Dataset Information

Frozen embryo transfer in the menstrual cycle after moderate-severe ovarian hyperstimulation syndrome: a retrospective analysis.

ABSTRACT:

Background

Ovarian hyperstimulation syndrome (OHSS) is a rare but serious complication of controlled ovarian stimulation. Frozen-embryo transfer (ET) is prompted to be performed in the next menstrual cycles after cancellation of fresh-ET after occurrence of OHSS. However, effects of frozen-ET in the second menstrual cycle have never been investigated. Therefore, this study aimed to assess this in the menstrual cycle after OHSS.

Methods

The OHSS group included 342 women with moderate-severe OHSS who underwent the first frozen-ET in the second menstrual cycle in the First Affiliated Hospital of Anhui Medical University from June 2018 to September 2019. A total of 342 women without OHSS who received frozen-ET in the second menstrual cycle were selected as control group matched by age, body mass index, fertility history, ovulation induction scheme. Uni- and multi-variable conditional logistic regression was used to estimate the association between moderate-severe OHSS and pregnancy outcomes.

Results

There were no significant differences in maternal outcomes (miscarriage, preterm birth and pregnancy complications including gestational diabetes mellitus, pregnancy-induced hypertension, placenta previa, premature rupture of membranes and postpartum hemorrhage) and in neonatal outcome (birth-weight and body length, neonatal congenital diseases and other complications) between the two groups in either uni- or multi-variable models.

Conclusions

Frozen-ET in the menstrual cycle after OHSS has similar maternal and neonatal outcomes as in women without OHSS. This study indicates that frozen-ET could be performed in the second menstrual cycle in women who recovered from moderate-severe OHSS.

SUBMITTER: Yang Y

PROVIDER: S-EPMC9724267 | biostudies-literature | 2022 Dec

REPOSITORIES: biostudies-literature

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Publications

Frozen embryo transfer in the menstrual cycle after moderate-severe ovarian hyperstimulation syndrome: a retrospective analysis.

Yang Yulu Y Zhu Damin D Wang Qiushuang Q Ma Cong C Li Danyang D Wang Jing J Zhou Ping P Wei Zhaolian Z Peng Xiaoqing X Cao Yunxia Y Xu Xiaofeng X

BMC pregnancy and childbirth 20221206 1

<h4>Background</h4>Ovarian hyperstimulation syndrome (OHSS) is a rare but serious complication of controlled ovarian stimulation. Frozen-embryo transfer (ET) is prompted to be performed in the next menstrual cycles after cancellation of fresh-ET after occurrence of OHSS. However, effects of frozen-ET in the second menstrual cycle have never been investigated. Therefore, this study aimed to assess this in the menstrual cycle after OHSS.<h4>Methods</h4>The OHSS group included 342 women with modera ...[more]

