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Contribution of cryopreservation to the cumulative live birth rate: a large multicentric cycle-based data analysis from the Italian National Registry
- Source :
- Journal of Assisted Reproduction and Genetics
- Publication Year :
- 2019
- Publisher :
- Springer US, 2019.
-
Abstract
- Purpose: To estimate the contribution of cryopreservation to the cumulative live birth rate (CLBR) after law modification in Italy in the era of vitrification and freeze-all. Methods: The Italian National Registry performed a cycle-based data collection. Nine Italian IVF clinics were involved incorporating a total of 10,260 fresh cycles performed between January 2015 and April 2016 resulting in 9273 oocyte retrievals and 3266 subsequent warming cycles from the same oocyte retrievals performed up to December 2016. Mean female age was 37 ± 4.3 years. Primary outcome measure was CLBR per oocyte retrieval. Confounding factors were tested in multivariate regression analysis, and the relative impact of cryopreservation to the CLBR in different patient categories was calculated. Results: CLBR per oocyte retrieval was 32.6%, 26.5%, 18.7%, 13.0%, and 5.5% for women younger than 36, aged 36–39, 40–41, and older than 41 years, respectively. The total relative contribution of oocyte/embryo cryopreservation was 40.6% (95% CI 38.41–42.75). An association between maternal age, number of oocytes retrieved, fertilization rate, cryopreservation, and cumulative live birth was shown. When adjusted for confounders, a 2.3-fold increase was observed in the chance of live birth when cryopreservation was performed (OR 2.3; 95% CI 1.99–2.56). In high responder patients (> 15 oocytes retrieved) where freeze-all was applied in 67.6% of cycles to avoid the risk of hyper stimulation syndrome, the relative contribution of vitrification to the CLBR was 80.6%. Conclusions: Cryopreservation is essential in IVF and should always be available to patients to optimize success rates. Multicentric, cycle-based data analyses are crucial to provide infertile couples, clinicians, and regulatory bodies with accurate information on IVF effectiveness including fresh and cryopreserved cycles.
- Subjects :
- 0301 basic medicine
medicine.medical_specialty
Cumulative delivery rate
Cryopreservation
ICSI
IVF
Live birth
National Register
MEDLINE
Reproductive medicine
Mistake
03 medical and health sciences
0302 clinical medicine
Genetics
Medicine
Assisted Reproduction Technologies
Genetics (clinical)
030219 obstetrics & reproductive medicine
business.industry
Published Erratum
Obstetrics and Gynecology
General Medicine
030104 developmental biology
Reproductive Medicine
Family medicine
National registry
business
Developmental Biology
Subjects
Details
- Language :
- English
- ISSN :
- 15737330 and 10580468
- Volume :
- 36
- Issue :
- 11
- Database :
- OpenAIRE
- Journal :
- Journal of Assisted Reproduction and Genetics
- Accession number :
- edsair.doi.dedup.....227042b5c65a42d4a007d35c3638f5d3