E-FREEZE: RCT in embryo transfer in women undergoing in-vitro fertilization

E-FREEZE: A randomised controlled trial evaluating the clinical and cost-effectiveness of a policy of freezing all embryos followed by thawed frozen embryo transfer, compared with a policy of fresh embryo transfer in women undergoing in-vitro fertilization

 

Despite improvements in technology, IVF success rates remain low with an overall live birth rate of 25% per treatment. Additionally, there are concerns about health outcomes for mothers and babies conceived through IVF, particularly after fresh embryo transfer, including maternal ovarian hyperstimulation syndrome (OHSS) and perinatal morbidity. It is believed that high levels of ovarian hormones during ovarian stimulation could create a relatively hostile environment for embryo implantation whilst increasing the risk of OHSS. It has been suggested that electively freezing embryos with the intention of thawing and replacing them within the uterus at a later stage (thawed frozen embryo transfer), instead of fresh embryo transfer, may lead to improved pregnancy rates and fewer complications. This two-arm parallel group randomised controlled trial, across multiple IVF centres in the UK, aims to address this question: http://www.nets.nihr.ac.uk/projects/hta/1311582.

More information on the trial is available at the Trial website and on the NIHR project portfolio. The ISRCTN registry is 61225414 (DOI: 10.1186/ISRCTN61225414).

HERU researchers involved in this research project: Graham Scotland

External collaborators: Mahashwari, A. (NHS Grampian); Macklon, N. (University of Southampton); Khalaf, Y. (Guy’s and St Thomas Hospital); Lavery, S. (Hammersmith Hospital); Child, T., Juszczak, E., Hardy, P., Kurinczuk, J. (University of Oxford); Rajkohwa, M. (Birmingham’s Women’s Hospital); Coomarasamy, A. (University of Birmingham); Cutting, R. (University of Sheffield); Brison, D. (Central Manchester University Hospital NHS Trust); Troup, S. (Liverpool Women’s Hospital); Lewis-Jones, C. (Infertility Network, UK); Raine-Fenning, N. (University of Nottingham) and Bhattacharya, S. (Obstetrics & Gynaecology, University of Aberdeen.

Publications

Maheshwari, A., Bhattacharya, S., Bowler, U., Brison, D., Child, T., Cole, C., Coomarasamy, A., Cutting, R., Harbottle, S., Hardy, P., Juszczak, E., Khalaf, Y., Kurinczuk, J.J., Lavery, S., Lewis-Jones, C., Macklon, N., Raine-Fenning, N.J., Rajkohwa, M., Scotland, G. and Troup, S. (2019) 'Study protocol: E-freeze - freezing of embryos in assisted conception: a randomised controlled trial evaluating the clinical and cost effectiveness of a policy of freezing embryos followed by thawed frozen embryo transfer compared with a policy of fresh embryo transfer, in women undergoing in vitro fertilisation', Reproductive Health, 16(1), 81.