Browsing by Author "Meiring, Elizabeth"
Now showing 1 - 1 of 1
Results Per Page
Sort Options
- ItemReport on the live birth rates and neonatal outcomes of ART patients at Aevitas Fertility Clinic : implications of a Frozen Embryo Transfer (FET) program(Stellenbosch : Stellenbosch University, 2020-03) Meiring, Elizabeth; Siebert, T. I.; Windt-De Beer, Marie-Lena; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Obstetrics and Gynaecology. Reproductive Medicine Unit.ENGLISH ABSTRACT : Background: The practice of Assisted Reproductive Technologies (ARTs) has become quite commercial in the last decade or two, since an increasing number of couple’s face fertility challenges and nevertheless remain hopeful for a family of their own. Recent refinements in ART, especially in the area of embryo cryopreservation especially vitrification, has also increased its popularity. Despite the many benefits of ART, concerns about the health of children born following ART treatment is a relevant topic of discussion. Pregnancy after infertility treatment is associated with negative neonatal and obstetric outcomes in comparison to spontaneous conceptions. Concerns about gestational age and birthweight in babies of patients of advanced maternal age have been voiced and recent evidence mentioned differences in neonatal outcomes between fresh embryo transfer (ET) cycles and frozen embryo transfer (FET) cycles. However, contradictory outcomes exist in the published literature on this subject. Some studies have hypothesized those inferior reproductive outcomes after ART may be due to parental characteristics, insemination method such as in vitro fertilization (IVF) an intracytoplasmic sperm injection (ICSI), embryo culture, cryopreservation and epigenetic modifications. It is therefore the professional responsibility of fertility specialists and scientists to be conscious of the risks of unfavourable outcomes in ART and to record and publish their results in peer reviewed publications. Aims: The primary aim was to conduct a retrospective audit of the fresh and the frozen (vitrified/warmed) embryo transfer (FET) cycle success at Aevitas Fertility Clinic for the period of 2015-2017, by calculating the LBR and evaluating neonatal outcomes. The secondary aim was to retrospectively investigate the possible effect of female age, number of ova retrieved at the time of oocyte pick up (OPU), number of embryos transferred at the time of embryo transfer (ET) and blastulation rate (BR) on the live birth rate (LBR) and neonatal outcomes in FET and fresh ET cycles. Materials and Methods: Data was acquired from the standard, routine de-identified data files of the Aevitas Fertility Clinic, using medical/laboratory records ONLY for the period of 2015-2017. Patients were included in the study after exclusion and inclusion criteria were applied. The data was submitted for statistical analysis and p-values of <0.05 were considered statistically significant. Multiple regression analyses compensated for cycle type (fresh ET/FET), female age, number of embryos transferred at the time of ET, and donor oocyte cycles. Results: The LBR (43,62% vs 45,15%), birthweight (2837,01g vs 2861,41g) and gestational age (36,29 weeks vs 36,53 weeks) of neonates were not significantly between the FET and the Fresh ET groups, respectively (p>0.05). Female age was significantly, negatively associated with the LBR (p=0.003) and neonatal birthweight (p=0.038) and oocyte donation cycles resulted in lower birthweight individuals (p=0.003). Blastulation rate was significantly different between the fresh ET and FET group (48, 18% and 65, 41%) (p=0.000). Conclusion: This retrospective study indicated similar LBRs between the fresh ET and FET groups, which is in agreement with some published works. Contrary to some reports in the literature, reporting improved outcomes on following FETs, our study showed no difference in neonatal birthweight or gestational age between the fresh ET and FET groups. This is possibly due to the compilation of the patient population. The results of the study indicate that the ART and also the blastocyst vitrification programs at Aevitas Fertility Clinic follow good clinical laboratory practices. It is very successful and in this study cohort of patients, no adverse neonatal outcomes were evident. The audit analysis could be followed up including a larger sample size, additional confounders could be added to increase the power of the findings and subgroup analysis might also give more relevant information.