Frozen versus fresh embryo transfer in women with low prognosis for in vitro fertilisation treatment: pragmatic, multicentre, randomised controlled trial

作者：Daimin Wei, Yun Sun, Han Zhao, Junhao Yan, Hong Zhou, Fei Gong, Aijun Zhang, Ze Wang, Lei Jin, Hongchu Bao, Shuyun Zhao, Zhuoni Xiao, Yingying Qin, Ling Geng, Linlin Cui, Yan Sheng, Mei Sun, Peihao Liu, Lingling Ding, Hong Liu, Keliang Wu, Li Y, Yao Lu, Bufang Xu, Bei Xu, Luqing Zhang, Heping Zhang, Richard S. Legro, Zi‐Jiang Chen · 发表于：BMJ · 年份：2025 · DOI：10.1136/bmj-2024-081474 · 被引用次数：35 · 研究领域：Ovarian function and disorders、Reproductive Health and Technologies、Assisted Reproductive Technology and Twin Pregnancy

Abstract Objective To test the hypothesis that a freeze-all strategy would increase the chance of live birth compared with fresh embryo transfer in women with low prognosis for in vitro fertilisation (IVF) treatment. Design Pragmatic, multicentre, randomised controlled trial. Setting Nine academic fertility centres in China. Participants 838 women with a low prognosis for IVF treatment defined by ≤9 oocytes retrieved or poor ovarian reserve (antral follicle count <5 or serum anti-Müllerian hormone level <8.6 pmol/L). Interventions Eligible participants were randomised (1:1) to undergo either frozen embryo transfer or fresh embryo transfer on the day of oocyte retrieval. Participants in the frozen embryo transfer group had all of their embryos cryopreserved and underwent frozen embryo transfer later. Participants in the fresh embryo transfer group underwent fresh embryo transfer after oocyte retrieval. Main outcome measures The primary outcome was live birth, defined as the delivery of neonates with a heartbeat and respiration at ≥28 weeks’ gestation. Secondary outcomes were clinical pregnancy, singleton or twin pregnancy, pregnancy loss, ectopic pregnancy, birth weight, maternal and neonatal complications, and cumulative live birth after embryo transfers within one year after randomisation. Results In an intention-to-treat analysis, the rate of live birth was lower in the frozen embryo transfer group than in the fresh embryo transfer group (32% (132 of 419) v 40% (168 o...