The relationship between endometrial thickness and outcome of medicated frozen embryo replacement cycles

El‐Toukhy, Tarek; Coomarasamy, Arri; Khairy, Mohammed; Sunkara, Kamal; Seed, Paul; Khalaf, Yacoub; Braude, Peter

doi:10.1016/j.fertnstert.2007.04.031

Cited by 198 publications

(127 citation statements)

References 45 publications

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“…The impact of endometrial thickness and pattern on pregnancy rates in FER cycles is controversial. In a retrospective observational study, an endometrial thickness of 9-14 mm on the day of progesterone supplementation was associated with significantly higher implantation and pregnancy rates compared with an endometrial thickness of 7-8 mm [73]. However, neither endometrial thickness nor endometrial pattern had any impact on implantation and pregnancy rates following euploid blastocyst transfer [74].…”

Section: Discussionmentioning

confidence: 94%

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: 94%

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

View full text Add to dashboard Cite

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“…All thaw cycles were programmed with luteal GnRH. Estradiol acetate (Estrace, Warner Chilcott, Rockaway, NJ, USA) was used to achieve a target endometrial thickness of ≥7 mm based on a previous study showing a significant reduction in implantation when the endometrial thickness was <7 mm [8]. Cycles were supplemented with intramuscular progesterone 25-50 mg daily starting 3 days prior to transfer through 10 weeks' gestational age or negative hCG.…”

Section: Clinical and Laboratory Protocolsmentioning

confidence: 99%

“…Several studies have shown a relationship between implantation rates and various parameters associated with thawed cleavage stage embryos including: survival of an intact embryo [4], resumption of mitosis in post-thaw culture [10], fresh embryo morphology [29], percent blastomere survival after thaw [7], the use of laser assisted hatching after thaw [2], lead cell number at transfer [9] and endometrial thickness [8]. Factors such as duration of embryo storage, post-thaw embryo morphology, length of time in post-thaw culture and age and body mass index (BMI) of the patient at embryo transfer have not been thoroughly evaluated.…”

Section: Introductionmentioning

confidence: 99%

Predictors of twin live birth following cryopreserved double embryo transfer on day 3

Kaser

Missmer

Correia

et al. 2013

J Assist Reprod Genet

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Purpose To determine embryo and cycle-specific parameters associated with twin live birth in day 3 cryopreserved double embryo transfer (DET) cycles, and to propose a new prediction model for external validation. Methods All cycles with autologous or donor cryopreserved DET of day 3 embryos from 2002 to 2011 at a single academic institution with a singleton or twin live birth were included (n=207). Patient characteristics, post-thaw embryo morphology and freeze-thaw parameters were compared between patients with a single and twin live birth. Results Demographic characteristics were similar, except that patients delivering twins were younger at age of cryopreserved embryo transfer (CET), fewer were parous and more were anovulatory. Duration of embryo storage, time in culture post-thaw, endometrial thickness and use of assisted hatching were comparable. Six predictors of twin delivery were identified: patient age <35 year at CET, intact survival of the lead embryo, resumption of mitosis, 7-8 viable cells in the non-lead embryo, transfer of a lead embryo with ≥7 cells and a sum of ≥14 viable cells in the two transferred embryos. Regression modeling predicted a step-wise increase in the probability of twins with addition of each predictor; with all six present, the risk of twins was predicted to be 53 % and with none present, the risk decreased to 6 %. Conclusions The six identified variables associated with twin live birth following day 3 cryopreserved DET have been applied to derive a prediction model for estimating the risk of twin delivery. External validation of the model is required prior to clinical application.

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“…Estrogen administration is continued until the endometrium reaches a thickness of 8 mm (determined using an ultrasonographic examination), and progesterone is then combined to initiate the secretory changes. Thus, an attempt is made to mimic the physiologic mid-cycle estrogen-progesterone transition (26,27). Estrogen can be administered as an oral tablet, transdermal plaster, or transvaginal ring.…”

Section: Artificial Endometrium Preparation By the Exogenous Administmentioning

confidence: 99%

“…The starting time for progesterone administration depends on endometrial thickness but not on the duration of estrogen administration. Progesterone administration can only be commenced when the endometrium thickness exceeds 8 mm (38,39). Natural progesterone (Federa, Sterop; Brussels, Belgium) or micronized progesterone (Utrogestan, Piette; Brussels, Belgium) are the most generally used progesterone preparations.…”

Section: Artificial Endometrium Preparation By the Exogenous Administmentioning

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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The relationship between endometrial thickness and outcome of medicated frozen embryo replacement cycles

Cited by 198 publications

References 45 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

Predictors of twin live birth following cryopreserved double embryo transfer on day 3

Methods for endometrial preparation in frozen-thawed embryo transfer cycles

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