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Rate of true recurrent implantation failure is low: results of three successive frozen euploid single embryo transfers

Abstract : Objective: To study the true prevalence of recurrent implantation failure. Design: Retrospective cohort study. Setting: A private assisted reproductive technology center. Patient(s): Women (n- 4,429) with anatomically normal uterus who underwent up to three consecutive frozen euploid single embryo transfers (FE-SETs) were included in the study. Cycles with donor eggs or gestational carriers were excluded. Intervention(s): None. Main Outcome Measure(s): Cumulative outcomes from these cycles were analyzed. A logistic regression model was used to assess the differences of outcomes between first, second, and third FE-SET and a Kaplan-Meier curve as used to analyze cumulative implantation rate. Result(s): The mean age of the patients included in the study was of 35.4 years. The sustained implantation rates of the first, second, and third FE-SET were 69.9%, 59.8%, and 60.3% per transfer, respectively. The cumulative sustained implantation rate after up to three consecutive FE-SET was 95.2%. The live birthrates after the first, second, and third FE-SET were 64.8%, 54.4%, and 54.1% per transfer, respectively. The cumulative live birth rate after up to three consecutive FE-SET was 92.6%. The miscarriage rate after observing a positive heartbeat was not different between the first (7.2%), second (8.8%), and third (12.7%) FE-SET. Conclusion(s): Our findings suggest that true recurrent implantation failure is rare. For those patients with the ability to make euploid blastocysts, <5% would fail to achieve a clinical pregnancy with three embryos transferred. It remains to be further investigated whether this threshold identifies a truly recalcitrant group or simply a statistical certainty based on random variation. (C) 2020 by American Society for Reproductive Medicine.
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https://hal.inrae.fr/hal-03184107
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Submitted on : Monday, March 29, 2021 - 11:11:14 AM
Last modification on : Wednesday, June 9, 2021 - 4:34:25 PM

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Paul Pirtea, Dominique de Ziegler, Xin Tao, Li Sun, Yiping Zhan, et al.. Rate of true recurrent implantation failure is low: results of three successive frozen euploid single embryo transfers. Fertility and Sterility, Elsevier, 2021, 115 (1), pp.45-53. ⟨10.1016/j.fertnstert.2020.07.002⟩. ⟨hal-03184107⟩

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