The Impact of Endometrial Preparation on Implantation following Cryopreserved-Thawed-Embryo Transfer

Tanos, Vasilios; Friedler, Shevach; Zajicek, G.; Neiger, Michal; Lewin, Aby; Schenker, Joseph G.

doi:10.1159/000292274

Cited by 20 publications

(13 citation statements)

References 14 publications

(14 reference statements)

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“…Pituitary suppression before the commencement of artificial cycles (i.e., with GAC) reduces the rate of cycle cancellation by suppressing spontaneous ovulation. In previous studies, the use of GAC resulted in similar implantation and clinical pregnancy rates [Gelbaya et al 2006;Glujovsky et al 2010;Tanos et al 1996] as well as higher live-birth rates compared to the modified natural cycle approach [Hill et al 2010]. However, with increased sample size, our data was able to show that modified natural cycles resulted in a higher ongoing pregnancy rate and lower late abortion rate than patients receiving GAC.…”

Section: Discussionmentioning

confidence: 45%

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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Section: Discussionmentioning

confidence: 45%

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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“…Of the six studies included, there is one RCT [44] and one quasi-randomized trial [45] with both studies reporting no difference.…”

Section: Discussionmentioning

confidence: 99%

“…A total of six studies, one RCT [44] and one quasi-randomized [45] and four retrospective cohort studies [46][47][48][49], making a total of 2933 ET cycles, were included.…”

Section: Tnc Versus Ac With 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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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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“…Multiple reports have suggested that neither implantation rate nor pregnancy rate is affected by estrogen replacement therapy in cryo-thaw cycles [6,8,9]. HRT cycles are those in which exogenous estrogen and progesterone are administered in order to control and optimize the recipient's hormonal and endometrial environment in preparation for the transfer of the cryo-thawed embryos.…”

Section: Discussionmentioning

confidence: 99%

Natural cycle cryo-thaw transfer may improve pregnancy outcome

Morozov

Ruman

Kenigsberg

et al. 2007

J Assist Reprod Genet

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Objective: To compare natural vs. hormone replacement treatment (HRT) for cryo-thaw embryo transfer cycles in patients with frozen embryos from previous ART. Design and Settings: Retrospective chart review of 164 patients (242 cycles) who underwent natural or HRT cryo-thaw embryo transfer between January 2002 and April 2005. Main Outcome Measures: Pregnancy rates per transfer in natural and HRT cryo-thaw cycles. Results: The pregnancy rate per transfer was higher with natural cycles (36.76% vs. 22.99%, P = 0.0298). There was no statistical difference in mean age, endometrial thickness, and average embryo quality in successful cycles. Mean endometrial thickness prior to transfer was greater in natural cycles (9.95 vs. 8.89 mm, P < 0.001). Mean serum estradiol levels were higher in the HRT group prior to transfer (526.1 vs. 103.8 pg/ml, P < 0.001), and were found to be lower in women who achieved pregnancy (337.1 vs. 433.3 pg/ml, P = 0.0136). Conclusion: Hormone replacement in preparation for cryo-thaw transfer of embryos was found to be associated with decreased pregnancy rates in comparison to natural cycle cryo-thaw transfer. Greater endometrial thickness was achieved with lower serum estradiol levels in patients undergoing natural cycles, suggesting Financial disclosure: none of the above authors had any financial interests with commercial companies.

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The Impact of Endometrial Preparation on Implantation following Cryopreserved-Thawed-Embryo Transfer

Cited by 20 publications

References 14 publications

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

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

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

Natural cycle cryo-thaw transfer may improve pregnancy outcome

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