Transfer of fresh versus frozen embryos in ovulatory women

Yuhua Shi, Yun Sun, Cuifang Hao, Heping Zhang, Daimin Wei, Yunshan Zhang, Yimin Zhu, Xiaohui Deng, Xiujuan Qi, Hong Li, Xiang Ma, Haiqin Ren, Yaqin Wang, Dan Zhang, Bo Wang, Fenghua Liu, Qiongfang Wu, Ze Wang, Haiyan Bai, Yuan LiYi Zhou, Mei Sun, Hong Liu, Jing Li, Lin Zhang, Xiaoli Chen, Songying Zhang, Xiaoxi Sun, Richard Legro, Zi Jiang Chen

Research output: Contribution to journalArticle

63 Citations (Scopus)

Abstract

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.).

Original languageEnglish (US)
Pages (from-to)126-136
Number of pages11
JournalNew England Journal of Medicine
Volume378
Issue number2
DOIs
StatePublished - Jan 11 2018

Fingerprint

Embryo Transfer
Embryonic Structures
Live Birth
Birth Rate
Ovarian Hyperstimulation Syndrome
Pregnancy
Infertility
China
Confidence Intervals
Natural Science Disciplines
Polycystic Ovary Syndrome
Cryopreservation
Fertilization in Vitro
Multicenter Studies
Registries
Clinical Trials

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Shi, Y., Sun, Y., Hao, C., Zhang, H., Wei, D., Zhang, Y., ... Chen, Z. J. (2018). Transfer of fresh versus frozen embryos in ovulatory women. New England Journal of Medicine, 378(2), 126-136. https://doi.org/10.1056/NEJMoa1705334
Shi, Yuhua ; Sun, Yun ; Hao, Cuifang ; Zhang, Heping ; Wei, Daimin ; Zhang, Yunshan ; Zhu, Yimin ; Deng, Xiaohui ; Qi, Xiujuan ; Li, Hong ; Ma, Xiang ; Ren, Haiqin ; Wang, Yaqin ; Zhang, Dan ; Wang, Bo ; Liu, Fenghua ; Wu, Qiongfang ; Wang, Ze ; Bai, Haiyan ; Li, Yuan ; Zhou, Yi ; Sun, Mei ; Liu, Hong ; Li, Jing ; Zhang, Lin ; Chen, Xiaoli ; Zhang, Songying ; Sun, Xiaoxi ; Legro, Richard ; Chen, Zi Jiang. / Transfer of fresh versus frozen embryos in ovulatory women. In: New England Journal of Medicine. 2018 ; Vol. 378, No. 2. pp. 126-136.
@article{c65db33af866421ba7e14fe9ba6208be,
title = "Transfer of fresh versus frozen embryos in ovulatory women",
abstract = "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.).",
author = "Yuhua Shi and Yun Sun and Cuifang Hao and Heping Zhang and Daimin Wei and Yunshan Zhang and Yimin Zhu and Xiaohui Deng and Xiujuan Qi and Hong Li and Xiang Ma and Haiqin Ren and Yaqin Wang and Dan Zhang and Bo Wang and Fenghua Liu and Qiongfang Wu and Ze Wang and Haiyan Bai and Yuan Li and Yi Zhou and Mei Sun and Hong Liu and Jing Li and Lin Zhang and Xiaoli Chen and Songying Zhang and Xiaoxi Sun and Richard Legro and Chen, {Zi Jiang}",
year = "2018",
month = "1",
day = "11",
doi = "10.1056/NEJMoa1705334",
language = "English (US)",
volume = "378",
pages = "126--136",
journal = "New England Journal of Medicine",
issn = "0028-4793",
publisher = "Massachussetts Medical Society",
number = "2",

}

Shi, Y, Sun, Y, Hao, C, Zhang, H, Wei, D, Zhang, Y, Zhu, Y, Deng, X, Qi, X, Li, H, Ma, X, Ren, H, Wang, Y, Zhang, D, Wang, B, Liu, F, Wu, Q, Wang, Z, Bai, H, Li, Y, Zhou, Y, Sun, M, Liu, H, Li, J, Zhang, L, Chen, X, Zhang, S, Sun, X, Legro, R & Chen, ZJ 2018, 'Transfer of fresh versus frozen embryos in ovulatory women', New England Journal of Medicine, vol. 378, no. 2, pp. 126-136. https://doi.org/10.1056/NEJMoa1705334

Transfer of fresh versus frozen embryos in ovulatory women. / Shi, Yuhua; Sun, Yun; Hao, Cuifang; Zhang, Heping; Wei, Daimin; Zhang, Yunshan; Zhu, Yimin; Deng, Xiaohui; Qi, Xiujuan; Li, Hong; Ma, Xiang; Ren, Haiqin; Wang, Yaqin; Zhang, Dan; Wang, Bo; Liu, Fenghua; Wu, Qiongfang; Wang, Ze; Bai, Haiyan; Li, Yuan; Zhou, Yi; Sun, Mei; Liu, Hong; Li, Jing; Zhang, Lin; Chen, Xiaoli; Zhang, Songying; Sun, Xiaoxi; Legro, Richard; Chen, Zi Jiang.

In: New England Journal of Medicine, Vol. 378, No. 2, 11.01.2018, p. 126-136.

Research output: Contribution to journalArticle

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

AU - Chen, Zi Jiang

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.).

UR - http://www.scopus.com/inward/record.url?scp=85040664635&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85040664635&partnerID=8YFLogxK

U2 - 10.1056/NEJMoa1705334

DO - 10.1056/NEJMoa1705334

M3 - Article

C2 - 29320646

AN - SCOPUS:85040664635

VL - 378

SP - 126

EP - 136

JO - New England Journal of Medicine

JF - New England Journal of Medicine

SN - 0028-4793

IS - 2

ER -

Shi Y, Sun Y, Hao C, Zhang H, Wei D, Zhang Y et al. Transfer of fresh versus frozen embryos in ovulatory women. New England Journal of Medicine. 2018 Jan 11;378(2):126-136. https://doi.org/10.1056/NEJMoa1705334