Patients, N
1,037
Patients’ age, years
31.8 ± 3.3a
Oocytes retrieved, N
18,173
Oocytes injected, N
14,551
Oocytes fertilized, N (%)
11,207 (77.7 ± 14.6a, 76.8–78.6c)
Embryos cleaved on day 2, N (%)
10,967 (98.1 ± 5.9a, 97.7–98.5c)
Embryos with ≥6 blastomeres on day 3, N (%)b
9,714 (87.2 ± 15.4a, 86.3–88.1c)
Compacting embryos on day 4, N (%)b
8,219 (74.0 ± 22.0a, 72.7–75.3c)
Blastocysts on day 5, N (%)b
8,270 (74.3 ± 18.3a, 73.2–75.4c)
Patients who underwent eSET, N
1,037
Implantations, N (%)
659 (63.5)
Positive pregnancies/eSET, N (%)
717 (69.1)
Clinical pregnancies/eSET, N (%)
642 (62.0)
Ongoing pregnancies/eSET, N (%)
579 (55.8)
Multiple pregnancy rate, N (%)
17 (2.6)
Confirmed live births from 883 eSET between 2007 and July 2013
Ongoing pregnancies/883 eSET, N (%)
474 (53.7)
Live birth rate/883 eSET, N (%)
457 (51.7)
Live births, N
469 (211 boys and 258 girls)
In all of the 1,037 eSET, blastocysts were available for transfer on day 5. Of note, 963 patients had cryopreservation (93 %) whereas only 74 patients (7 %) ended up with no cryopreservation at all. It should be mentioned that 30 % of the “no cryopreservation” group had no cryopreservation because they declined to sign the relevant consent. A total of 4,961 blastocysts were vitrified, yielding an average of five blastocysts per patient.
Applying eSET to a large proportion of patients, more embryos would be available for vitrification which in turn would result in more successful vitrified–warmed cycles. The majority of blastocysts were vitrified on day 5 (67.5 %), whereas only 32.5 % were vitrified on day 6 (see Table 19.2). As shown in Table 19.2, patients with no embryos suitable for cryopreservation had the same chance to get pregnant compared with the group of patients having surplus embryos for cryopreservation.
Table 19.2
Retrospective outcome data from 1,037 autologous elective single-embryo transfers on day 5 with or without having embryos suitable for cryopreservation
Total number of eSETs | 1,037 | |
|---|---|---|
With cryopreservation | Without cryopreservation | |
Patients, N | 963 | 74 |
Patients’ age, years | 31.7 ± 3.2a | 32.0 ± 4.3a |
Blastocysts vitrified, N | 4,961 | – |
Average number of blastocyst per patient vitrified | 5 | – |
Day 5 blastocysts vitrified, N (%) | 3,347 (67.5) | – |
Day 6 blastocysts vitrified, N (%) | 1,614 (32.5) | – |
Implantations, N (%) | 612 (63.6)* | 47 (63.5) |
Positive pregnancies/eSET, N (%) | 667 (69.3)* | 50 (67.6) |
Clinical pregnancies/eSET, N (%) | 597 (62.0)* | 45 (60.8) |
Ongoing pregnancies/eSET, N (%) | 535 (55.6)* | 38 (51.4) |
Results on Blastocyst Vitrification After Failed Fresh eSET
To calculate a patient-specific augmented pregnancy rate, it is essential to include as augmentation only those pregnancies from vitrified blastocysts among patients who did not have a pregnancy after fresh eSET. This represents true augmentation of the patient-specific expectation of pregnancy from the same oocyte harvest. After 1,037 eSET, a total of 464 patients experienced a negative outcome. 320 patients (30.1 %) faced a negative pregnancy test, 75 patients achieved a biochemical or ectopic pregnancy only, and additional 69 patients lost their ongoing pregnancy beyond 7 weeks. To reflect the true augmenting effect of vitrification, only the first transfer of vitrified embryos occurring after an unsuccessful fresh eSET was analyzed. 333 patients returned for a frozen embryo transfer; 70.3 % achieved a positive pregnancy, with a clinical and ongoing pregnancy rate of 62.2 % and 57.7 %, respectively (see Table 19.3).
Table 19.3
Retrospective outcome data from 333 autologous vitrified–warmed embryo transfers after failed fresh elective single-embryo transfers compared with 1,037 fresh day 5 eSETs
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