Factors influencing the pregnancy outcome in normotensive women undergoing frozen embryo transfer cycles
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20260884Keywords:
Frozen embryo transfer, Normotensive women, PregnancyAbstract
Background: Infertility is defined as a failure to conceive within one or more year of regular unprotected intercourse. Assisted Reproductive techniques have been developed rapidly over the past few decades helping couple who are unable to conceive naturally. The overall clinical pregnancy rate of ART is over 50%. Many factors can influence the success of a clinical pregnancy such as maternal age, ovarian reserve, duration of infertility, type of infertility, hormonal levels and endometrial receptivity. Maintaining a normal blood pressure level is generally considered positive for fertility outcomes, as elevated blood pressure can negatively impact a woman's ability to conceive, potentially leading to issues with ovulation, implantation and increased risk of miscarriage. However, there are still some unknown risk factors that could affect the pregnancy outcome of ART.
Methods: This study included 80 normotensive women who underwent frozen embryo transfer cycles. Blood pressure was measured on all the women undergoing frozen embryo transfer. Female patient’s age, unique health identification, body mass index, type of infertility, blood pressure, endometrium thickness, number of embryos transferred, embryo grade and beta human chorionic gonadotropin were recorded.
Results: Among 80 normotensive women who underwent frozen embryo transfer, all factors were non-significantly associated with the clinical pregnancy rate. Factors that resulted in higher clinical pregnancy rate includes higher blood pressure, primary infertility, PCOS, overweight, day 4 embryo transfer, endometrium thickness >9 mm and morula grade embryo transfer. This could be because of limited sample size and time restrictions.
Conclusions: There is no significant association between blood pressure, type of infertility, polycystic ovarian syndrome, day of embryo transfer, embryo grade, body mass index and endometrium thickness with pregnancy rate in normotensive women undergoing frozen embryo transfer cycles. Further investigations with randomized trials are required to confirm the confounding nature of the factors analysed and their influence on pregnancy outcome in normotensive women undergoing frozen embryo transfer.
References
Malizia BA, Hacker MR, Penzias AS. Cumulative live-birth rates after in vitro fertilization. N Engl J Med. 2009;360:236–43. DOI: https://doi.org/10.1056/NEJMoa0803072
Important contributions to clinical medicine during the past 30 years from the study of human blood pressure. Bull Johns Hopkins Hosp. 1915;26:341–50.
Pasqualotto EB, Agarwal A, Sharma RK, Izzo VM, Pinotti JA, Joshi NJ, et al. Effect of oxidative stress in follicular fluid on the outcome of assisted reproductive procedures. Fertil Steril. 2004;81:973–6. DOI: https://doi.org/10.1016/j.fertnstert.2003.11.021
Teede HJ, Misso ML, Costello MF, Dokras A, Laven J, Moran L, et al. Recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome. Fertil Steril. 2018;110(3):364–79. DOI: https://doi.org/10.1111/cen.13795
Holte J, Gennarelli G, Berne C, Bergh T, Lithell H. Elevated ambulatory day-time blood pressure in women with polycystic ovary syndrome: a sign of a pre-hypertensive state. Hum Reprod. 1996;11(1):23-8. DOI: https://doi.org/10.1093/oxfordjournals.humrep.a019028
Carmina E. Cardiovascular risk and events in polycystic ovary syndrome. Climacteric. 2009;12(1):22-5. DOI: https://doi.org/10.1080/13697130903003842
Bhattacharya S, Campbell DM, Liston WA, Bhattacharya S. Effect of Body Mass Index on pregnancy outcomes in nulliparous women delivering singleton babies. BMC Public Health. 2007;7:168. DOI: https://doi.org/10.1186/1471-2458-7-168
Eryilmaz OG. Endometrial thickness measurement throughout a menstrual cycle in non-obese infertile patients with polycystic ovary syndrome. Arch Gynecol Obst. 2012;286:1597-600. DOI: https://doi.org/10.1007/s00404-012-2488-y
El-Toukhy T. The relationship between endometrial thickness and outcome of medicated frozen embryo replacement cycles. Fertil Steril. 2008;89:832-9. DOI: https://doi.org/10.1016/j.fertnstert.2007.04.031
Taugourdeau A, Desquiret-Dumas V, Hamel JF, Chupin S, Boucret L, Ferre-L’Hotellier V, et al. The mitochondrial DNA content of cumulus cells may help predict embryo implantation. J Assist Reprod Genet. 2019;36:223–8. DOI: https://doi.org/10.1007/s10815-018-1348-5
Björndahl L, Mortimer D, Barratt CLR, Castilla JA, Menkveld R, Kvist U, et al. A Practical Guide to Basic Laboratory Andrology. Cambridge: Cambridge University Press. 2010. DOI: https://doi.org/10.1017/CBO9780511729942
HuijunChen Even high normal blood pressure affects livebirth rate in women undergoing fresh embryo transfer. Human Reprod. 2022;37(11):2578-88. DOI: https://doi.org/10.1093/humrep/deac201
Johanna A, Joseph A. Success of single euploid embryo transfer in patients experiencing primary versus secondary infertility. Fert Ster. 2024;122(4):304. DOI: https://doi.org/10.1016/j.fertnstert.2024.07.930
Liu S, Mo M, Xiao S, Li L, Hu X, Hong L, et al. Pregnancy outcomes of women with polycystic ovary syndrome for the first in vitro fertilization treatment: a retrospective cohort study with 7678 patients. 2020;25:11:575337. DOI: https://doi.org/10.3389/fendo.2020.575337
Funabiki S, Taguchi T, Hayashi Y. The influence of body mass index (BMI) on pregnancy outcomes among Japanese infertile women. Fert Ster. 2011;2:23-9. DOI: https://doi.org/10.1016/j.fertnstert.2011.07.452
Lee SH, Lee SH. Comparison of the clinical outcomes of day 4 and 5 embryo transfer cycles. Clin Exp Reprod Med. 2013;2:87-9. DOI: https://doi.org/10.5653/cerm.2013.40.3.122
Bu Z, Wang K, Dai W, Sun Y. Endometrial thickness significantly affects clinical pregnancy and live birth rates in frozen-thawed embryo transfer cycles. Gynecol Endocrinol. 2016;32(7):524-8. DOI: https://doi.org/10.3109/09513590.2015.1136616
Li RS, Hwu YM, Lee RKK, Li SH, Lin MH. Day 4 good morula embryo transfer provided compatible live birth rate with day 5 blastocyst embryo in fresh IVF/ET cycles. Taiwan J Obstet Gynecol. 2018;57(1):52-7. DOI: https://doi.org/10.1016/j.tjog.2017.12.008
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