Peer Reviewed

1

Document Type

Article

Publication Date

6-11-2008

Keywords

IVF, Ovarian Hyperstimulation Syndrome, Embryo Cryopreservation

Comments

This article is also available at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2585559/

Abstract

OBJECTIVE:

To review utilisation of elective embryo cryopreservation in the expectant management of patients at risk for developing ovarian hyperstimulation syndrome (OHSS), and report on reproductive outcome following transfer of thawed embryos.

MATERIALS AND METHODS:

Medical records were reviewed for patients undergoing IVF from 2000-2008 to identify cases at risk for OHSS where cryopreservation was electively performed on all embryos at the 2 pn stage. Patient age, total number of oocytes retrieved, number of 2 pn embryos cryopreserved, interval between retrieval and thaw/transfer, number (and developmental stage) of embryos transferred (ET), and delivery rate after IVF were recorded for all patients.

RESULTS:

From a total of 2892 IVF cycles undertaken during the study period, 51 IVF cases (1.8%) were noted where follicle number exceeded 20 and pelvic fluid collection was present. Elective embryo freeze was performed as OHSS prophylaxis in each instance. Mean (+/- SD) age of these patients was 32 +/- 3.8 yrs. Average number of oocytes retrieved in this group was 23 +/- 8.7, which after fertilisation yielded an average of 14 +/- 5.7 embryos cryopreserved per patient. Thaw and ET was performed an average of 115 +/- 65 d (range 30-377 d) after oocyte retrieval with a mean of 2 +/- 0.6 embryos transferred. Grow-out to blastocyst stage was achieved in 88.2% of cases. Delivery/livebirth rate was 33.3% per initiated cycle and 43.6% per transfer. Non-transferred blastocysts remained in cryostorage for 24 of 51 patients (46.1%) after ET, with an average of 3 +/- 3 blastocysts refrozen per patient.

CONCLUSION:

OHSS prophylaxis was used in 1.8% of IVF cycles at this institution; no serious OHSS complications were encountered during the study period. Management based on elective 2 pn embryo cryopreservation with subsequent thaw and grow-out to blastocyst stage for transfer did not appear to compromise embryo viability or overall reproductive outcome. For these patients, immediate elective embryo cryopreservation and delay of ET by as little as 30 d allowed for satisfactory conclusion of the IVF sequence, yielding a livebirth-delivery rate (per ET) >40%.

Disciplines

Medicine and Health Sciences | Obstetrics and Gynecology

Citation

Sills ES, McLoughlin LJ, Genton MG, Walsh DJ, Coull GD, Walsh AP. Ovarian hyperstimulation syndrome and prophylactic human embryo cryopreservation: analysis of reproductive outcome following thawed embryo transfer. Journal of Ovarian Research. 2008;1(1):7.

PubMed ID

19014420

DOI Link

10.1186/1757-2215-1-7

Creative Commons License

Creative Commons License
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