| Background:The clinical pregnancy rate is increasing with the development of in vitro fertilization and embryo transfer(IVF-ET),however,a small number of treatment cycles has not achieved satisfactory pregnancy outcomes.The common reasons for embryos frozen include:ovarian hyperstimulation syndrome(OHSS)risk,high level of serum progesterone,endometrial factor,and poor embryos quality et al.Current evidences suggest that embryos frozen reduce the risk of late ovarian hyperstimulation,while avoiding the negative effects of high level of serum progesterone and endometrial factor on endometrial receptivity.Frozen embryo transfer can improve pregnancy outcomes.In clinical practice,the causes of embryos frozen and the indicators of cancellation for fresh embryo transfer have been changing with the development of assisted reproductive technology(ART).Objective:To analyze the proportion and changes of causes for cancellation of fresh embryo transfer during in vitro fertilization(IVF)/intracytoplasmic sperm injection(ICSI)treatment from 2008 to 2017 in the Reproductive Hospital Affiliated to Shandong University.Methods:A retrospective analysis was performed among 17601 cycles with fresh embryo transfer cancellation during IVF/ICSI treatment,including 3018 cycles from 2008 to 2012,and 14583 cycles from 2013 to 2017.The age ranged from 20 to 44 years old.Infertility reasons included tubal factor,ovulation dysfunction,endometriosis and the male factors.Long,short,ultra-long GnRHa,GnRH antagonist and mini-stimulation protocols were applied in controlled ovarian hyperstimulation.The causes of cancellation included ovarian hyperstimulation syndrome(OHSS),high level of serum progesterone,endometrial factors,poor embryo quality,hydrosalpinx,arind others.Further analysis was performed according to the female age(<35 yrs and≥35yrs)and different protocols.Results:(1)The major cause for cancellation was OHSS risk,which showed an increasing trend in all age groups from 2008 to 2017(2)For women exceeding 35 yrs,the main reason was poor embryo quality,whereas for women less than 35 yrs was OHSS risk.(3)An obvious increase was observed in the proportion of hydrosalpinx resulting in cancellation in all age groups in the past 10 years(4)For long,GnRH antagonist and ultra-long GnRHa protocols,the prominent cause for cancellation was OHSS risk.For mini-stimulation,short protocols,the major cause was poor embryo qualityConclusion:The main reason for cancellation was OHSS risk,followed by poor embryo quality.Effective methods could be considered to reduce the rate of cancellation,such as preventing ovarian hyperresponsiveness,improving embryo quality,and controlling pelvic inflammation. |
