# Immediate frozen-embryo transfer: a viable option after hysteroscopic polypectomy to shorten time to pregnancy without compromising live birth rate

## TL;DR

Immediate frozen embryo transfer after polyp removal doesn't reduce pregnancy success compared to waiting a cycle, offering a faster option for some patients.

## Contribution

Shows immediate embryo transfer after polypectomy is viable without compromising live birth rates, supporting individualized treatment plans.

## Key findings

- Immediate transfer group had similar clinical pregnancy and live birth rates as the delayed transfer group.
- Transfer timing had no significant impact on outcomes after adjusting for confounding factors.
- Maternal age negatively correlated with pregnancy and live birth rates.

## Abstract

To compare the effects of frozen-thawed embryo transfer at different times after hysteroscopic endometrial polyp resection on pregnancy outcomes and to provide evidence for individualized clinical treatment.

This study was a single-center retrospective cohort study involving 756 infertile patients who underwent hysteroscopic polypectomy for endometrial polyps from 2023 to 2024 and underwent natural cycle frozen-thawed embryo transfer for the first time after surgery, divided into two groups: Group A (178 cases) underwent transfer during the menstrual cycle after the operation, while Group B (578 cases) underwent transfer after next menses after the operation. Baseline characteristics, clinical pregnancy rate, live birth rate and miscarriage rate were compared between the two groups. Additionally, a correlation analysis between the interval from surgery to embryo transfer and pregnancy outcomes in the immediate transfer group.

There were no significant differences in baseline characteristics such as age, BMI, AMH level between the two groups. Unadjusted, there were no statistically significant differences in clinical pregnancy rate (60.7% vs. 58.3%), live birth rate (57.9% vs. 56.4%), early miscarriage rate (2.8% vs. 8.9%), and late miscarriage rate (1.9% vs. 2.7%) between group A and group B (all P > 0.05). After adjusting for confounding factors such as age, prevalence of endometritis, and type of transplanted embryo, the timing of transplantation still had no significant effect on pregnancy outcomes (clinical pregnancy rate OR = 0.99, 95% CI: 0.68–1.42; live birth rate OR = 1.02, 95% CI: 0.71–1.46). However, binary logistic regression showed a negative correlation between maternal age and pregnancy rate and live birth rate. In group A, the interval from surgery to transplantation was not significantly correlated with clinical pregnancy and live birth outcome.

There was no significant difference in pregnancy outcomes between frozen-thawed embryo transfer in the current menstrual cycle and the next menstrual cycle after hysteroscopic endometrial polyp resection, and the choice of transfer timing was not a key factor affecting pregnancy outcomes. For patients with special clinical needs, transplanting in the same menstrual cycle after surgery is a feasible option, which helps to shorten the waiting time and reduce mental stress.