The difference in early trimester fetal growth between singletons after frozen embryo transfer and fresh embryo transfer
Notice bibliographique
Résumé
Frozen embryo transfer resulted in a higher birth weight and an increased risk of macrosomia compared with fresh embryo transfer. However, the mechanism was still unclear. When did the impact of frozen embryo transfer on fetal growth begin was unknown. Crown-rump length at 11-13 weeks had been regarded as a good indicator of fetal growth at the first trimester and had been used for gestational age calculation in women with uncertain last menstrual period. To evaluate the association between frozen embryo transfer and early fetal growth, particularly the crown-rump length, compared with fresh embryo transfer. The secondary objective was to investigate the potential correlation between the crown-rump length and birth weight. This was a retrospective cohort study conducted at the Reproductive Medical Center of Shandong University. A total of 4949 patients who obtained singleton pregnancy after frozen embryo transfer and 1793 patients who got singleton pregnancy after fresh embryo transfer during January 1, 2017 and December 31, 2022 were included. The primary outcome was the crown-rump length measured via ultrasound at 11-13 weeks gestation. The secondary outcomes were perinatal outcomes including birth weight and the risk of large for gestational age, small for gestational age, macrosomia, low birth weight and premature delivery. Multivariable linear regression models were used to adjust for potential confounders of crown-rump length. A total of 6,742 live singleton births after frozen embryo transfer or fresh embryo transfer were included in this study. In the univariable analysis, the frozen embryo transfer group had a larger crown-rump length (5.75±0.53cm vs. 5.57±0.48cm, P<0.001), and an increased risk of larger-than-expected crown-rump length (13.5% vs.11.2%, P=0.013) compared with the fresh embryo transfer group. After adjusting for confounders in multivariable linear regression models, frozen embryo transfer was still associated with a larger crown-rump length (adjusted odds ratio: 0.020, 95% confidence intervals: 0.133-0.212, P<0.001). When subgrouped by fetal gender, the crown-rump length of the frozen embryo transfer group was larger than the fresh embryo transfer group in both male fetus and female fetus. The crown-rump length was also consistently larger in the frozen embryo transfer group than the fresh embryo transfer group in subgroups of the peak estradiol levels. The comparisons among different crown-rump length groups showed that smaller-than-expected crown-rump length was associated with increased risks of small for gestational age (6.3% vs.3.0%, P<0.001) and preterm delivery (9.6% vs.6.7%, P=0.004) than normal crown-rump length. Frozen embryo transfer was associated with a larger crown-rump length compared with fresh embryo transfer, suggesting that the effect of frozen embryo transfer on fetal growth may begin at early trimester. Suboptimal fetal growth in the first trimester may be associated with low birth weight and premature delivery.
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Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».