PCOS patients; how the endometrium can be ready for frozen embryo transfer? A retrospective study

Wageh, Alaa; Fawzy, Muhammad

doi:10.1016/j.mefs.2018.06.004

Cited by 4 publications

(6 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…PCOS resulted in infertility could have been attributed to anovulation as well as endometrial dysfunction which affect endometrial receptivity. 16 In particular, hyperandrogenism and high level of LH during the follicular phase may decrease the rate of conception, the latter may lead to poor oocyte quality and embryo quality. Tomas et al noticed that the hormone replacement therapy (HRT) population has a higher pregnancy loss risk, which could be correlated with a higher prevalence of PCOS.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Comparison of Stimulated Cycles with Low Dose r-FSH versus Hormone Replacement Cycles for Endometrial Preparation Prior to Frozen-Thawed Embryo Transfer in Young Women with Polycystic Ovarian Syndrome: A Single-Center Retrospective Cohort Study from China

Li¹,

Gao²,

Zhang³

et al. 2021

DDDT

View full text Add to dashboard Cite

Objective The principal purpose of this study was to compare reproductive outcomes for stimulated cycles (STC) and hormone replacement cycles (HRC) for endometrial preparation before frozen-thawed embryo transfer (FET) in young women with polycystic ovary syndrome (PCOS). Methods We conducted a retrospective study of 1434 FET cycles from January, 2017 to March, 2020 in our reproductive center, in which stimulated and hormone replacement cycles were used for endometrial preparation. Pregnancy outcomes of couples undergoing routine STC-FET or HRC-FET were analyzed by propensity score matching (PSM) and multivariable logistic regression analyses. Results Data on 1234 HRC protocols (86% of the total) and 200 STC protocols (14%) were collected. After PSM, 199 patients were included in both groups, respectively. There was no significant difference in positive pregnancy rate (52.7% vs 54.8%, p=0.763 ), clinical pregnancy rate (51.8% vs 52.8%, p=0.841 ), live birth rate (45.2% vs 43.7%, p=0.762 ), pregnancy loss rate (9.7% vs 16.2%, p=0.164 ) and ectopic pregnancy rate (1.5% vs 0.5%, p=0.615 ) between STC and HRC protocols. Subsequent multivariate logistic regression analysis also yielded similar results. Conclusion STC for endometrial preparation had similar pregnancy outcomes compared with HRC protocols. Evidence is available which shows that for young women with PCOS in preparation for FET, HRC could be a reasonable choice for patients who are unwilling to accept injections. However, STC may reduce unnecessary anxiety and operational costs and offer more flexibility for patients. Eventually, we must embrace the concepts of individualization, securitization, and optimization in the clinic.

show abstract

Section: Discussionmentioning

confidence: 99%

“… 4 , 15 In addition, in the light of menstrual dysfunction, the natural cycle used in the preparation of endometrium is not applicable. 16 The mild ovarian stimulation induces follicular development by generating endogenous hormones. That process of follicular development and ovulation is important to function of the corpus luteum.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Stimulated Cycles with Low Dose r-FSH versus Hormone Replacement Cycles for Endometrial Preparation Prior to Frozen-Thawed Embryo Transfer in Young Women with Polycystic Ovarian Syndrome: A Single-Center Retrospective Cohort Study from China

Li¹,

Gao²,

Zhang³

et al. 2021

DDDT

View full text Add to dashboard Cite

show abstract

“…Another randomized controlled trial showed no difference between HRT and GnRHa + HRT in patients with repeated implantation failure ( n = 67) [ 15 ]. One retrospective study compared clinical outcome between GnRH downregulation and HRT, however, they only reported chemical pregnancy and clinical pregnancy, without reporting live birth rate ( n = 95) [ 16 ]. Studies have shown long-term GnRHa before IVF treatment in infertile women with endometriosis increases pregnancy rate [ 17 , 18 ].…”

Section: Discussionmentioning

confidence: 99%

Pretreatment with a GnRH agonist and hormone replacement treatment protocol could not improve live birth rate for PCOS women undergoing frozen-thawed embryo transfer cycles

