A randomized controlled, non-inferiority trial of modified natural versus artificial cycle for cryo-thawed embryo transfer

Groenewoud, Eva R.; Cohlen, Ben J; Al-Oraiby, Amani; Brinkhuis, Egbert A.; Broekmans, Frank J.; Bruin, Jan-Peter de; Dool, G. Van Den; Fleisher, Katrin; Friederich, Jaap; Goddijn, Mariëtte; Hoek, Annemieke; Hoozemans, Diederik A.; Kaaijk, Eugenie M.; Koks, Carolien A.M.; Laven, Joop S.E.; Linden, Paul J.Q. van der; Manger, A Petra; Slappendel, Els; Spinder, T.; Kollen, Boudewijn J.; Macklon, Nick S.

doi:10.1093/humrep/dew120

Cited by 170 publications

(123 citation statements)

References 32 publications

Supporting

Mentioning

114

Contrasting

Unclassified

Order By: Relevance

“…Of the six studies included, there is one powerful, multi-center RCT (ANTARCTICA trial) reporting comparable live birth rates [50]. However, significantly more cycles had been cancelled in the AC without suppression group (124/464 versus 101/495, OR 1.4, 95 % CI 1.1-1.9, p = 0.02).…”

Section: Discussionmentioning

confidence: 99%

“…In two studies, no LPS was employed in the mNC arm [36,50]. Without LPS, there was no significant difference for clinical pregnancy (OR 1.08, 95 % CI 0.88-1.33; two studies) or live birth rates (OR 1.23 95 % CI 0.98-1.55; two studies).…”

Section: Tnc Versus Ac With Suppressionmentioning

confidence: 94%

“…4). A total of six studies, one RCT [50] and five retrospective cohort studies [32,35,36,51,52] making a total of 6074 ET cycles, were included.…”

Section: Tnc Versus Ac With Suppressionmentioning

confidence: 99%

See 2 more Smart Citations

Preparation of endometrium for frozen embryo replacement cycles: a systematic review and meta-analysis

Yaralı́

Polat

Mümüşoğlu

et al. 2016

J Assist Reprod Genet

108

View full text Add to dashboard Cite

Purpose The purpose of this study was to evaluate the best protocol to prepare endometrium for frozen embryo replacement (FER) cycles. Methods This study is a systematic review and meta-analysis. Following PubMed and OvidSP search, a total of 1166 studies published after 1990 were identified following removal of duplicates. Following exclusion of studies not matching our inclusion criteria, a total of 33 studies were analyzed. Primary outcome measure was live birth. The following protocols, including true natural cycle (tNC), modified natural cycle (mNC), artificial cycle (AC) with or without suppression, and mild ovarian stimulation (OS) with gonadotropin (Gn) or aromatase inhibitor (AI), were compared. Results No statistically significant difference for both clinical pregnancy and live birth was noted between tNC and mNC groups. When tNC and AC without suppression groups are compared, there was a statistically significant difference in clinical pregnancy rate in favor of tNC, whereas it failed to reach statistical significance for live birth. When tNC and AC with suppression groups are compared, there was a statistically significant difference in live birth rate favoring the latter. Similar pregnancy outcome was noted among mNC versus AC with or without suppression groups. Similarly, no difference in clinical pregnancy and live birth was noted when ACs with or without suppression groups are compared. Conclusions There is no consistent superiority of any endometrial preparation for FER. However, mNC has several advantages (being patient-friendly; yielding at least equivalent or better pregnancy rates when compared with tNC and AC with or without suppression; may not require LPS). Mild OS with Gn or AI may be promising.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Tnc Versus Ac With Suppressionmentioning

confidence: 94%

See 1 more Smart Citation

Preparation of endometrium for frozen embryo replacement cycles: a systematic review and meta-analysis

Yaralı́

Polat

Mümüşoğlu

et al. 2016

J Assist Reprod Genet

108

View full text Add to dashboard Cite

show abstract

“…In a randomized multicenter clinical trial, Groenewoud et al in 2012 detected that there is no significant difference in live birth rates between natural and artificial methods (11). In another study in 2016, modified natural withthe artificial cycle for cryo-thawed embryo transferwere compared and it was observed observed that there is no significant differences in live birth rate (11.5% vs. 8.8%) and clinical pregnancy rate (19% vs. 16.0%) between two groups of modified NC-FET and AC-FET(12). A recent meta-analysis by Yarali et al shows that at the moment there is not sufficient evidence to support the use of any protocols (13).…”

