Investigating Factors Influencing Clinical Pregnancy Rates in Frozen-Thawed Embryo Transfer Cycles at IVF Centers in Sari, Northern Iran: A Cross-Sectional Study
g Factors Influencing Clinical Pregnancy Rates in Frozen-Thawed Embryo Transfer
Sažetak
Background/Aim: Approximately 50% of embryo transfer cycles are conducted as frozen embryo transfer (FET) cycles; however, research on the factors influencing pregnancy rates in these cycles is limited in northern Iran. This study aimed to identify the factors affecting the clinical pregnancy rate in FET cycles among infertile women.
Methods: This descriptive-analytical observational study analyzed FET cycles involving 429 infertile couples whose embryos were obtained via microinjection at two IVF (In Vitro Fertilization) 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.
Results: 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%) experienced chemical pregnancies, while 156 cases (36.3%) achieved clinical pregnancies. Multivariate regression analysis revealed significant differences between the clinically pregnant and non-pregnant groups (p < 0.05) concerning 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.
Conclusion: Our results indicate that women's age at oocyte retrieval, infertility duration, occupation, BMI, embryo developmental stage, transfer catheter type, and embryo grade are critical for success rates in FET cycles. These findings can enhance clinical practices and patient counseling.
Reference
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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. Front Endocrinol (Lausanne). 2023; 14:1250847. https://doi.org/10.3389/fendo.2023.1250847.
3- Muhaidat N, Karam AM, Nabhan MS, Dabbah T, Odeh B, Eid M, et al. Factors Affecting the Outcomes of First in vitro Fertilization and Embryo Transfer: A Retrospective Investigation. Int J Womens Health. 2023; 15:1537-1545. https://doi.org/10.2147/IJWH.S431468.
4- Hayashi N, Enatsu N, Iwasaki T, Otsuki J, Matsumoto Y, Kokeguchi S, et al. Predictive factors influencing pregnancy rate in frozen embryo transfer. Reprod Med Biol. 2020; 19(2):182-188. https://doi.org/10.1002/rmb2.12322.
5- Grebe TA, Khushf G, Greally JM, Turley P, Foyouzi N, Rabin-Havt S, et al. ACMG Social, Ethical, and Legal Issues Committee. Clinical utility of polygenic risk scores for embryo selection: A points to consider statement of the American College of Medical Genetics and Genomics (ACMG). Genet Med. 2024; 26(4):101052. https://doi.org/10.1016/j.gim.2023.101052.
6- Dabbagh Rezaeiyeh R, Mehrara A, Mohammad Ali Pour A, Fallahi J, Forouhari S. Impact of Various Parameters as Predictors of The Success Rate of In Vitro Fertilization. Int J Fertil Steril. 2022; 16(2):76-84. https://doi.org/10.22074/IJFS.2021.531672.1134.
7- Eftekhar M, Rahmani E, Pourmasumi S. Evaluation of clinical factors influencing pregnancy rate in frozen embryo transfer. Iran J Reprod Med. 2014; 12(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. Taiwan J Obstet Gynecol. 2011; 50(2):159-64. https://doi.org/10.1016/j.tjog.2011.01.037.
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&S Reviews. 2022; 3(2): 105-120. https://doi.org/10.1016/j.xfnr.2022.03.001
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 Childbirth. 2023; 23(1):806. https://doi.org/10.1186/s12884-023-06111-5.
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. Arch Gynecol Obstet. 2023; 307(6):2001-2010. https://doi.org/10.1007/s00404-023-07019-3.
12- 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; 16(4):392-405. https://doi.org/10.22074/cellj.2015.486.
13- Akhondi MM, Ranjbar F, Shirzad M, Behjati Ardakani Z, Kamali K, et al. Practical Difficulties in Estimating The Prevalence of Primary Infertility in Iran. Int J Fertil Steril. 2019; 13(2):113-117. https://doi.org/10.22074/ijfs.2019.5583.
14- 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. Sci Rep. 2023; 13(1):14516. https://doi.org/10.1038/s41598-023-41842-7.
15- 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. Taiwan J Obstet Gynecol. 2017; 56(2):175-180. https://doi.org/10.1016/j.tjog.2016.04.039.
16- 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. Front Med (Lausanne). 2020; 7:94. https://doi.org/10.3389/fmed.2020.00094.
17- Li YX, Wang J, Sun TZ, Lv MQ, Ge P, Li HN, et al. Pregnancy outcomes after day 5 versus day 6 blastocyst-stage embryo transfer: A systematic review and meta-analysis. J Obstet Gynaecol Res. 2020; 46(4):595-605. https://doi.org/10.1111/jog.14188.
18- 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. Front Endocrinol (Lausanne). 2021; 12:621221. https://doi.org/10.3389/fendo.2021.621221.
19- Farhi J, Ben-Haroush A, Sapir O, Fisch B, Ashkenazi J. High-quality embryos retain their implantation capability in overweight women. Reprod Biomed Online. 2010; 21(5):706-11. https://doi.org/10.1016/j.rbmo.2010.06.040.
20- 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. J Assist Reprod Genet. 2021; 38(2):347-355. https://doi.org/10.1007/s10815-020-02011-1.
21- 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; 15(25): 1-7. https://doi.org/10.22038/ijogi.2012.5642.
22- Cai QF, Wan F, Huang R, Zhang HW. Factors predicting the cumulative outcome of IVF/ICSI treatment: a multivariable analysis of 2450 patients. Hum Reprod. 2011; 26(9):2532-40. https://doi.org/10.1093/humrep/der228.
23- 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. Hum Reprod. 2005; 20(11):3114-21. https://doi.org/10.1093/humrep/dei198.
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25- 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 Med J. 2020; 9:e1862. https://doi.org/10.31661/gmj.v9i0.1862.
26- 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. https://doi.org/10.1371/journal.pone.0242024.
27- 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. Int J Mol Sci. 2024; 25(2):726. https://doi.org/10.3390/ijms25020726.
Objavljeno
2025/11/19
Broj časopisa
Rubrika
Originalni rad / Original article