This study tests the hypothesis that controlled ovarian stimulation impairs endometrial receptivity in high responders.

The purpose of this study is to determine if blastocyst transfers in cycles of post-thaw extended culture (PTEC) have different efficacy than transfers of fresh blastocysts in patients with expected high response to ovarian stimulation.

Multiple studies have found altered endometrial histology and gene expression following controlled ovarian stimulation.

PTEC cycles require cryopreservation of the entire 2pn oocyte cohort in the prior cycle. Once thawed, the embryos are cultured to the blastocyst stage before transfer.

In typical cycles using frozen-thawed embryos, many thawed embryos that appear to survive do not actually resume and continue development. PTEC ensures the transfer of embryos that resumed development and continued developing at least to the blastocyst stage (4-5 days post-thaw).

The viability of a blastocyst in a PTEC cycle has been shown to be on par with that of a fresh blastocyst. Therefore, comparing outcomes of blastocyst transfers in PTEC cycles with that in fresh autologous cycles allows the potential endometrial impact of controlled ovarian stimulation to be assessed.

Inclusion Criteria:

1. Female patient 18 to 40 years of age seeking their first IVF treatment.
2. Cycle day 3 FSH less than 10.0 IU/l.
3. More than 15 antral follicles observed on ultrasound.

Exclusion Criteria:

1. Failure to follow the protocol.
2. Embryo biopsy.
3. Any prior IVF cycle(s).