Section: Discussionmentioning

confidence: 99%

Can letrozole plus HMG protocol improve pregnancy outcomes in frozen-thawed embryo transfer? An RCT

Aleyasin

Aghahosseini

Safdarian

et al. 2017

IJRM

View full text Add to dashboard Cite

Background:There are different methods in endometrial preparation for frozen-thawed embryo transfer (FET).Objective:The purpose of this study was to compare the live birth rate in the artificial FET protocol (estradiol/ progesterone with GnRH-agonist) with stimulated cycle FET protocol (letrozole plus HMG).Materials and Methods:This randomized clinical trial included 100 women (18-42 years) randomly assigned to two groups based on Bernoulli distribution. Group I received GnRH agonist [Bucerelin, 500μg subcutaneously] from the previous midlutea lcycle, Then estradiol valerat [2 mg/ daily orally] was started on the second day and was increased until the observation of 8mm endometrial thickness. Finally progesterone [Cyclogest, 800 mg, vaginally] was started. Group II received letrozole on the second day of the cycle for five days, then HMG 75 IU was injected on the7th day. After observing [18 mm folliclhCG10000 IU was injected for ovulation induction. Trans cervical embryo transfer was performed in two groups. The main outcome was the live birth rate. The rate of live birth, implantation, chemical, and clinical pregnancy, abortion, cancellation and endometrial thickness were compared between two groups.Results:Implantation rate was significantly higher in group I. Live birth rate was slightly increased in group I without significant difference (30% vs. 26%). The rate of chemical and clinical pregnancy was similar in two groups. The abortion rate was lower in letrozole protocol but the difference was not statistically significant. The mean endometrial thickness was not different between two groups. Conclusion:Letrozole plus HMG method cannot improve pregnancy outcomes in frozen-thawed embryo transfer but it has only one injection compare to daily injections in artificial method.

show abstract

“…Following treatment with exogenous ovarian steroids after pituitary desensitization, we expected conditions in the endometrium approximating those in the normal menstrual cycle, as it happens in an artificial endometrium developed by these steroids for transfer of cryopreserved embryos, which in terms of the clinical outcome is not inferior to an endometrium in a modified natural cycle [34]. In the present study, a group of normally cycling women was not included; however, the hormonal profile in the simulated cycles in terms of E2 and PRG changes resembled that in a spontaneous cycle and did not differ significantly between the metformin group and the control group.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Metformin on the Endometrium of Women with Polycystic Ovary Syndrome

Dragamestianos

Messini

Antonakis

et al. 2018

Gynecol Obstet Invest

View full text Add to dashboard Cite

Objectives: To investigate the effect of metformin on endometrial receptivity in women with polycystic ovary syndrome (PCOS). Methods: Twenty volunteer women with polycystic ovaries and oligomenorrhea were prospectively investigated. All women were treated with exogenous estradiol and progesterone to simulate a normal menstrual cycle (28-day duration) after GnRH-induced pituitary desensitization. Ten of the women received no other medication (group A, control), while the remaining 10 received metformin (group B, metformin). Endometrial biopsy was performed in all women on day 21 of the 2 simulated cycles. Results: The expression of corticotropin – releasing hormone and urocortin in the endometrium was investigated. There was no significant difference between the 2 groups. A 3-day delay in the secretory maturation of the glandular epithelium relatively to the stroma was observed in 7 out of 10 women of group B (70%) as compared to only 1 out of 10 women of group A (10%, p = 0.02). Conclusions: It is shown for the first time that metformin administration to women with PCOS did not affect the expression of endometrial receptivity markers but delayed histological glandular maturation. It is suggested that metformin may have an impact on the function of the endometrium in PCOS.

show abstract

A randomized controlled, non-inferiority trial of modified natural versus artificial cycle for cryo-thawed embryo transfer

Abstract: 20 April 2009.

Cited by 170 publications

References 32 publications

Preparation of endometrium for frozen embryo replacement cycles: a systematic review and meta-analysis

Preparation of endometrium for frozen embryo replacement cycles: a systematic review and meta-analysis

Can letrozole plus HMG protocol improve pregnancy outcomes in frozen-thawed embryo transfer? An RCT

The Effect of Metformin on the Endometrium of Women with Polycystic Ovary Syndrome

Contact Info

Product

Resources

About