A Novel Promising Endometrial Preparation Protocol for Frozen-Thawed Embryo Transfer: A Randomized Controlled Trial

Li, Jianchun; Wang, Yanhong; Peng, Liying; Zhou, Yun; Chao, Sheng D.

doi:10.3389/fendo.2021.730059

Cited by 2 publications

(4 citation statements)

References 31 publications

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“…To the best of our knowledge, Down-regulation ovulation-induction is a novel endometrial preparation protocol first proposed and practiced in FET by our team ( 18 ). The results of this study showed that the DROI approach could significantly improve CPR and OPR in single blastocyst FET (64.08% VS 46.94%, P<0.01; 56.34% VS 38.78%, P<0.01).…”

Section: Discussionmentioning

confidence: 99%

“…The procedure of DROI protocol was summarized in our previous report ( 18 ). Briefly, 75–150 IU of HMG (Lizhu Pharmaceutical Trading Co, Zhuhai, China) started after 35-42 Day administration of a full dose (3.75 mg) Leuprorelin Acetate (Lizhu Pharmaceutical Trading Co, Shanghai, China).…”

Section: Methodsmentioning

confidence: 99%

“…Inspired by preferable endometrial receptivity of the depot GnRH-a COS protocol ( 16 , 17 ), we proposed the DROI as an endometrial preparation protocol and demonstrated in a pilot RCT that DROI could significantly improve the reproductive outcome of FET compared to modified natural cycle ( 18 ). In the previous pilot RCT, as the average number of embryos transferred in DROI group reached 1.67, the multiple pregnancy rates reached 30.28% that was unacceptable in modern IVF practice.…”

Section: Introductionmentioning

confidence: 99%

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Down-Regulation Ovulation-Induction Leads to Favorable Outcomes in a Single Frozen-Thawed Blastocyst Transfer RCT

Chao

Wang²,

Li³

et al. 2022

Front. Endocrinol.

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ObjectiveElective single embryo transfer (eSET) has been increasingly advocated to achieve the goal of delivering a single healthy baby. A novel endometrial preparation approach down-regulation ovulation-induction (DROI) proposed by our team was demonstrated in an RCT that DROI could significantly improve the reproductive outcome compared with modified natural cycle. We aimed to evaluate whether DROI improved clinic pregnancy rate in this single frozen-thawed blastocyst transfer RCT compared with hormone replace treatment (HRT).MethodEligible participants were recruited and randomized into one of two endometrial preparation regimens: DROI or HRT between March 15, 2019 and March 12, 2021. The primary outcome was clinical pregnancy rate (CPR). The secondary endpoints included ongoing pregnancy rate (OPR), biochemical miscarriage and first trimester pregnancy loss. This trial is registered at the Chinese Clinical Trial Registry, number ChiCTR2000039804.Result (s)A total of 330 women were randomized in a 1:1 ratio between two groups and 289 women received embryo transfer and completed the study (142 DROI; 147HRT). Pregnancy outcomes were significantly different between the two groups. The CPR and OPR in the DROI group were significantly higher than those of the HRT group (64.08% versus 46.94%, P<0.01; 56.34% versus 38.78%,P<0.01). The biochemical miscarriage and first trimester pregnancy loss were comparable between the two groups.Conclusion (s)The findings of this RCT support the suggestion that the DROI might be a more efficient and promising alternative endometrial preparation approach for FET. Moreover, DROI could play a critical role in promoting uptake of single embryo transfer strategies in FET.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Down-Regulation Ovulation-Induction Leads to Favorable Outcomes in a Single Frozen-Thawed Blastocyst Transfer RCT

Chao

Wang²,

Li³

et al. 2022

Front. Endocrinol.

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“…GnRHa pretreatment is widely used for pituitary downregulation in FET. It is associated with a higher implantation rate and clinical pregnancy rate, partly due to improved endometrial receptivity ( 4 ). Though the effect of GnRHa pretreatment before FET is conflicting ( 5 – 13 ), some studies have shown an increased tendency of clinical pregnancy rate following GnRHa pretreatment before FET cycles in patients with endometriosis, PCOS, or RIF ( 9 – 13 ).…”

Section: Introductionmentioning

confidence: 99%

HCG Trigger of GnRH Agonist-Induced Functional Ovarian Cysts Does Not Decrease Clinical Pregnancy Rate in GnRHa Pretreated Frozen Cycles: Evidence From a Retrospective Cohort Study

Hong

Zhang

et al. 2022

Front. Endocrinol.

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BackgroundGnRH agonist (GnRHa) pretreatment before the frozen-thawed embryo transfer (FET) was increasingly utilized. However, the incidence of GnRHa-induced functional ovarian cysts (FC) was inevitable. The feasibility and efficacy of HCG triggering GnRHa-induced FC are unknown.ObjectiveThe aim of the study was to investigate the effect of HCG triggering GnRHa-induced FC on FET outcomes.MethodsA total of 657 HRT-FET cycles with GnRHa pretreatment were retrospectively analyzed. Patients were divided into the FC group and the no functional cysts (NC) group according to whether the patient developed FC (follicular diameter of ≥7 mm and E2 of ≥100 pg/ml). Risk factors associated with the incidence of GnRHa-induced FC were determined by multivariate regression analysis. Pregnancy outcomes were compared between the FC group and the NC group. Propensity score matching (PSM) was performed to reduce the impact of confounding factors. Three multivariate regression models were performed to assess the association between HCG triggering GnRHa-induced FC and clinical pregnancy. Interactive analysis and subgroup analysis were also analyzed.ResultsThe incidence rate of GnRHa-induced FC was 9.74%. Older age (aOR 1.10, 95% CI 1.05-1.15, p-value < 0.001) and lower BMI (aOR 0.81, 95% CI 0.71-0.93, p-value=0.002) are risk factors for GnRHa-induced FC. The implantation rate, clinical pregnancy rate (CPR), and miscarriage rate were not significantly different between the FC group and the NC group before or after PSM (p-value > 0.05). Multivariate logistic models showed that HCG triggering GnRHa-induced FC does not decrease CPR in the general population (p-value > 0.05). The effect of HCG triggering GnRHa-induced FC on clinical pregnancy is interactive with age (p-value for interaction: 0.003); HCG trigger is associated with significantly higher CPR than HRT-FET cycles without FC in patients ≥35 years (aOR 4.40, 95% CI 1.57–12.3, p-value = 0.005).ConclusionsHCG triggering GnRHa-induced FC does not decrease the chance of clinical pregnancy in HRT-FET cycles pretreated with GnRHa.

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A Novel Promising Endometrial Preparation Protocol for Frozen-Thawed Embryo Transfer: A Randomized Controlled Trial

Cited by 2 publications

References 31 publications

Down-Regulation Ovulation-Induction Leads to Favorable Outcomes in a Single Frozen-Thawed Blastocyst Transfer RCT

Down-Regulation Ovulation-Induction Leads to Favorable Outcomes in a Single Frozen-Thawed Blastocyst Transfer RCT

HCG Trigger of GnRH Agonist-Induced Functional Ovarian Cysts Does Not Decrease Clinical Pregnancy Rate in GnRHa Pretreated Frozen Cycles: Evidence From a Retrospective Cohort Study

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