Revisiting the management of recurrent implantation failure through freeze-all policy.

Objective: To determine whether a freeze-all policy for in vitro human blastocysts improves the ongoing pregnancy rate in patients with recurrent implantation failure (RIF).

Design: Prospective cohort study.

Setting: Single private center.

Patient(s): A total of 171 women with RIF divided into two groups: freeze-all policy group (n = 81) and fresh embryo transfer (ET) group (n = 90).

Intervention(s): Freeze-all policy.

Main Outcome Measure(s): Ongoing pregnancy rate.

Result(s): The clinical pregnancy rate (52% vs. 28%; odds ratio [OR] 1.86; 95% confidence interval [CI], 1.29-2.68) and ongoing pregnancy rate (44% vs. 20%; OR 2.2; 95% CI, 1.04-3.45) were statistically significantly higher in the freeze-all group than the fresh ET group, respectively. The implantation rate was also statistically significant (freeze-all group 44.2% vs. fresh ET group 15.8%; OR 2.80; 95% CI, 2.00-3.92).

Conclusion(s): The freeze-all policy statistically significantly improved the ongoing pregnancy and implantation rates. Thus, a freeze-all policy is likely to be the new key to helping open the black box of RIF. These findings also are useful for further investigating the adverse effect of controlled ovarian stimulation on in vitro fertilization outcomes.