#Grand Rounds

Frozen or Fresh Embryos for IVF Transfer?

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BACKGROUND AND PURPOSE:

  • Frozen embryo transfer is associated with a higher rate of live births than fresh embryos during IVF in women with PCOS but evidence lacking in women without PCOS
  • Vuong et al. (NEJM, 2018) determined whether the same preference towards frozen embryos exists for women with infertility without PCOS

METHODS:

  • Single center randomized controlled trial
  • Women undergoing a first or second IVF cycle were randomly assigned to receive
    • Frozen embryo on day 3: Maximum of two embryos were thawed on the day of transfer in the following cycle
    • Fresh embryo on day 3: Maximum of two fresh embryos were transferred in the stimulated cycle
  • The primary outcome was ongoing pregnancy after the first embryo transfer

RESULTS:

  • 391 women were randomized into each group
  • After the first completed cycle, ongoing pregnancy occurred in
    • 36.3% in the frozen-embryo group
      • risk ratio (RR) 1.05; 95% CI 0.87 to 1.27; P=0.65
    • 34.5% in the fresh-embryo group
  • Rates of live birth after the first transfer were
    • 33.8% in the frozen embryo group
      • RR 1.07; 95% CI, 0.88 to 1.31
    • 31.5% in the fresh embryo group

CONCLUSION:

  • There was no significant increase in ongoing pregnancy rates in infertile women without PCOS after IVF of frozen embryos, compared to fresh embryos

Learn More – Primary Sources:

IVF Transfer of Fresh or Frozen Embryos in Women without Polycystic Ovaries.

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Related ObG Topics:

Infertility Evaluation: Who, When and How
ASRM guidance: ART and recommended number of embryos to transfer

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