4.4 Article

Increased pregnancy complications following frozen-thawed embryo transfer during an artificial cycle

Journal

JOURNAL OF ASSISTED REPRODUCTION AND GENETICS
Volume 36, Issue 5, Pages 925-933

Publisher

SPRINGER/PLENUM PUBLISHERS
DOI: 10.1007/s10815-019-01420-1

Keywords

Natural cycle; Artificial cycle; Pregnancy; Obstetric; Neonatal outcomes

Funding

  1. National Basic Research Program of China [2016YFC1000206]

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PurposeThis study aimed to clarify the risks of adverse pregnancy outcomes in patients and their offspring after frozen embryo transfer (FET) during an artificial cycle (AC).MethodsWe conducted a retrospective cohort study that included all FET cycles and subsequent deliveries in a single centre between August 2013 and March 2016. Pregnancy, obstetric and neonatal outcomes were compared among patients treated during an AC or a natural cycle with luteal phase support (NC-LPS). Multivariate logistic regression was performed to evaluate the relationship between endometrial preparation schemes and pregnancy, obstetric and neonatal outcomes.ResultsAC-FET was not a significant risk factor for clinical pregnancy rate, multiple birth rate or miscarriage rate after adjusting for potential confounders. However, AC-FET was a significant risk factor for ectopic pregnancy rate (adjusted odds ratio (AOR), 1.738; 95% confidence interval (CI), 1.086-2.781) and live birth rate (AOR, 0.709; 95% CI, 0.626-0.802). Regarding obstetric outcomes, AC-FET was found to be associated with an increased risk for hypertension disorder (AOR, 1.780; 95% CI, 1.262-2.510) and caesarean section (AOR, 1.507; 95% CI, 1.195-1.900). In multiples, birth weight (2550g (2150-2900g) in AC-FET vs. 2600g (2350-2900g) in NC-LPS; P=0.023), gestational age (36.6weeks (35.3-37.6weeks) vs. 37.1weeks (36.1-37.9weeks); P<0.001), and z-score (-0.5 (-1.1, -0.0) vs. -0.4 (-1.0, 0.2); P=0.009) were higher in the NC-LPS group than in the AC-FET group, although there were no differences in these variables among singletons.ConclusionCompared with NC-LPS, AC-FET seemed to have a negative effect on obstetric outcomes.

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