The window is wide: flexible timing for vitrified–warmed embryo transfer in natural cycles

Bartels, Chantal; Ditrio, Lauren; Grow, Daniel R.; O’Sullivan, David; Benadiva, Claudio; Engmann, Lawrence; Nulsen, John

doi:10.1016/j.rbmo.2019.04.003

Cited by 23 publications

(8 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A transvaginal ultrasound was also carried out at this time to ensure a follicle had been recruited and that the endometrial stripe measured about 8 mm. Six days after detecting the LH surge (LH ≥20 IU/l), FET was carried out and the luteal phase supplemented with vaginal progesterone (Crinone, Merck, Kenilworth, NJ, USA; and Endometrin, Ferring Pharmaceuticals, Parsippany, NJ, USA), commencing 2 days after the LH surge (Bartels et al, 2019).…”

Section: Methodsmentioning

confidence: 99%

Maternal and perinatal outcomes in programmed versus natural vitrified–warmed blastocyst transfer cycles

Makhijani

Bartels

Godiwala

et al. 2020

Reproductive BioMedicine Online

Self Cite

View full text Add to dashboard Cite

show abstract

Section: Methodsmentioning

confidence: 99%

Maternal and perinatal outcomes in programmed versus natural vitrified–warmed blastocyst transfer cycles

Makhijani

Bartels

Godiwala

et al. 2020

Reproductive BioMedicine Online

Self Cite

View full text Add to dashboard Cite

show abstract

“…The duration from the first day of menstrual cycle to the hCG trigger day and then to the embryo transfer day, follicular diameter on hCG day, endometrial thickness on hCG day, E2 level on hCG day were recorded. Definitions of the beginning of LH surge vary between ≥ 10 IU/L and ≥ 20 IU/L in different studies [6,7,[11][12][13]. In our study LH surge was defined as the LH level reaching ≥ 15 IU/L and LH peak as the LH level reaching ≥ 40 IU/L.…”

Section: Follicular Monitoring and Endometrial Preparationmentioning

confidence: 96%

“…Embryos were first checked for survival 30 min after thawing. A second check occurred 2 h after warming for re-expansion, hatching, extensive cytoplasmic granulation, and the presence of necrotic foci, which are predictors of the rates of implantation, pregnancy, and live birth [7]. Eligible blastocysts with at least 80% re-expansion and vitality were transferred in the afternoon of the same day.…”

Section: Embryo Scoring Vitrification and Thawingmentioning

confidence: 99%

“…A further related study by Reichman et al [6], in which the LH surge was defined by an LH level > 17 IU/L during the follicular phase with a subsequent dropping E2 level thereafter, also reported improved cycle outcomes with hCG booster given to patients within 1 day post-LH surge. Bartels et al [7] reported that when LH reached ≥ 20 IU/L, there was no difference in outcomes regardless of whether transfer was performed on day 6 or day 7 after the initial surge. On the other hand, Litwicka et al [8] suggested that LH elevation ≥ 13 before hCG administration may negatively affect the clinical results in mNC and advised routine performance of LH determination during the regular ultrasonographic evaluation of dominant follicle growth and avoidance of hCG in cases of elevated LH, when embryo transfer should be performed after spontaneous follicular rupture.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Is there a critical LH level for hCG trigger after the detection of LH surge in modified natural frozen-thawed single blastocyst transfer cycles?

Kahraman

Sahin

2020

J Assist Reprod Genet

View full text Add to dashboard Cite

Purpose There is no consensus yet in the literature on an optimal luteinizing hormone (LH) level for human chorionic gonadotrophin (hCG) trigger timing in patients undergoing frozen-thawed embryo transfer (FET) with modified natural cycles (mNC). The objective of our study was to compare the clinical results of hCG trigger at different LH levels in mNC-FET cases. Methods This retrospective study was conducted in Istanbul Memorial Hospital ART and Genetics Center. A total of 1076 cases with 1163 mNC-FET cycles were evaluated. LH levels between the start of LH rise (15 IU/L) and LH peak level (> 40 IU/L) were evaluated. Cycles were analyzed in four groups: group A (n = 287) LH level on the day prior to the day of hCG; groups B, C and D, LH levels on the day of hCG: group B (n = 245) LH 15–24.9; group C (n = 253), LH 25–39.9; group D (n = 383) LH ≥ 40. Cycle outcomes in the four groups were compared. Results Subgroup analyses of mNC-FET groups showed that implantation, clinical and ongoing pregnancy rates, and pregnancy losses were not significantly different in patients with different LH levels on the day of hCG trigger. Conclusion Our study suggests that hCG can be administered at any time between the start of LH rise (≥ 15 IU/L) and LH peak level (≥ 40 IU/L) without a detrimental effect on clinical outcome.

show abstract

“…In addition, the optimal timing for NC-FET should be considered carefully with due consideration to the luteinizing hormone (LH) surge by serum monitoring in combination with a decrease in the serum estradiol level and an increase in the serum progesterone level, as well as the ultrasound detection of ovulation. Although most comparative studies have failed to reach a consensus on the definition of this event for NC-FET [7][8][9], it seems that different reproductive centers achieve their "ideal success rate" based on their own standards designed as per the encountered conditions. An intensive monitoring of spontaneous ovulation is essential for timely determination of NC-FET.…”

Section: Introductionmentioning

confidence: 99%

Follicular phase length has no influence on frozen-thawed embryo transfers in natural cycles

et al. 2020

View full text Add to dashboard Cite

Background: Whether menstrual variability in women with regular and ovulatory cycle could affect embryo implantation remains controversial, with conflicting evidences presented in the literature. Thus, in this study, we evaluated the impact of prolonged follicular phase length (FPL) on the clinical pregnancy rate (CPR) after frozenthawed embryo transfer (FET) in true natural cycles (NC). Methods: This retrospective cohort study utilized data from a large university-affiliated reproductive medicine center. Women undergoing true NC-FET were grouped as per their FPL type: Prolonged FPL (n = 127) and Normal FPL (n = 737). The primary study outcome was CPR in these 2 groups. Results: The FPL in the current cycle was significantly longer in the Prolonged FPL group (23.0 ± 2.4) than in the Normal FPL group (16.0 ± 2.2; p < 0.001). The crude CPR was significantly higher in the Prolonged FPL group (61.4%) than in the Normal FPL group (51.7%; p = 0.043). After adjusting for the results of potential confounders including the age, BMI, percent of optimal embryos transferred, and endometrial thickness, the difference in the CRP between the 2 groups disappeared (OR 1.28, 95% CI: 0.86-1.91, p = 0.232). No statistically significant difference was noted in the rates of implantation and miscarriage. Conclusions: The current FET should not be cancelled if the ovulation time exceeds the predicted period based on the length of the previous menstrual cycle in the light of no negative effect on the pregnancy outcome.

show abstract

The window is wide: flexible timing for vitrified–warmed embryo transfer in natural cycles

Cited by 23 publications

References 30 publications

Maternal and perinatal outcomes in programmed versus natural vitrified–warmed blastocyst transfer cycles

Maternal and perinatal outcomes in programmed versus natural vitrified–warmed blastocyst transfer cycles

Is there a critical LH level for hCG trigger after the detection of LH surge in modified natural frozen-thawed single blastocyst transfer cycles?

Follicular phase length has no influence on frozen-thawed embryo transfers in natural cycles

Contact Info

Product

Resources

About