Liu

Shi

Bai

et al. 2021

BMC Pregnancy Childbirth

View full text Add to dashboard Cite

Background The ideal protocols of endometrial preparation for polycystic ovary syndrome (PCOS) patients are lacking and need further declaration. Our objective was to compare the clinical outcomes of frozen-thawed embryo transfer (FET) with and without pretreatment gonadotropin-releasing hormone agonist (GnRHa) in PCOS patients. Methods In this retrospective cohort study, we used propensity score matching (PSM) to compare the live birth rate between patients who underwent FET with hormone replacement treatment (HRT) and patients with GnRHa pretreatment (GnRHa + HRT). Patients using GnRHa + HRT (n = 514) were matched with 514 patients using HRT. Results The live birth rate was higher in the GnRHa + HRT group compared with the HRT group with no significant difference (60.12% vs 56.03%, p = 0.073). The clinical pregnancy rate (75.29% vs 70.62%), miscarriage rate (14.20% vs 13.81%) and ectopic pregnancy rate (0.39% vs 0.19%) were similar between the two groups. The preterm birth rate in GnRHa + HRT was higher than HRT (20.23% vs 13.04%). No difference was found in live birth between GnRHa +HRT and HRT before adjusting for covariates (crude OR 1.22, 95%CI, 0.99–1.51, p = 0.062) and after PSM (OR 1.47, 95%CI, 0.99–2.83, p = 0.068). In addition, there is a marginally difference after adjusting for covariates (aOR 1.56, 95%CI, 1.001–2.41, p = 0.048), this finding with p-value close to 0.05 represent insufficient empirical evidence. Similar results were obtained after propensity score matching in the entire cohort. Conclusions GnRHa pretreatment could not improve the live birth rate in women with PCOS.

show abstract

“…Our ndings showed that there was no statistical signi cance in the pregnancy outcomes between two groups. PCOS resulted in infertility could have been attributed to anovulation as well as endometrial dysfunction which affect endometrial receptivity 16 . In particular, hyperandrogenism and high level of LH during the follicular phase may decrease the rate of conception, the latter may lead to poor oocyte quality and embryo quality.…”

Section: Discussionmentioning

confidence: 99%

“…However, it is reported that premature ovulation and follicular dysplasia lead to the cancelation of cycle, especially in women with PCOS 4,15 . In addition, In the light of menstrual dysfunction, the natural cycle used in the preparation of endometrium is not applicable 16 . The mild ovarian stimulation induces follicular development by generating endogenous hormones.…”

Section: Introductionmentioning

confidence: 99%

Comparison of stimulated cycles with low dose r-FSH versus hormone replacement cycles for endometrial preparation prior to frozen-thawed embryo transfer in young women with polycystic ovarian syndrome: A propensity scores matching analysis from 1434 patients

Gao

Zhang

et al. 2021

Preprint

View full text Add to dashboard Cite

Objective The principal purpose of this study was to compare reproductive outcomes for stimulated cycles (STC) and hormone replacement cycles (HRC) for endometrial preparation before frozen-thawed embryo transfer (FET) in young women with polycystic ovary syndrome (PCOS). Methods We conducted a retrospective study of 1434 FET cycles from January, 2017 to March, 2020 in our reproductive center, in which stimulated and hormone replacement cycles were used for endometrial preparation. Pregnancy outcomes of couples undergoing routine STC-FET or HRC-FET were analyzed before and after propensity score matching (PSM). Results Data on 1234 HRC protocols (86% of the total) and 200 STC protocols (14%) were collected. After PSM, 199 patients were included in both groups, respectively. There was no significant difference in positive pregnancy rate (52.7% vs. 54.8%, p = 0.763), clinical pregnancy rate (51.8% vs. 52.8%, p = 0.841), live birth rate (45.2% vs. 43.7%, p = 0.762), pregnancy loss rate (9.7% vs. 16.2%, p = 0.164) and ectopic pregnancy rate (1.5% vs. 0.5%, p = 0.615) between STC protocols and HRC protocols. Conclusion STC for endometrial preparation had similar pregnancy outcomes compared with HRC protocols by excluding heterogeneous factors after PSM. Evidence is available which shows that for young women with PCOS who were undergoing in-vitro fertilization, HRC could be a reasonable choice for patients who are unwilling to accept injections. Additionally, STC may offer more flexibility for young PCOS patients and reproductive centres.

show abstract

PCOS patients; how the endometrium can be ready for frozen embryo transfer? A retrospective study

Cited by 4 publications

References 26 publications

Comparison of Stimulated Cycles with Low Dose r-FSH versus Hormone Replacement Cycles for Endometrial Preparation Prior to Frozen-Thawed Embryo Transfer in Young Women with Polycystic Ovarian Syndrome: A Single-Center Retrospective Cohort Study from China

Comparison of Stimulated Cycles with Low Dose r-FSH versus Hormone Replacement Cycles for Endometrial Preparation Prior to Frozen-Thawed Embryo Transfer in Young Women with Polycystic Ovarian Syndrome: A Single-Center Retrospective Cohort Study from China

Pretreatment with a GnRH agonist and hormone replacement treatment protocol could not improve live birth rate for PCOS women undergoing frozen-thawed embryo transfer cycles

Comparison of stimulated cycles with low dose r-FSH versus hormone replacement cycles for endometrial preparation prior to frozen-thawed embryo transfer in young women with polycystic ovarian syndrome: A propensity scores matching analysis from 1434 patients

Contact Info

Product

Resources

About