Fresh or frozen-embryo transfer results in similar pregnancy rates in women without PCOS

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Healthy infertile women with no polycystic ovarian syndrome have the same ongoing pregnancy and live birth rates from IVF irrespective of whether the embryo was fresh or frozen reports the results of two recent clinical trials published in JAMA. 

Recent clinical trials have documented higher pregnancy and live birth rates with the transfer of frozen embryos as compared to fresh ones. A clinical review published in the Journal of Human Reproduction Update also favored “elective frozen embryo transfer (eFET) not only in terms of achieving higher pregnancy rates but, more importantly, also in terms of lower maternal and infant morbidity and mortality.”

The two current studies were conducted to see whether fresh frozen embryo transfer resulted in higher birthrates in women who do not have PCOS.

The first multicenter, randomized trial recruited 2157 women who were scheduled to undergo their first IVF cycles. They were randomly assigned to undergo either fresh-embryo transfer or embryo cryopreservation followed by frozen-embryo transfer. The maximum embryo transferred in each participant was two with the live birth rate as the primary outcome after the first embryo transfer.

There was no significant difference in terms of live birth rates in the frozen-embryo group and the fresh-embryo group (48.7% and 50.2%; P=0.50) respectively. Both the groups were also similar in terms of risks of obstetrical and neonatal complications, rates of implantation, clinical pregnancy, overall pregnancy loss, and ongoing pregnancy.

But, frozen embryo transfer did result in a significantly lower risk of the ovarian hyperstimulation syndrome than fresh-embryo transfer (0.6% vs. 2.0%; P=0.005).

The second study randomly assigned 782 healthy infertile women with no PCOS to receive either a frozen embryo or a fresh embryo on day 3 during their first or second IVF. In this study also, the pregnancy rates were comparable in both the groups, 36.3% in the frozen-embryo group 34.5% in the fresh-embryo group (P = .65).

The authors concluded that in women who do not have PCOS, the pregnancy rates are similar with fresh or frozen embryos. In healthy infertile women, probably the uterine environment was favorable for fresh embryos transfer. 

Abstract-NEJM

Abstract-NEJM

Abstract-JAMA

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