Live birth rates with a freeze-only strategy versus fresh embryo transfer: secondary analysis of a randomized clinical trial

Lan N. Vuong*, Toan D. Pham, Vinh Q. Dang, Tuong M. Ho, Vu N.A. Ho, Robert J. Norman, Ben W. Mol

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

6 Citations (Scopus)

Abstract

Research question: What are the roles of serum progesterone and endometrial thickness as biomarkers in the decision between a freeze-only and fresh embryo transfer in IVF for women without polycystic ovary syndrome (PCOS)? Design: This was a secondary analysis of a randomized controlled trial including 782 couples who were followed up until the end of the first completed cycle. Couples scheduled for their first or second IVF cycle with a FSH/gonadotrophin-releasing hormone antagonist protocol were randomized to a freeze-only (n = 391) or fresh embryo transfer (n = 391) strategy. The endpoint for this analysis was live birth rate (LBR) after the first embryo transfer. Results: There was no significant difference in LBR after the first cycle between a freeze-only and fresh transfer strategy. When serum progesterone levels at trigger were in the third quartile (Q3, 1.14–1.53 ng/ml), LBR was significantly higher in the freeze-only versus fresh transfer group (P = 0.01); when serum progesterone was ≥1.14 ng/ml, LBR was significantly better in the freeze-only group (37.4% versus 23.8% in the fresh transfer group; P = 0.004). LBRs in the freeze-only and fresh embryo transfer groups were similar across all quartiles of endometrial thickness, although a small advantage for freeze-only in women with a very thin endometrium could not be excluded. Conclusions: Serum progesterone level on the day of trigger may have potential as a biomarker on which to base a prospective decision about whether to use a freeze-only or fresh embryo transfer strategy in women undergoing IVF.

Original languageEnglish
Pages (from-to)387-396
Number of pages10
JournalReproductive Biomedicine Online
Volume38
Issue number3
Early online date20 Dec 2018
DOIs
Publication statusPublished - Mar 2019

Keywords

  • Biomarkers
  • Endometrial thickness
  • Freeze-only protocol
  • IVF
  • Progesterone
  • Randomized clinical trial

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