Articles translation丨Professor Rizk’s View on Controversy in ART

　　Everyone will encounter some problems more or less along their fertility journey. Professor Rizk shared his view on some controversy in the current assisted reproductive technology and it’s translated as below.

　　Professor Botros Rizk, M.D received trainings from Professor Robert Edwards, the Nobel laureate and Father of IVF. As the Medical Director of CFG Group and the Founder and Leader of CEF, Professor Rizk has 40 years’ experience in medical practice and has handled more than 10,000 IVF cases.

　　There were numerous previous statistics showing frozen embryo transfers have higher pregnancy rates than those of fresh embryos transfers.Therefore,people start to think that freeze-all policy applies to every situation and every single patient regardless of their different characteristics.However,Dr.Rizk delivered a speech themed“Controversy in ART”on the symposium at the 75th ASRM.

　　Controversy

　　However,the truth is that freezing of all embryos in In Vitro Fertilization(IVF)is beneficial in high responders,but not intermediate and low responders who are of better outcome with fresh embryo transfers.The Meta-Analysis has divided patients into three groups.

　　Poor responders:1-5 eggs retrieved;

　　Intermediate responders:6-14 oocytes retrieved;

　　High responders:15+oocytes retrieved.

　　The truth is that freezing of all embryos in In Vitro Fertilization (IVF) is beneficial to high responders, but not to intermediate and low responders who are of better outcome with fresh embryo transfers. The Meta-Analysis has divided patients into three groups.

　　Poor responders: 1-5 eggs retrieved;

　　Intermediate responders : 6-14 oocytes retrieved;

　　High responders: 15+ oocytes retrieved.

　　Meta-Analysis：

　　There were total of 82,935 cycles completed,composing 69,102 fresh transfers,and 13,833“freeze all”followed by FET.

　　Conclusions:

　　The conclusions can be drawn from the comparisons as listed in the graphics down below(green stands for Fresh Embryo Transfer,aka Fresh ET;while blue stands for Frozen Embryo Transfer,aka FET)：

　　1.Freeze-all strategy is beneficial for pregnancy outcomes in high responders(15+oocytes retrieved),while for patients who are intermediate and poor responders,fresh transfer tend to be a better option;

　　2.In intermediate(6-14 oocytes retrieved)and low(1-5 oocytes retrieved)responders,clinical pregnancy and live birth rates are higher following fresh embryo transfer;

　　3.Birthweights are higher after FET vs fresh ET in infants born to high and intermediate responders.