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Transfer of thawed frozen embryo versus fresh embryo to improve the healthy baby rate in women undergoing IVF:The E-Freeze RCT

Authors :
Maheshwari, Abha
Bari, Vasha
Bell, Jennifer L.
Bhattacharya, Siladitya
Bhide, Priya
Bowler, Ursula
Brison, Daniel
Child, Tim
Chong, Huey Yi
Cheong, Ying
Cole, Christina
Coomarasamy, Arri
Cutting, Rachel
Goodgame, Fiona
Hardy, Pollyanna
Hamoda, Haitham
Juszczak, Edmund
Khalaf, Yacoub
King, Andrew
Kurinczuk, Jennifer J.
Lavery, Stuart
Lewis-Jones, Clare
Linsell, Louise
Macklon, Nick
Mathur, Raj
Murray, David
Pundir, Jyotsna
Raine-Fenning, Nick
Rajkohwa, Madhurima
Robinson, Lynne
Scotland, Graham
Stanbury, Kayleigh
Troup, Stephen
Maheshwari, Abha
Bari, Vasha
Bell, Jennifer L.
Bhattacharya, Siladitya
Bhide, Priya
Bowler, Ursula
Brison, Daniel
Child, Tim
Chong, Huey Yi
Cheong, Ying
Cole, Christina
Coomarasamy, Arri
Cutting, Rachel
Goodgame, Fiona
Hardy, Pollyanna
Hamoda, Haitham
Juszczak, Edmund
Khalaf, Yacoub
King, Andrew
Kurinczuk, Jennifer J.
Lavery, Stuart
Lewis-Jones, Clare
Linsell, Louise
Macklon, Nick
Mathur, Raj
Murray, David
Pundir, Jyotsna
Raine-Fenning, Nick
Rajkohwa, Madhurima
Robinson, Lynne
Scotland, Graham
Stanbury, Kayleigh
Troup, Stephen
Source :
Maheshwari , A , Bari , V , Bell , J L , Bhattacharya , S , Bhide , P , Bowler , U , Brison , D , Child , T , Chong , H Y , Cheong , Y , Cole , C , Coomarasamy , A , Cutting , R , Goodgame , F , Hardy , P , Hamoda , H , Juszczak , E , Khalaf , Y , King , A , Kurinczuk , J J , Lavery , S , Lewis-Jones , C , Linsell , L , Macklon , N , Mathur , R , Murray , D , Pundir , J , Raine-Fenning , N , Rajkohwa , M , Robinson , L , Scotland , G , Stanbury , K , Troup , S & E-Freeze Trial Collaborative Group 2022 , ' Transfer of thawed frozen embryo versus fresh embryo to improve the healthy baby rate in women undergoing IVF : The E-Freeze RCT ' , Health Technology Assessment , vol. 26 , no. 25 .
Publication Year :
2022

Abstract

Background Freezing all embryos, followed by thawing and transferring them into the uterine cavity at a later stage (freeze-all), instead of fresh-embryo transfer may lead to improved pregnancy rates and fewer complications during in vitro fertilisation and pregnancies resulting from it. Objective We aimed to evaluate if a policy of freeze-all results in a higher healthy baby rate than the current policy of transferring fresh embryos. Design This was a pragmatic, multicentre, two-arm, parallel-group, non-blinded, randomised controlled trial. Setting Eighteen in vitro fertilisation clinics across the UK participated from February 2016 to April 2019. Participants Couples undergoing their first, second or third cycle of in vitro fertilisation treatment in which the female partner was aged < 42 years. Interventions If at least three good-quality embryos were present on day 3 of embryo development, couples were randomly allocated to either freeze-all (intervention) or fresh-embryo transfer (control). OutcomesThe primary outcome was a healthy baby, defined as a live, singleton baby born at term, with an appropriate weight for their gestation. Secondary outcomes included ovarian hyperstimulation, live birth and clinical pregnancy rates, complications of pregnancy and childbirth, health economic outcome, and State–Trait Anxiety Inventory scores. Results A total of 1578 couples were consented and 619 couples were randomised. Most non-randomisations were because of the non-availability of at least three good-quality embryos (n = 476). Of the couples randomised, 117 (19%) did not adhere to the allocated intervention. The rate of non-adherence was higher in the freeze-all arm, with the leading reason being patient choice. The intention-to-treat analysis showed a healthy baby rate of 20.3% in the freeze-all arm and 24.4% in the fresh-embryo transfer arm (risk ratio 0.84, 95% confidence interval 0.62 to 1.15). Similar results were obtained using complier-average causal effe

Details

Database :
OAIster
Journal :
Maheshwari , A , Bari , V , Bell , J L , Bhattacharya , S , Bhide , P , Bowler , U , Brison , D , Child , T , Chong , H Y , Cheong , Y , Cole , C , Coomarasamy , A , Cutting , R , Goodgame , F , Hardy , P , Hamoda , H , Juszczak , E , Khalaf , Y , King , A , Kurinczuk , J J , Lavery , S , Lewis-Jones , C , Linsell , L , Macklon , N , Mathur , R , Murray , D , Pundir , J , Raine-Fenning , N , Rajkohwa , M , Robinson , L , Scotland , G , Stanbury , K , Troup , S & E-Freeze Trial Collaborative Group 2022 , ' Transfer of thawed frozen embryo versus fresh embryo to improve the healthy baby rate in women undergoing IVF : The E-Freeze RCT ' , Health Technology Assessment , vol. 26 , no. 25 .
Notes :
application/pdf, English
Publication Type :
Electronic Resource
Accession number :
edsoai.on1382519391
Document Type :
Electronic Resource