TY - JOUR
T1 - Transfer of fresh versus frozen embryos in ovulatory women
AU - Shi, Yuhua
AU - Sun, Yun
AU - Hao, Cuifang
AU - Zhang, Heping
AU - Wei, Daimin
AU - Zhang, Yunshan
AU - Zhu, Yimin
AU - Deng, Xiaohui
AU - Qi, Xiujuan
AU - Li, Hong
AU - Ma, Xiang
AU - Ren, Haiqin
AU - Wang, Yaqin
AU - Zhang, Dan
AU - Wang, Bo
AU - Liu, Fenghua
AU - Wu, Qiongfang
AU - Wang, Ze
AU - Bai, Haiyan
AU - Li, Yuan
AU - Zhou, Yi
AU - Sun, Mei
AU - Liu, Hong
AU - Li, Jing
AU - Zhang, Lin
AU - Chen, Xiaoli
AU - Zhang, Songying
AU - Sun, Xiaoxi
AU - Legro, Richard S.
AU - Chen, Zi Jiang
N1 - Funding Information:
The live-birth rate did not differ significantly between fresh-embryo transfer and frozen-embryo transfer among ovulatory women with infertility, but frozen-embryo transfer resulted in a lower risk of the ovarian hyperstimulation syndrome. (Funded by the National Key Research and Development Program of China and the National Natural Science Foundation of China; Chinese Clinical Trial Registry number, ChiCTR-IOR-14005406.)
Funding Information:
Supported by grants from the National Key Research and Development Program of China (2017YFC1001000), the Major Program of the National Natural Science Foundation of China (81490743), and the State Key Program of the National Natural Science Foundation of China (81430029).
Publisher Copyright:
Copyright © 2018 Massachusetts Medical Society.
PY - 2018/1/11
Y1 - 2018/1/11
N2 - BACKGROUND Elective frozen-embryo transfer has been shown to result in a higher live-birth rate than fresh-embryo transfer among anovulatory women with the polycystic ovary syndrome. It is uncertain whether frozen-embryo transfer increases live-birth rates among ovulatory women with infertility. METHODS In this multicenter, randomized trial, we randomly assigned 2157 women who were undergoing their first in vitro fertilization cycle to undergo either freshembryo transfer or embryo cryopreservation followed by frozen-embryo transfer. Up to two cleavage-stage embryos were transferred in each participant. The primary outcome was a live birth after the first embryo transfer. RESULTS The live-birth rate did not differ significantly between the frozen-embryo group and the fresh-embryo group (48.7% and 50.2%, respectively; relative risk, 0.97; 95% confidence interval [CI], 0.89 to 1.06; P = 0.50). There were also no significant between-group differences in the rates of implantation, clinical pregnancy, overall pregnancy loss, and ongoing pregnancy. Frozen-embryo transfer resulted in a significantly lower risk of the ovarian hyperstimulation syndrome than freshembryo transfer (0.6% vs. 2.0%; relative risk, 0.32; 95% CI, 0.14 to 0.74; P = 0.005). The risks of obstetrical and neonatal complications and other adverse outcomes did not differ significantly between the two groups. CONCLUSIONS The live-birth rate did not differ significantly between fresh-embryo transfer and frozen-embryo transfer among ovulatory women with infertility, but frozenembryo transfer resulted in a lower risk of the ovarian hyperstimulation syndrome. (Funded by the National Key Research and Development Program of China and the National Natural Science Foundation of China; Chinese Clinical Trial Registry number, ChiCTR-IOR-14005406.).
AB - BACKGROUND Elective frozen-embryo transfer has been shown to result in a higher live-birth rate than fresh-embryo transfer among anovulatory women with the polycystic ovary syndrome. It is uncertain whether frozen-embryo transfer increases live-birth rates among ovulatory women with infertility. METHODS In this multicenter, randomized trial, we randomly assigned 2157 women who were undergoing their first in vitro fertilization cycle to undergo either freshembryo transfer or embryo cryopreservation followed by frozen-embryo transfer. Up to two cleavage-stage embryos were transferred in each participant. The primary outcome was a live birth after the first embryo transfer. RESULTS The live-birth rate did not differ significantly between the frozen-embryo group and the fresh-embryo group (48.7% and 50.2%, respectively; relative risk, 0.97; 95% confidence interval [CI], 0.89 to 1.06; P = 0.50). There were also no significant between-group differences in the rates of implantation, clinical pregnancy, overall pregnancy loss, and ongoing pregnancy. Frozen-embryo transfer resulted in a significantly lower risk of the ovarian hyperstimulation syndrome than freshembryo transfer (0.6% vs. 2.0%; relative risk, 0.32; 95% CI, 0.14 to 0.74; P = 0.005). The risks of obstetrical and neonatal complications and other adverse outcomes did not differ significantly between the two groups. CONCLUSIONS The live-birth rate did not differ significantly between fresh-embryo transfer and frozen-embryo transfer among ovulatory women with infertility, but frozenembryo transfer resulted in a lower risk of the ovarian hyperstimulation syndrome. (Funded by the National Key Research and Development Program of China and the National Natural Science Foundation of China; Chinese Clinical Trial Registry number, ChiCTR-IOR-14005406.).
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U2 - 10.1056/NEJMoa1705334
DO - 10.1056/NEJMoa1705334
M3 - Article
C2 - 29320646
AN - SCOPUS:85040664635
SN - 0028-4793
VL - 378
SP - 126
EP - 136
JO - New England Journal of Medicine
JF - New England Journal of Medicine
IS - 2
ER -