Endometrial preparation for frozen–thawed embryo transfer cycles: a systematic review and network meta-analysis

Wu, Hanglin; Zhou, Ping; Lin, Xiaona; Wang, Shasha; Zhang, Songying

doi:10.1007/s10815-021-02125-0

Cited by 48 publications

(27 citation statements)

References 47 publications

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“…In a recent network meta-analysis of 26 RCTs, no difference in LBR was reported between t-NC and modified-NC FET (OR=1.21, 95% CI 0.81 -1.82, low quality evidence) (75).…”

Section: Comparison Of T-nc Versus Modified-ncmentioning

confidence: 95%

“…In a very recent network meta-analysis of 26 RCTs, regarding LBR, HRT ranked as the worst (albeit not reaching statistical significance), when compared with t-NC (OR= 0.85, 95% CI 0.48 -1.49) and modified-NC (OR= 0.79, 95% CI 0.56 -1.11) (75). In the same study, the authors also did a pairwise meta-analysis of 113 observational studies; HRT was associated with a significantly lower LBR when compared with t-NC (OR= 0.81, 95% CI 0.70 -0.93) or modified-NC (OR= 0.85, 95% CI 0.77 -0.93) (75).…”

Section: Comparison Of Different Fet Protocols T-nc/modified-nc Versus Hrtmentioning

confidence: 97%

“…In a recent network meta-analysis of 26 RCTs comparing different FET protocols, when compared with HRT, significantly higher LBRs were reported with mild-OS using gonadotropin (OR=1.77, 95%CI 1.06 -2.98; very-low quality of evidence) or mild-OS using letrozole (OR=1.67, 95%CI 1.22 -2.28; low quality of evidence) (75). However, no significant difference in LBR was noted between t-NC, modified-NC and mild-OS protocols (75).…”

Section: Mild-os Versus Hrtmentioning

confidence: 99%

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Preparation of the Endometrium for Frozen Embryo Transfer: A Systematic Review

et al. 2021

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Despite the worldwide increase in frozen embryo transfer, the search for the best protocol to prime endometrium continues. Well-designed trials comparing various frozen embryo transfer protocols in terms of live birth rates, maternal, obstetric and neonatal outcome are urgently required. Currently, low-quality evidence indicates that, natural cycle, either true natural cycle or modified natural cycle, is superior to hormone replacement treatment protocol. Regarding warmed blastocyst transfer and frozen embryo transfer timing, the evidence suggests the 6th day of progesterone start, LH surge+6 day and hCG+7 day in hormone replacement treatment, true natural cycle and modified natural cycle protocols, respectively. Time corrections, due to inter-personal differences in the window of implantation or day of vitrification (day 5 or 6), should be explored further. Recently available evidence clearly indicates that, in hormone replacement treatment and natural cycles, there might be marked inter-personal variation in serum progesterone levels with an impact on reproductive outcomes, despite the use of the same dose and route of progesterone administration. The place of progesterone rescue protocols in patients with low serum progesterone levels one day prior to warmed blastocyst transfer in hormone replacement treatment and natural cycles is likely to be intensively explored in near future.

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“…In a recent network meta-analysis of 26 RCTs, no difference in LBR was reported between t-NC and modified-NC FET (OR=1.21, 95% CI 0.81 -1.82, low quality evidence) (75).…”

Section: Comparison Of T-nc Versus Modified-ncmentioning

confidence: 95%

Section: Comparison Of Different Fet Protocols T-nc/modified-nc Versus Hrtmentioning

confidence: 97%

Section: Mild-os Versus Hrtmentioning

confidence: 99%

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Preparation of the Endometrium for Frozen Embryo Transfer: A Systematic Review

et al. 2021

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“…Over the past 40 years, studies have noted that the mode of administration (oral, transdermal, intramuscular, and vaginal) and the exact duration of estrogen supplementation may not matter as long as an adequate endometrial response, lining thickness, and trilaminar architecture are achieved (6)(7)(8)(9). In fact, emerging data have suggested potential obstetric benefits of natural cycle (NC) frozen embryo transfer (FET; NC-FET), wherein the corpus luteum remains functional and contributes to the support of early pregnancy (10,11). Therefore, it seems that when the uterine lining responds well and mimics the natural form, there may be many equally viable options for reaching that point; however, several questions remain, ''what about when the uterine lining is thin?…”

Section: The Importance Of the Endometriummentioning

confidence: 99%

Endometrial thickness: How thin is too thin?

