- Patient-specific predictors of successful frozen embryo transfer using the freeze-all protocol: a retrospective observational study
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Hyun Joo Lee, Eun Hee Yu, Jong Kil Joo
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J Yeungnam Med Sci. 2025;42:28. Published online February 25, 2025
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DOI: https://doi.org/10.12701/jyms.2025.42.28
[Epub ahead of print]
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 Abstract
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- Background
The aim of this study was to examine various patient factors affecting first programmed embryo transfer (ET) outcomes under the freeze-all policy at a single tertiary university infertility center.
Methods
This retrospective observational study reviewed the medical records of 243 couples who underwent their first ET using blastocysts collected under the freeze-all antagonist-controlled ovarian stimulation (COS) protocol from 2015 to 2023. Patients were grouped into pregnant and nonpregnant groups, and their data, including demographics, COS and ET outcomes, and embryo storage duration, were analyzed.
Results
Patient body mass index, cause of infertility, follicle-to-oocyte index, distribution of blastocyst grades, number of transferred embryos, and embryo storage duration were not significantly different between the groups. In a simple comparative analysis, patients with successful clinical pregnancy tended to have significantly lower female and male age (33.83±3.67 and 35.32±4.54 years vs. 37.07±4.15 and 39.33±5.60 years, respectively), higher anti-Müllerian hormone levels (6.27±5.32 ng/mL vs. 4.14±3.82 ng/mL) and antral follicle counts (14.20±8.26 vs. 10.04±5.75), and higher numbers of retrieved oocytes and metaphase II oocytes (13.74±6.92 and 9.64±6.19 vs. 11.21±6.04 and 7.53±5.56, respectively). Multivariate logistic regression analysis of these variables revealed that only male age was a significant factor for successful clinical pregnancy (odds ratio, 4.768; 95% confidence interval, 1.252–18.162; p=0.022).
Conclusion
During the first programmed ET using blastocysts collected under the freeze-all antagonist COS protocol, male age and correspondingly the quality of gametes for fertilization were crucial for successful pregnancy, having more importance than calculated female ovarian reserve and embryo storage duration.
- Clinical factors that affect the pregnancy rate in frozen-thawed embryo transfer in the freeze-all policy
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Seo Yoon Hwang, Eun Hye Jeon, Seung Chul Kim, Jong Kil Joo
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Yeungnam Univ J Med. 2020;37(1):47-53. Published online September 27, 2019
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DOI: https://doi.org/10.12701/yujm.2019.00346
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Abstract
PDF
- Background
This study was conducted to analyze clinical factors that can affect pregnancy rates in normal responders undergoing the freeze-all policy in in vitro fertilization.
Methods
We evaluated 153 embryo transfer cycles in 89 infertile women with normal response to controlled ovarian stimulation (COS). After COS, all embryos were cultured to the blastocyst stage, and good quality blastocysts were vitrified for elective frozen-thawed embryo transfer (FET). Clinical variables associated with COS and the results of COS and culture, including the number of retrieved oocytes, fertilized oocytes, and frozen blastocysts were compared between the pregnant group and the non-pregnant group.
Results
After a single cycle of COS for each patient, 52 patients became pregnant while 37 did not. Significant differences were observed in the number of matured oocytes, fertilized oocytes, frozen blastocysts, and transferred embryos. The number of frozen blastocysts in the pregnant group was almost twice that in the non-pregnant group (5.6±3.1 vs. 2.8±1.9, p<0.001). The area under the receiver operating characteristic curve for the 4 frozen blastocysts was 0.801 in the pregnant group.
Conclusion
In the freeze-all policy, the number of matured oocytes, number of fertilized oocytes, and number of frozen blastocysts might be predictive factors for pregnancy.
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Citations
Citations to this article as recorded by  - Even high normal blood pressure affects live birth rate in women undergoing fresh embryo transfer
Huijun Chen, Xiaoli Zhang, Sufen Cai, Jian Li, Sha Tang, Carl-Friedrich Hocher, Benjamin Rösing, Liang Hu, Ge Lin, Fei Gong, Bernhard K Krämer, Berthold Hocher
Human Reproduction.2022; 37(11): 2578. CrossRef
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Yeungnam University College of Medicine
