Endometrial Preparation for Frozen-Thawed Embryo Transfer With or Without Pre-Treatment With Gonadotropin Releasing Hormone Agonist

Prato, Luca Dal; Borini, Andrea; Cattoli, Monica; Bonu, M.A; Sciajno, Raffaella; Flamigni, Carlo

doi:10.1016/s0015-0282(00)01000-1

Cited by 11 publications

(23 citation statements)

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“…Of the included seven studies, there was no RCT. Inferior pregnancy outcome in AC cycles without suppression might be due to escape from pituitary suppression, which is encountered in 1.9 to 7.4 % of such cycles [15,16] Of the seven included studies, both endocrine and ultrasonographic monitoring was performed in only two studies in the AC without suppression arm, which might have contributed to inferior pregnancy outcome in our meta-analysis [38,41]. Finally, lack of homogenous assignment of either anovulatory or ovulatory patients to both arms, with their different propensity for escape from ovulation, may introduce allocation bias.…”

Section: Discussionmentioning

confidence: 99%

“…A total of five studies, four RCTs [15,[55][56][57] and one retrospective cohort study [16], making a total of 1752 ET cycles, were included. …”

Section: Ac With Suppression Versus Ac Without Suppressionmentioning

confidence: 99%

“…Although AC with suppression is robust to avoid ovulation, AC without suppression is more patient-friendly. However, premature ovulation leading to cycle cancellation, encountered in 1.9 to 7.4 % of the cycles, is the main drawback of AC without suppression [15,16]. Luteal phase should be supported in AC with or without suppression.…”

Section: Introductionmentioning

confidence: 99%

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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

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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.

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Section: Discussionmentioning

confidence: 99%

“…A total of five studies, four RCTs [15,[55][56][57] and one retrospective cohort study [16], making a total of 1752 ET cycles, were included. …”

Section: Ac With Suppression Versus Ac Without Suppressionmentioning

confidence: 99%

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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

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“…This rate is in the higher end of what is published in the SART data as well as the literature. When examining the published literature, some studies show no difference in outcomes between non-downregulated FET cycles vs GnRH agonist down-regulated ones [20,21], while others show superiority of GnRH down-regulated cycles [22]. Although the randomized study by Toukhy and colleagues showed that In conclusion, our study showed that the use of a "natural cycle override" regimen appears to be an adequate substitute to GnRH analogue suppression cycles with the added benefits of shorter cycle length, less injections for the patients, and lower costs.…”

Section: Discussionmentioning

confidence: 99%

Intramuscular route of progesterone administration increases pregnancy rates during non-downregulated frozen embryo transfer cycles

Haddad

Saguan

Maxwell

et al. 2007

J Assist Reprod Genet

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Objective The optimal route of progesterone (P4) administration in embryo transfer (FET) cycles remains to be determined. The objective of this study is to compare the pregnancy outcomes between intramuscular (IM) and vaginal progesterone (PV) administration for endometrial preparation in non-donor FET cycles. Study design A retrospective clinical study in a private practice infertility setting.Results No significant differences in patient demographics and embryo characteristics were noted between the two groups. The clinical pregnancy rate as well as the live birth rate were significantly higher in the IM arm compared to the PV arm (38.2% vs 28%, 34.5 % vs 22.8%, respectively). Conclusion Although both routes of progesterone administration had similar rates of initial positive pregnancy tests, the IM route had a significantly higher live birth rate. The exact reason for this difference remains to be determined.

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“…Some investigators have suggested that artificial cycles may optimize endometrial receptivity with a more consistent interval, duration, and concentration of estrogen and progesterone compared to the intrinsic variability of the LH surge, ovulation, and follicular/corpus luteum steroidogenesis of the natural cycle [Ghobara and Vandekerckhove 2008;Zheng et al 2013]. In addition, the introduction of GnRH agonist suppression to prevent spontaneous ovulation in artificial cycles [Dal Prato et al 2002;Gelbaya et al 2006;Hil et al 2010], has added a special type for artificial cycles.…”

Section: Introductionmentioning

confidence: 99%

A modified natural cycle results in higher live birth rate in vitrified-thawed embryo transfer for women with regular menstruation

Guan

Fan

Styer

et al. 2016

Systems Biology in Reproductive Medicine

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(2016) A modified natural cycle results in higher live birth rate in vitrified-thawed embryo transfer for women with regular menstruation, Systems Biology in Reproductive Medicine, 62:5, 335-342, DOI: 10.1080/19396368.2016 To link to this article: https://doi.org/10. 1080/19396368.2016 There is no consensus regimen for the optimal endometrial preparation for cryopreservation and vitrified-thawed embryo transfer cycles. This is largely caused by the lack of sufficient investigation and analyses on the respective pregnancy and perinatal outcomes by different regimens. This study aimed to compare both pregnancy and perinatal outcomes between the modified natural and artificial cycles in vitrified-thawed day three embryo transfer for women with regular menstruation. A total of 1,482 vitrified-thawed day three embryo transfer cycles were reviewed including 427 modified natural cycles (NC), 132 ovulation induction cycles (OC), 794 artificial cycles (AC), and 129 GnRH agonist artificial cycles (GAC). The primary outcome that was evaluated was live birth rate. The NC regimen demonstrated a higher rate of ongoing pregnancy (43.8% vs. 30.2%, P = 0.002) and a lower rate of late abortion (2.8% vs. 14.0%, P = 0.003) than the GAC regimen as well as a higher implantation rate (31.9% vs. 27.1%, P = 0.008) and live birth rate (43.1% vs. 34.1%, P = 0.002) than the AC regimen. A significantly higher peak endometrial thickness before transfer was observed in patients using the NC and GAC regimens (10.0 ± 1.7, 9.9 ± 2.4) compared to the AC regimens (9.2 ± 1.5, P = 0.000). Multivariate logistic regression showed that the NC protocol was associated with a higher live birth rate. There were no significant differences in rates of pregnancy complications, neonatal mortality, birth defects, mean birth weight, and other perinatal outcomes among the regimens. Modified natural cycle endometrial preparation regimen for vitrified-thawed day three embryo transfer is associated with superior live birth pregnancy outcomes compared to artificial cycles. Future studies are warranted to investigate the underlying biologic mechanisms of these findings.Abbreviations ART: assisted reproductive technology; BMI: body mass index; FET: frozen-thawed embryo transfer; HCG: human chorionic gonadotropin; IVF: in-vitro fertilization; IVF-ET: in-vitro fertilization and embryo transfer; OHSS: ovarian hyperstimulation syndrome; RCTs: randomized controlled trials ARTICLE HISTORY

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Endometrial Preparation for Frozen-Thawed Embryo Transfer With or Without Pre-Treatment With Gonadotropin Releasing Hormone Agonist

Cited by 11 publications

References 0 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

Intramuscular route of progesterone administration increases pregnancy rates during non-downregulated frozen embryo transfer cycles

A modified natural cycle results in higher live birth rate in vitrified-thawed embryo transfer for women with regular menstruation

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