical factors influencing pregnancy rate in frozen embryo transfer. Iran J Reprod Med. 2014;(7):513–8.
8.
Ashrafi M, Jahangiri N, Hassani F, Akhoond MR, Madani T. The factors affecting the outcome of frozen–thawed embryo transfer cycle. Taiwanese Journal of Obstetrics and Gynecology. 2011;50(2):159–64.
9.
Reshef EA, Robles A, Hynes JS, Turocy JM, Forman EJ. A review of factors influencing the implantation of euploid blastocysts after in vitro fertilization. F&amp;S Reviews. 2022;3(2):105–20.
10.
Li J, Ji J, Guo H, Wang F, Fu Y, Hu R. Stratified analysis of clinical pregnancy outcomes of sequential embryo transfer in frozen embryo transfer cycles based on different factors: a retrospective study. BMC Pregnancy and Childbirth. 2023;23(1).
11.
Holschbach V, Kordes H, Dietrich JE, Bruckner T, Strowitzki T, Germeyer A. Patient- and cycle-specific factors affecting the outcome of frozen–thawed embryo transfers. Archives of Gynecology and Obstetrics. 2023;307(6):2001–10.
12.
Gardner DK, Schoolcraft WB. Culture and transfer of human blastocysts. Current Opinion in Obstetrics and Gynaecology. 1999;11(3):307–11.
13.
Nasiri N, Eftekhari-Yazdi P. An overview of the available methods for morphological scoring of pre-implantation embryos in in vitro fertilization. Cell J. 2015;(4):392–405.
14.
Akhondi M, Ranjbar F, Shirzad M. Practical Difficulties in Estimating the Prevalence of Primary Infertility in Iran. Int J Fertil Steril. 2019;(2):113–7.
15.
Wang P, Zhao C, Xu W, Jin X, Zhang S, Zhu H. The association between the number of oocytes retrieved and cumulative live birth rate in different female age strata. Scientific Reports. 2023;13(1).
16.
Su YT, Lin PY, Huang FJ, Kung FT, Lin YJ, Tsai YR, et al. Age is a major prognosticator in extremely low oocyte retrieval cycles. Taiwanese Journal of Obstetrics and Gynecology. 2017;56(2):175–80.
17.
Pan Y, Hao G, Wang Q, Liu H, Wang Z, Jiang Q, et al. Major Factors Affecting the Live Birth Rate After Frozen Embryo Transfer Among Young Women. Frontiers in Medicine. 2020;7.
18.
Li Y, Wang J, Sun T, Lv M, Ge P, Li H, et al. Pregnancy outcomes after day 5 versus day 6 blastocyst‐stage embryo transfer: A systematic review and meta‐analysis. Journal of Obstetrics and Gynaecology Research. 2020;46(4):595–605.
19.
Ai J, Jin L, Zheng Y, Yang P, Huang B, Dong X. The Morphology of Inner Cell Mass Is the Strongest Predictor of Live Birth After a Frozen-Thawed Single Embryo Transfer. Frontiers in Endocrinology. 2021;12.
20.
Tawde S, Bavishi H, Bavishi F, Bavishi P. Comparative analysis of outcome of morula versus blastocyst transfer. The Onco Fertility Journal. 2020;3(1):26.
21.
Korkmaz C, Gül Yıldız Ü, Fidan U, Baykal B, Temel Ceyhan S, Ağaçayak E. Investigation of transfer results of human embryos that were vitrified and thawed at the cleavage, morula and blastocyst stages. Zygote. 2020;28(3):191–5.
22.
Tao J, Craig RH, Johnson M, Williams B, Lewis W, White J, et al. Cryopreservation of human embryos at the morula stage and outcomes after transfer. Fertility and Sterility. 2004;82(1):108–18.
23.
Perlman BE, Minis E, Greenberg P, Krishnamoorthy K, Morelli SS, Jindal SK, et al. Increased male live-birth rates after blastocyst-stage frozen-thawed embryo transfers compared with cleavage-stage frozen-thawed embryo transfers: a SART registry study. F&amp;S Reports. 2021;2(2):161–5.
24.
Glujovsky D, Quinteiro Retamar AM, Alvarez Sedo CR, Ciapponi A, Cornelisse S, Blake D. Cleavage-stage versus blastocyst-stage embryo transfer in assisted reproductive technology. Cochrane Database of Systematic Reviews. 2022;2022(6).
25.
Farhi J, Ben-Haroush A, Sapir O, Fisch B, Ashkenazi J. High-quality embryos retain their implantation capability in overweight women. Reproductive BioMedicine Online. 2010;21(5):706–11.
26.
Romanski PA, Bortoletto P, Magaoay B, Chung A, Rosenwaks Z, Spandorfer SD. Live birth outcomes in infertile patients with class III and class IV obesity following fresh embryo transfer. Journal of Assisted Reproduction and Genetics. 2020;38(2):347–55.
27.
Eftekhar M, Rahmani E. Assessment of Effect of Some Clinical Factors on Successful Cryopreserved Embryo-Transfer at Yazd Research-Clinical Center of Infertility. Iran J Obstet Gynecol Infertil. 2012;(25):1–7.
28.
Cai QF, Wan F, Huang R, Zhang HW. Factors predicting the cumulative outcome of IVF/ICSI treatment: a multivariable analysis of 2450 patients. Human Reproduction. 2011;26(9):2532–40.
29.
Abou-Setta AM, Al-Inany HG, Mansour RT, Serour GI, Aboulghar MA. Soft versus firm embryo transfer catheters for assisted reproduction: a systematic review and meta-analysis*. Human Reproduction. 2005;20(11):3114–21.
30.
Yao Z, Vansteelandt S, Van der Elst J, Coetsier T, Dhont M, De Sutter P. The efficacy of the embryo transfer catheter in IVF and ICSI is operator-dependent: a randomized clinical trial. Human Reproduction. 2008;24(4):880–7.
31.
Rakhshaee Z, Maasoumi R, Nedjat S, Khakbazan Z. Sexual Health Literacy, a Strategy for the Challenges of Sexual Life of Infertile Women: A Qualitative Study. Galen Medical Journal. 2020;9:e1862.
32.
Aimagambetova G, Issanov A, Terzic S, Bapayeva G, Ukybassova T, Baikoshkarova S, et al. The effect of psychological distress on IVF outcomes: Reality or speculations? PLOS ONE. 2020;15(12):e0242024.
33.
Zanettoullis AT, Mastorakos G, Vakas P, Vlahos N, Valsamakis G. Effect of Stress on Each of the Stages of the IVF Procedure: A Systematic Review. International Journal of Molecular Sciences. 2024;25(2):726.

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