Jacobs

Voorhis

Kawwass³

et al. 2022

Fertility and Sterility

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“…Many infertility treatments are performed in natural cycles in which only medication to trigger ovulation is administered. One reason is that low-dose monofollicular ovarian gonadotropin stimulation does not increase the pregnancy rate in regular cycles as shown for timed intercourse, intrauterine inseminations and IVF thawing cycles ( 1 , 2 ).…”

Section: Introductionmentioning

confidence: 99%

Optimal Timing of Ovulation Triggering to Achieve Highest Success Rates in Natural Cycles—An Analysis Based on Follicle Size and Oestradiol Concentration in Natural Cycle IVF

et al. 2022

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IntroductionTiming of ovulation triggering is essential in infertility treatments including treatments based on natural menstrual cycles. However, data on follicle size and oestradiol (E2) concentration are limited. Therefore, the model of natural cycle IVF (NC-IVF) was applied to provide more detailed information on these parameters to better schedule the optimal time for triggering ovulation.Materials and MethodsA retrospective cross-sectional analysis of 606 monofollicular NC-IVF cycles was performed at a university-based IVF centre from 2016 to 2019. Follicle size and E2 and LH serum concentrations were evaluated on day -5 to 0 (day 0 = day of oocyte retrieval). Ovulation was triggered if follicle size was 14–22 mm. Patients with irregular cycles, endometriosis >II°, cycles with azoospermia or cryptozoospermia and cycles with inconsistent data were excluded. All parameters were analysed inter- and intraindividually, and associations of the parameters were evaluated. Associations were adjusted for age, cause of infertility and number of previous transfers.ResultsThe mean age of women undergoing NC-IVF was 35.8 ± 4.0 years. Follicle size increased by 1.04 ± 0.03 mm, and E2 concentration by 167 ± 11.0 pmol/l per day.Based on a multivariate adjusted mixed model with follicle size, E2 and their interaction, the number of retrieved oocytes was associated with E2 concentration (aOR 1.91, 95% CI: 1.03–3.56; p = 0.040). Maturity of oocytes was associated not only with E2 concentration (aOR 2.01, 95% CI: 1.17–3.45; p = 0.011) but also with follicle size (aOR 1.27, 95% CI: 1.01–1.60; p = 0.039), as was the interaction of both parameters (aOR 0.96, 95% CI: 0.93–0.99; p = 0.017).LH surge was calculated to start in 25% of cases at an E2 level of 637 pmol/l, in 50% of cases at 911 pmol/l and in 75% of cases at an E2 level of 1,480 pmol/l.The live birth rate per follicle aspiration cycle was (non-significantly) higher in cycles with follicles sizes at the time of oocyte retrieval of 18–22 mm (7.7%–12.5%) versus in cycles with follicles sizes of 14–17 mm (1.6%–4.3%).ConclusionThe study contributes to an optimization of infertility treatments involving natural cycles. The study gives guidance about the number of days required after follicle monitoring to schedule the optimal time for triggering ovulation.

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Endometrial preparation for frozen–thawed embryo transfer cycles: a systematic review and network meta-analysis

Cited by 48 publications

References 47 publications

Preparation of the Endometrium for Frozen Embryo Transfer: A Systematic Review

Preparation of the Endometrium for Frozen Embryo Transfer: A Systematic Review

Endometrial thickness: How thin is too thin?

Optimal Timing of Ovulation Triggering to Achieve Highest Success Rates in Natural Cycles—An Analysis Based on Follicle Size and Oestradiol Concentration in Natural Cycle IVF

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