Research question

Does a freeze-all strategy improve live birth rates in women of different age groups?

Design

Retrospective cohort study of 1882 first embryo transfer cycles, performed between January 2013 and December 2015. Reproductive outcomes between fresh (FRESH) or frozen (FROZEN) embryo transfers were compared in patients stratified by age: < 35, between 35 and 38, or > 38 years. Student’s t test for independent samples and χ² analyses were used as needed. A multivariable logistic regression analysis was performed adjusting for age, triggering drug, number of retrieved oocytes, number of transferred embryos, and percentage of top-quality embryos.

Main results and the role of chance

Live birth rates (LBR) were significantly higher for FROZEN in the < 35 years group (43.7% vs 24%; p < 0.001). In both the 35–38 and > 38 years groups, LBR for FROZEN vs FRESH were not statistically different (30.9% in the FROZEN group vs 29.3% in the FRESH group, p = 0.70, and 19.8% in the FROZEN group vs 12.7% in the FRESH group, p = 0.07, respectively). The multivariate analysis found a significantly positive effect of performing FROZEN on LBR in the younger group (OR 2.46, 95% CI 1.31–4.62; p = 0.005) but had no impact in women between 35 and 38 years (OR 1.01, 95% CI 0.55–1.83; p = 0.98) or older (OR 0.96, 95% CI 0.43–2.13; p = 0.92).

Conclusions

Performing a freeze-all strategy seems to result in better reproductive outcomes when compared with a fresh ET in women under 35 years, with no significant impact on older women.

中文翻译：

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全部冻结策略不会增加高龄育龄妇女的活产率。

研究问题

冻结所有策略是否可以提高不同年龄组女性的活产率？

设计

在 2013 年 1 月至 2015 年 12 月之间进行的 1882 个第一个胚胎移植周期的回顾性队列研究。在按年龄分层的患者中比较新鲜 (FRESH) 或冷冻 (FROZEN) 胚胎移植之间的生殖结果：< 35、35 至 38 或 > 38 岁。根据需要使用独立样本的学生t检验和 χ ² 分析。对年龄、触发药物、回收卵母细胞数量、移植胚胎数量和优质胚胎百分比进行了多变量逻辑回归分析。

主要结果和机会的作用

< 35 岁组中 FROZEN 的活产率 (LBR) 显着更高（43.7% 对 24%；p  < 0.001）。在 35-38 岁和 > 38 岁组中，FROZEN 与 FRESH 的 LBR 没有统计学差异（FROZEN 组 30.9% vs FRESH 组 29.3%，p  = 0.70，FROZEN 组 19.8% vs 12.7%在 FRESH 组中，分别为p  = 0.07）。多变量分析发现，在年轻组中进行 FROZEN 对 LBR 有显着的积极影响（OR 2.46，95% CI 1.31-4.62；p  = 0.005），但对 35 至 38 岁的女性没有影响（OR 1.01，95% CI 0.55–1.83；p  = 0.98) 或更早（OR 0.96，95% CI 0.43–2.13；p  = 0.92）。

结论

在 35 岁以下的女性中，与新鲜 ET 相比，执行全冷冻策略似乎可以带来更好的生殖结果，而对老年女性没有显着影响。