Endometrial preparation protocol of the frozen-thawed embryo transfer in patients with polycystic ovary syndrome

Yu, Jianglong; Ma, Yanping; Wu, Ze; Li, Yonggang; Tang, Li; Li, Yunxiu; Deng, Bo

doi:10.1007/s00404-014-3396-0

Cited by 37 publications

(41 citation statements)

References 41 publications

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“…There was no difference in clinical pregnancy rate (41.0 % vs. 41.6 %), ongoing pregnancy rate (36.6 % vs. 34.7 %) and live birth rate (30.0 % vs. 31.7 %) between two groups simillar to our study (19). Cochrane meta-analysis (2008) reported that there was no preference for methods to another (10).…”

Section: Discussionsupporting

confidence: 59%

“…In a different study artificial cycle was compared with stimulated cycle which was induced by HMG for endometrial preparation prior to FET(19). There was no difference in clinical pregnancy rate (41.0 % vs. 41.6 %), ongoing pregnancy rate (36.6 % vs. 34.7 %) and live birth rate (30.0 % vs. 31.7 %) between two groups simillar to our study (19).…”

Section: Discussionmentioning

confidence: 99%

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

Aleyasin

Aghahosseini

Safdarian

et al. 2017

IJRM

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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.

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Section: Discussionsupporting

confidence: 59%

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

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“…Of the four studies included, two are RCTs [60,61] and the remaining two are retrospective cohort studies [53,58]. These data suggest that mild stimulation with either Gn or AI may overcome subtle defects in folliculogenesis, potentially correct luteal phase, and hence improve endometrial receptivity.…”

Section: Discussionmentioning

confidence: 97%

“…A total of four studies, two RCTs [60,61] and two retrospective cohort studies [53,58], making a total of 1850 ET cycles, were included.…”

Section: Ac (With or Without Suppression) Versus Mild Os With Gn Or Amentioning

confidence: 99%

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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“…In a study by Gelbaya et al (56), the natural cycles and downregulated artificial cycles did not differ from each other in this respect. Clinical pregnancy, ongoing pregnancy, and live birth rates have not been found to differ between endometrial preparations induced by human menopausal gonadotrophin (HMG) or by exogenously administered estrogen-progesterone in patients with polycystic ovary syndrome (PCOS) or those with anovulation; however, a thin endometrium was more frequently observed in HMG-induced cycles (57,58). Some studies have shown that long-term GnRH agonist administration before IVF/ICSI in infertile women with endometriosis or adenomyosis significantly increases the chances of pregnancy (59).…”

Section: Which Methods Is Preferable?mentioning

confidence: 99%

Methods for endometrial preparation in frozen-thawed embryo transfer cycles

Kalem

Gürgan

2016

J Turkish German Gynecol Assoc

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Review 168 IntroductionFrozen-thawed (FT) embryo transfer is a procedure used for the storage and transfer of excess embryos obtained during in vitro fertilization (IVF)-intracytoplasmic sperm injection (ICSI) cycles. In recent years, improvements in laboratory conditions and limitations on the number of embryos to be transferred have led to a progressive increase in FT embryo transfer cycles. Another preferred practice to prevent multiple pregnancies in IVF cycles is to transfer a single embryo and freeze all surplus embryos (1). However, the best solution for endometrial preparation in these cycles is still a matter of debate (2). Frozen-thawed embryo transfer prevents embryo waste and increases the probability of pregnancy in a single stimulated cycle. Protocols applied in FT cycles aim for endometrial preparation only and are therefore simpler than complicated protocols that aim to develop many follicles. As the treatment for subfertility increases, so does the importance of FT embryo transfer; however, there is no consensus about which method is the best (3, 4). Pregnancy rates following FT embryo transfer have been found to be higher than those following fresh embryo transfer (5). Further, FT embryo transfer increases the cumulative pregnancy rate and decreases the cost; in addition, it is easy to perform and can be applied in a shorter time duration when compared to repetitive fresh embryo transfers (5). Using frozen excess embryos obtained as a result of the time-totime implementation of in vitro maturation (IVM) in patients with polycystic ovaries, successful pregnancies have been achieved (6). Therefore, studies have concentrated on factors affecting the success rate of FT embryo transfer cycles.Various cycle protocols are used for the preparation of the endometrium in an FT embryo transfer cycle. In one of these procedures, the transfer time is determined either by the natural course of a cycle [i.e., in an ovulatory patient exhibiting a natural (spontaneous) cycle] or by inducing ovulation during the course of a natural cycle. The second procedure involves the artificial preparation of the endometrium through the administration of exogenous estrogen and progesterone, which can be performed with or without the association of a gonadotropin-releasing hormone agonist. In the third procedure, the cycle is stimulated by gonadotropins and ovulation is induced by recombinant-human chorionic gonadotropin (rHcg) or hCG; however, this practice is no longer applied (7,8). Embryo transfer in a natural (spontaneous) cycleBoth embryo and endometrial development have to be synchronized in FT embryo transfer cycles in order to maximize the pregnancy rate (9). This synchronization can be achieved in several ways. The easiest is the endocrinological preparation of the endometrium during the natural cycle using the patient's own follicular sex steroids. In this application, the timing for embryo transfer (ET) is determined by either investigating the spontaneous luteinizing hormone (LH) surge or by the administration o...

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Endometrial preparation protocol of the frozen-thawed embryo transfer in patients with polycystic ovary syndrome

Cited by 37 publications

References 41 publications

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

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

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

Methods for endometrial preparation in frozen-thawed embryo transfer cycles

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