The year 2023 was a particularly successful one for our Center.

Last year, we had a total of 555 initiated MAR procedures, of which 310 IVF/ICSI procedures, 6 egg cryopreservation procedures, 173 frozen embryo transfers and 65 inseminations.

In 555 initiated cycles, we had 162 positive pregnancy tests, corresponding to a success rate of 29.5% per any cycle initiated at the Center (IVF + FET + AIH, including both egg cryopreservation and “freeze all” cycles). The age of women undergoing MAR procedures ranged from 18 to 43 years. The youngest patient who achieved pregnancy was 18 years old, and although we accept patients up to the age of 45, the oldest woman who achieved pregnancy was 42 years old, which underscores the importance of age in determining the success of MAR procedures.

IVF/ICSI

A total of 310 fresh IVF/ICSI cycles were initiated. In 12 cycles, the procedure was discontinued prior to aspiration, of which in 5 cycles due to the lack of follicular growth, in 4 cycles due to poor response to stimulation, in 2 due to a decline in oestradiol during stimulation or premature luteinisation of the follicles, and in 1 cycle due to a positive COVID-19 test of the patient.

The embryo transfer was not performed in 70 patients. In 25 patients, we opted for the “freeze all” procedure, mainly to prevent the development of ovarian hyperstimulation syndrome (OHSS). No egg was retrieved in 14 aspirated patients. In 28 patients, aspiration resulted in the retrieval of an egg, but due to insufficient egg quality, absence of fertilisation or improper fertilisation, inadequate embryo development, and other medical reasons, there were no embryo transfers. In two patients undergoing a fresh procedure, the embryo transfer was abandoned because it was not possible to pass through the cervical canal, so the embryos were cryopreserved and the embryo transfer was postponed.

There were 228 embryo transfers in the fresh cycle. Of these, a blastocyst embryo transfer was performed in 30 cycles (13.1%), and the rest were embryo transfers of embryos aged 2-4 days. In 123 cycles (53.9%), embryo transfer of one embryo was performed; in 92 cycles (40.4%), embryo transfer of two embryos was performed; and in 13 cycles (5.7%), embryo transfer of three embryos was performed. In exceptional cases, we may decide to transfer three embryos in women with a poorer prognosis due to age or previous failed procedures. We achieved pregnancy in only one cycle with 3 transferred embryos, and it was a normal singleton pregnancy. There were no multiple pregnancies with 3 transferred embryos.

In fresh IVF/ICSI procedures, we achieved 71 pregnancies, which represents a success rate of 31.1% per fresh embryo transfer. After 92 embryo transfers of two embryos, there were 5 twin pregnancies (5.4%), and the number of twin pregnancies in the total IVF/ICSI population was 5/228 = 0.2%.

Of the 310 initiated IVF/ICSI procedures, a standard ovulation stimulation protocol (full stimulation) was used in 229 cycles, a mild ovulation stimulation protocol was used in 65 cycles, in 14 patients the IVF/ICSI was performed in a natural cycle, and a secondary ICSI was performed in 2 cycles.

Frozen embryo transfer (FET)

In 2023, a total of 172 frozen embryo transfers were performed, and in one cycle the transfer was abandoned because it was not possible to pass through the cervical canal. We mainly freeze five-day-old embryos, so blastocysts were transferred in 163 cycles, and in 10 cycles, three-day-old or four-day-old embryos were transferred. Frozen embryo transfer resulted in 81 pregnancies, which represents a success rate of 47.1% per frozen embryo transfer. Most of the cryo procedures (83.1%) were performed in stimulated cycles, mainly using oestrogens and gestagens, due to a lower risk of abandonment. Pregnancy occurred after 72 frozen embryo transfers of one blastocyst, and after 9 frozen embryo transfers of two blastocysts. Of these, two were twin pregnancies.

Insemination (AIH)

In 2023, 66 inseminations were performed, 7 of them in a natural cycle. The majority of inseminations are performed in a stimulated cycle because the most common indication for insemination is anovulation. Pregnancy occurred in 9 cycles, which represents a success rate of 13.6% per cycle. Pregnancy was achieved in women aged 29-36 years.

TWIN PREGNANCIES

Our goal remains to reduce the number of twin pregnancies. In 2023, a total of 8 twin pregnancies were achieved, which is 4.1% of the total number of pregnancies. Five twin pregnancies occurred after a fresh IVF/ICSI procedure, and three after frozen embryo transfer. We also had less than 5% of twin pregnancies in previous years, which is a satisfactory percentage because our goal is to achieve a successful pregnancy and childbirth, with minimal risk to both mother and child.