Efficiency of Freeze-All Embryo Transfer on Pregnancy in the Patients with Poor Ovarian Reserve.

Abstract

Serum levels of anti-Müllerian hormone (AMH) have been demonstrated to positively correlate with the size of the primordial follicle pool and considered to marker for ovarian reserve. As a woman ages, there is a decrease in blood level of AMH by the decrease the number of growing follicles. According to the known evidences, due to the development of methods for freezing and thawing of embryos during in vitro fertilization (IVF), fresh embryos can be frozen and withheld for embryo transfer (ET) in fresh cycles depending on the patient's physiological and histological status, and thawed at the appropriate time for patients. And many studies have shown that this method is similar to the fresh cycle pregnancy rate. So far, it is not well uncovered about the positive effects of freeze-all embryo transfer (FAET) in poor ovarian revere groups. To improve the IVF-ET in poor responder or poor ovarian-responder (POR), a study is needed to determine whether FAET has the same results in the ovarian low-response group compared with normal-response group. The normal and poor responder groups can be distinguished according to internationally defined ovarian response deterioration standards. Based on the criteria the IVF-ET patients were distinguished and compared by the clinical criteria with retrospective study method (from March 2018 to November 2019 at Suzy Maria Hospital). The patients were classified into fresh cycle and FAET cycle. The characteristics of the patients were compared and analyzed by dividing the normal ovary response group and the low ovary response group. Analyze the results of FAET in the normal ovarian response group and the POR group. In the POR group, the results of fresh cycle embryo transfer and thawing embryo transfer were analyzed. As a result of the analysis, there was no statistically significant difference between the fresh cycle and thawed after FAET cycle．Although there was no statistical significance, the tendency of the pregnancy rate to decrease as the ovarian function decreased overall was clear. Although needed more number of case, FAET had tendency to more positive in successful pregnancy in normal responder after 42 years old but not showed similar patterns in poor responder. The characters which mostly affect on pregnancy in 38≦~<40 was the numbr of collected oocytes and tranfered embryos, in 40≦~<42 was the blood P4 level, in 42≦~<44 was no significant criteria, and in ≧44 was the number of transfered embryos in poor responder fresh ET groups. On the other hand, in the poor responder with FAET, the characters which mostly affect on pregnancy was no significant criteria in 38≦~<40, the blood P4 level in 40≦~<42, the blood levels of FSH and AMH in 40≦~<42, and the blood levels of FSH and E2, BMI, and the number of transfered embryos in ≧44 group. Therefore, it seems to be necessary to make more careful decisions about the timing of transplantation of the poor-response group.