PMID: 36474167

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Project description:To explore the risk factors of moderate to severe ovarian hyperstimulation syndrome (Ovarian hyperstimulation syndrome, OHSS) in patients using the early-follicular phase long-acting gonadotropin-releasing hormone agonist long protocol (EFLL) group in fresh cycles, and to establish a nomogram model to predict the risk of moderate to severe OHSS. We retrospectively analyzed clinical data from 4,204 patients who receiving in vitro fertilization/intracytoplasmic sperm injection and embryo transfer (IVF/ICSI-ET) at the Reproductive Medicine Department of the Second Affiliated Hospital of Zhengzhou University from January 2015 to August 2024. A total of 4204 cases using EFLL protocol were included. The clinical cases were randomly divided into a modeling group (2,942 cases) and a verification group (1,262 cases) at a ratio of 7:3. Logistic regression analysis was used to identify the independent risk factors associated with the occurrence of moderate to severe OHSS in fresh cycles, Based on the selected independent risk factors and correlated regression coefficients, we established a nomogram model to predict the probability of moderate to severe OHSS in this patients, and the predictive accuracy of the model was measured using the area under the receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis. Univariate and multivariate logistic regression analyses showed that Antal follicle count (AFC) (OR, 1.04; 95%CI, 1.02-1.07; P = 0.002), estrogen levels on the day of hCG injection (OR, 1.01; 95%CI, 1.01-1.01; P<0.01), progesterone levels on the day of hCG injection (OR, 1.18; 95%CI, 1.04-1.34; P = 0.011),, whether the patient had a hypothyroidism (OR, 3.62; 95%CI, 2.10-6.23; P < 0.001), and infertility type (OR, 0.59; 95%CI, 0.35-0.99; P = 0.048) are the independent risk factors for the occurrence of moderate to severe OHSS in fresh cycles. The ROC curve (AUC) being 0.83 (95% CI: 0.78-0.88) for the modeling group and 0.84 (95% CI: 0.78-0.90) for the validation group. The calibration curve and decision curve demonstrated good consistency between the predicted rates of moderate to severe OHSS and the actual incidence. AFC, estrogen levels on the day of hCG injection, progesterone levels on the day of hCG injection, whether the patient had a hypothyroidism, and infertility type are the independent risk factors for moderate to moderate to severe OHSS in fresh cycles. The established nomogram model has proven to be a novel tool that can intuitively predict the incidence of moderate to severe OHSS in the patients that receiving EFLL protocol in fresh cycles, and this nomogram model developed in this study showed better net benefit, have a good clinical applicability for decision-making and could help the clinician to set up a better clinical management strategies for conducting a precise personal therapy.

Project description:Background: Nowadays, the choice of frozen embryo transfer (FET) regimens is mainly guided by personal convenience. Clinicians prefer the predictability and reliability of artificial cycle (AC) FET and have extended its usage to general in vitro fertilization population. More recent primary studies are beginning to challenge the comparability of AC-FET and suggest reduced clinical pregnancy rate and live birth rate (LBR) compared with those in modified natural cycle (mNC) FET (ovulation triggered by human chorionic gonadotrophin) and stimulated cycle (SC) FET. Objective: To assess the pregnancy outcomes within matched mNC-FET, SC-FET, and AC-FET cycles by using propensity score matching (PSM) in a larger cohort. Methods: A total of 16,946 women who underwent their first autologous FET cycle between July 2014 and July 2017 were evaluated. PSM, using the nearest neighbor matching, were established to adjust the baseline features within the three protocols in proportion of 1:1 (mNC-FET vs. SC-FET, mNC-FET vs. AC-FET, SC-FET vs. AC-FET). Furthermore, there were 3,567, 2,917, and 3,964 cycles compared between matched mNC-FET and SC-FET, mNC-FET and AC-FET, and SC-FET and AC-FET after the PSM, respectively. Results: LBR was significant lower in the AC-FET group than that in the mNC-FET (40.0 vs. 43.3%) and SC-FET groups (40.9 vs. 46.5%). The adjusted odds ratios (95% CIs) were 1.11 (1.00, 1.24) for mNC/AC (P = 0.044) and 0.84 (0.76, 0.92) for AC/SC (P < 0.001), which indicated that the AC-FET group was associated with lowest LBR. The LBR was comparable between matched mNC-FET and SC-FET after adjusting for endometrial thickness. Moreover, a lower clinical pregnancy rate and a higher risk of early pregnancy loss were discovered in AC-FET cycles compared with those in SC-FET. Conclusion: In view of our data, AC used for scheduling FET was associated with lower LBR compared with SC and modified natural cycle. This interpretation requires future verification from well-designed prospective multicenter randomized clinical trials, although the comparisons in our study were conducted in the homogenous population after the PSM.

Dataset Information

Frozen embryo transfer in the menstrual cycle after moderate-severe ovarian hyperstimulation syndrome: a retrospective analysis.

Background

Methods

Results

Conclusions

Publications

Frozen embryo transfer in the menstrual cycle after moderate-severe ovarian hyperstimulation syndrome: a retrospective analysis.

Similar Datasets

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