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Borini, Andrea; Prato, Luca Dal; Bianchi, Liana; Violini, F.; Cattoli, Monica; Flamigni, Carlo

doi:10.1023/a:1009472416305

Cited by 51 publications

(13 citation statements)

References 20 publications

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“…In our study, the longest duration of estrogen administration was 26 days, and no breakthrough bleeding was observed in the study population. On the other hand, unopposed estrogen administration within a range of 11-40 days has been shown to result in the best pregnancy outcomes, and shorter durations have been correlated with high rates of early pregnancy loss [10,11], which is consistent with our results. The rates of biochemical and clinical pregnancies were signi cantly higher in the late initiation group than in the early initiation group, whereas the ongoing pregnancy rate was similar between the two groups.…”

Section: Discussionsupporting

confidence: 91%

The Timing for Initiating Estrogen Stimulation in Artificial Cycle for Frozen-Thawed Embryo Transfer can be Flexible

Ying

Liu

et al. 2021

Preprint

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Background: There remains a lack of evidence to demonstrate whether the initiation time of estrogen stimulation is flexible in the proliferative endometrial phase during the artificial cycle for frozen-thawed embryo transfer (AC-FET).Methods: FET records were retrospectively reviewed from a large university-affiliated reproductive medicine center. Only the patients who were undergoing their first embryo transfer with a single blastocyst in the AC-FET cycles were included: thereby 660 cycles were recruited, and the patients were grouped according to their day of estrogen usage initiation as early initiation group (estrogen stimulation initiated during days 2–5 of menses, n = 128) and the late initiation group (estrogen stimulation initiated on or after the sixth day of menses, n = 532). The primary outcome was the ongoing pregnancy rates (OPR). Results: The rates of biochemical and clinical pregnancies were significantly higher in the late initiation group relative to those in the early initiation group, however, no significant differences were noted between the 2 groups for OPR. Furthermore, after adjusting for the results of the potential confounders, no impact was observed in the initiation time of estrogen stimulation on the OPR.Conclusions: This study provides evidence that initiating the estrogen stimulation on after days 2–5 of menses do not exert adverse effects on the OPR in AC-FETs. Thus, FET can be scheduled in a flexible manner, according to the ovulatory and endometrial statuses and patient and/or clinic preference, without compromising on the clinical outcomes.

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Section: Discussionsupporting

confidence: 91%

The Timing for Initiating Estrogen Stimulation in Artificial Cycle for Frozen-Thawed Embryo Transfer can be Flexible

Ying

Liu

et al. 2021

Preprint

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show abstract

“…Therefore, there does not appear to be an upper limit for the duration of estrogen stimulation. However, one study has reported that prolonged unopposed estrogen administration beyond 40 days is associated with a high rate of breakthrough bleeding [10]. In our study, the longest duration of estrogen administration was 26 days, and no breakthrough bleeding was observed in the study population.…”

Section: Discussionmentioning

confidence: 39%

The timing for initiating estrogen stimulation in artificial cycle for frozen-thawed embryo transfer can be flexible

Ying

Liu

et al. 2021

Reprod Health

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Background There remains a lack of evidence to demonstrate whether the initiation time of estrogen stimulation is flexible in the proliferative endometrial phase during the artificial cycle for frozen-thawed embryo transfer (AC-FET). Methods FET records were retrospectively reviewed from a large university-affiliated reproductive medicine center. Only the patients who were undergoing their first embryo transfer with a single blastocyst in the AC-FET cycles were included: thereby 660 cycles were recruited, and the patients were grouped according to their day of estrogen usage initiation as early initiation group (estrogen stimulation initiated during days 2–5 of menses, n = 128) and the late initiation group (estrogen stimulation initiated on or after the 6th day of menses, n = 532). The primary outcome was the ongoing pregnancy rates (OPR). Results The rates of biochemical and clinical pregnancies were significantly higher in the late initiation group relative to those in the early initiation group, however, no significant differences were noted between the two groups for OPR. Furthermore, after adjusting for the results of the potential confounders, no impact was observed in the initiation time of estrogen stimulation on the OPR. Conclusions This study provides evidence that initiating the estrogen stimulation on after days 2–5 of menses do not exert adverse effects on the OPR in AC-FETs. Thus, AC-FET can be scheduled in a flexible manner without compromising on the pregnancy outcomes.

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“…This slight tendency to better results with longer oestrogen exposure contrasts with previous studies found in the literature, which have claimed that shorter periods of oestrogen exposure are more beneficial to pregnancy outcome [less than 24 days until progesterone onset in Bourdon et al (4) and less than 20 days in Sunkara et al (6)]. In addition, Borini and Younis proposed the optimal length of oestrogen exposure in oocyte donation cycles to be between 12 and 19 days (7,8). In contrast, we didn't see any significant drop in pregnancy rates beyond 19 days (Table 3), also in line with previously evidences proving that periods of oestrogen exposure longer than 35 days in oocyte donation cycles do not hamper clinical outcomes (14).…”

Section: Discussionmentioning

confidence: 69%

Duration of oestrogen exposure does not affect reproductive outcome in artificial cycles: a retrospective analysis of more than 7000 hormonal replacement therapy cycles for an embryo transfer

Rodríguez-Varela,

Salvaleda-Mateu,

Labarta

2023

Front. Endocrinol.

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IntroductionOptimal duration of oestrogen exposure before an embryo transfer in artificial cycles has not been defined yet, as its correlation with reproductive outcome remains controversial. The length of oestrogen treatment before starting luteal phase support varies significantly among patients.Materials and methodsIn this study, we conducted a retrospective analysis of a huge database of our own clinical results in artificial cycles in the past five years. The aim of this study was to assess the effect of the length of estrogen exposure on reproductive outcome and to evaluate if there is any optimal duration of estrogen exposure in order to maximize success rates.ResultsDifferences in pregnancy rates according to oestrogen length, if present, were not clinically relevant.DiscussionOur results suggest that the length of oestrogen exposure (in days) before exogenous progesterone administration do not affect clinical outcomes.

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Abstract: Endometrial receptivity is tolerant to a wide duration of E2 treatment (until 2 months), while waiting for oocytes available for donation, but best results are achieved with a treatment range of 11 to about 40 days.

Cited by 51 publications

References 20 publications

The Timing for Initiating Estrogen Stimulation in Artificial Cycle for Frozen-Thawed Embryo Transfer can be Flexible

The Timing for Initiating Estrogen Stimulation in Artificial Cycle for Frozen-Thawed Embryo Transfer can be Flexible

The timing for initiating estrogen stimulation in artificial cycle for frozen-thawed embryo transfer can be flexible

Duration of oestrogen exposure does not affect reproductive outcome in artificial cycles: a retrospective analysis of more than 7000 hormonal replacement therapy cycles for an embryo transfer

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