Frozen-thawed blastocyst transfer in natural cycle increase implantation rates compared artificial cycle

This study evaluated which endometrial preparation protocol in frozen embryo transfer (FET) cycles provides the best results for polycystic ovarian syndrome (PCOS) patients and the general population. This retrospective study of 634 FET cycles was conducted 2016–2018. Cycles were divided into Group A: Artificial endometrial preparations for FET (aFET; n = 348), Group B: Ovulatory cycle (n = 286) to compare two methods of endometrial preparation for FET. Artificial endometrial preparation with exogenous estrogen and progesterone versus natural ovulation cycles, modified natural cycles using hCG for the final triggering and letrozole-induced ovulation with hCG. Anovulatory patients were analyzed separately. Anovulatory PCOS patients had significantly higher pregnancy rates with letrozole treatment compared with aFET cycles (44% vs. 22.5%; p = 0.044). For the entire cohort, ovulatory cycles and aFET were similar in terms of patient characteristics, demographics, infertility causes, treatment protocols and number of embryos transferred. Although the mean ESHRE score of the transferred embryos was higher in the aFET group, we found higher clinical pregnancy rate in the ovulatory cycle FET (41.3% vs. 27.3%, p < 0.0001). A better pregnancy rate was found after ovulatory cycle FET. In the ovulatory cycles, the outcome of letrozole-induced and non-induced cycles were comparable. PCOS patients, as well as the general population, may benefit from ovulation induced FET cycles, with significantly better outcomes in FET in ovulatory cycles.

show abstract

“…Several studies reported better cycle outcomes with Ovu-FET [29][30][31][32]. Our results support these later studies.…”

Section: Afet Vs Ovu-fetsupporting

confidence: 91%

Ovulatory-Based FET Cycles May Achieve Higher Pregnancy Rates in the General Population and among Anovulatory Women

Aslih

Dorzia

Atzmon

et al. 2021

JCM

View full text Add to dashboard Cite

show abstract

“…Previous studies by Kawamura et al (15) and Kim et al (16), with sample sizes ranging from 125 to 856, have indicated that the type of endometrial preparation has no statistically significant effect on the clinical outcome of FET. By contrast, Cardenas Armas et al (17), Morozov et al (12), Orvieto et al (18), and Chang et al (19), with sample sizes ranging from 242 to 1,097, have suggested the NC provides clinical outcomes than HT. Our results with a larger sample size are consistent with those of Cardenas Armas et al (17).…”

Section: Discussionmentioning

confidence: 97%

“…By contrast, Cardenas Armas et al (17), Morozov et al (12), Orvieto et al (18), and Chang et al (19), with sample sizes ranging from 242 to 1,097, have suggested the NC provides clinical outcomes than HT. Our results with a larger sample size are consistent with those of Cardenas Armas et al (17). Notably, our is the largest Chinese study of its kind and has great value for the large population base of the People's Republic of China now that the two-child policy is being opened up.…”

Section: Discussionmentioning

confidence: 97%

Natural cycle frozen-thawed embryo transfer in young women with regular menstrual cycles increases the live-birth rates compared with hormone replacement treatment: a retrospective cohort study

Liu

Shi

2020

Fertility and Sterility

View full text Add to dashboard Cite

Objective: To determine the optimal endometrial preparation protocols of frozen-thawed embryo transfer (FET) in young women with regular menstrual cycles. Design: Retrospective cohort study. Setting: Public fertility center. Patient(s): Infertile women with regular menstrual cycles undergoing FET. Intervention(s): Natural cycle (NC) treatment for patients with proven ovulation in previous cycles or who refused medication (n ¼ 308), or hormone treatment (HT) for patients who could not be frequently monitored (n ¼ 1,538). Main Outcome Measure(s): Live-birth rates. Result(s):The live-birth rates were 61.73% in the NC group and 55.11% in the HT group. The effect size of the endometrial preparation on live-birth rates was evaluated in prespecified and exploratory subgroups in each subgroup, and multivariable logistic regression analysis was used to determine which variables could be independently associated with the live-birth rate. The HT patients had a lower chance of live birth in all subgroups: endometrial thickness on the day of progesterone administration, triple-line endometrial pattern, female age at embryo transfer, fertilization type, and protocol in the fresh cycle. Multivariable analysis showed NC to be associated with an increased likelihood of live birth compared with HT. Conclusion(s): Natural cycle treatment has a higher chance of live birth than HT for endometrial preparation in young women with regular menstrual cycles. (Fertil Steril Ò 2020;113:811-7. Ó2019 by American Society for Reproductive Medicine.) El resumen está disponible en Español al final del artículo.

show abstract

“…Two large scale meta-analyses comparing different cycle regimens of FET failed to show a superiority of one approach over the others in terms of reproductive outcomes, however, the majority of studies included were often of a low or very low quality of evidence as most were retrospective nature with limited sample size, and some fail to report important clinical outcomes, or had a poor reporting of study methods [6,16]. A retrospective cohort study of 1265 cycles revealed that the implantation rate was signi cantly higher in NC, while there were no signi cant differences between the groups in the clinical pregnancy, ongoing pregnancy, live birth, and miscarriages rate [17]. El-Toukhy T and coworkers conducted a prospective randomized trial of 234 patients and found that using GnRH-a prior to exogenous steroid supplementation for endometrial preparation achieved signi cantly higher clinical pregnancy (24% vs 11.3%, OR 2.5, 95%CI 1.2-5.5) and live birth rates (20% vs 8.5%, OR 2.9, 95%CI 1.2-8).…”

Section: Discussionmentioning

confidence: 99%

Optimal Endometrial Preparation Protocols for Frozen-thawed Embryo Transfer Cycles by Maternal Age

Zheng

Zhang

et al. 2021

Reprod. Sci.

View full text Add to dashboard Cite

Background: It is paramount to consider the appropriate preparation of the endometrium to receive the transferred embryos as the amount of frozen embryo transfer (FET) cycles is increasing worldwide. However, there remains lack of evidence about what is the most optimal protocol of endometrial preparation regarding pregnancy outcomes in different subgroup of infertile women. This retrospective cohort study was aim to explore the best endometrial preparation protocols among different maternal age groups.Methods: A total of 16870 FET cycles were categorized into three groups based on endometrial preparation protocols: Natural cycle (NC n=3893), arti cial cycles (AC, n=11459) and AC with pretreatment with GnRH-a (AC+GnRH-a, n=1518). Logistic regression was performed to investigate the independent effect of endometrial preparation protocols on IVF pregnancy outcomes. Subgroup analyses were conducted to evaluate the most optimal endometrial preparation protocols for different maternal age groups.Results: In overall populations, after controlling for potential confounders, the incidence of live birth (NC as reference; AC: adjusted odds ratio (aOR) =0.840, 95%CI 0.774-0.912; AC+GnRHa: aOR=0.907, 95%CI 0.795-1.034) in NC was signi cantly higher than that of AC, while comparable to that of AC+GnRH-a. The early miscarriage rate (AC: aOR=1.413, 95%CI 1.220-1.638; AC+GnRHa: aOR=1.537, 95%CI 1.232-1.919) was signi cantly lower in NC compared to either AC group. In younger women, the live birth rates (AC: aOR=0.894, 95%CI 0.799-1.001; AC+GnRHa: aOR=1.111, 95%CI 0.923-1.337) were comparable between the three groups, with a slightly higher in AC+GnRH-a. Early miscarriage rate was only signi cantly lower in NC compared to that of AC without GnRH-a (aOR=1.452, 95%CI 1.159-1.820). While in older women, the incidence of live birth (AC: aOR=0.811, 95%CI 0.718-0.916; AC+GnRHa: aOR=0.760, 95%CI 0.626-0.923) was signi cantly higher, and early miscarriage (AC: aOR=1.358, 95%CI 1.114-1.655; AC+GnRHa: aOR=1.717, 95%CI 1.279-2.305) was signi cantly lower in NC compared to those of two AC groups.Conclusions: NC protocol is associated with lower early miscarriage late in overall IVF population. There is a mild favor of AC+GnRH-a in younger women, while the priority of NC is remarkable in older women.Maternal age should be a considerable factor when determine endometrial preparation method for FET.

show abstract

Frozen-thawed blastocyst transfer in natural cycle increase implantation rates compared artificial cycle

Cited by 22 publications

References 18 publications

Ovulatory-Based FET Cycles May Achieve Higher Pregnancy Rates in the General Population and among Anovulatory Women

Ovulatory-Based FET Cycles May Achieve Higher Pregnancy Rates in the General Population and among Anovulatory Women

Natural cycle frozen-thawed embryo transfer in young women with regular menstrual cycles increases the live-birth rates compared with hormone replacement treatment: a retrospective cohort study

Optimal Endometrial Preparation Protocols for Frozen-thawed Embryo Transfer Cycles by Maternal Age

Contact Info

Product

Resources

About