Disparities in reproductive outcomes according to the endometrial preparation protocol in frozen embryo transfer
- 304 Downloads
The purpose of this study was to determine the effect of stimulated and artificial endometrial preparation protocols on reproductive outcomes in frozen embryo transfer (FET) cycles.
We performed a retrospective study of 1926 FET cycles over a 3.5-year period in the Fertility Unit at a University Hospital. Stimulated and artificial protocols were used for endometrial preparation. The embryos for FET were obtained from either in vitro fertilization or intracytoplasmic sperm injection cycles. Live birth rate and early pregnancy loss rates were retrospectively compared.
In artificial protocols, oral or vaginal administration of oestradiol 2 mg two or three times a day was followed by vaginal supplementation with progesterone 200 mg two or three times a day. In stimulated protocols, recombinant follicle-stimulating hormone was administered from day 4 onward. Vaginal ultrasound was used for endometrial and ovarian monitoring. A pregnancy test was performed 14 days after FET. If it was positive, oestradiol and progesterone were administered up until the 12th week of gestation in artificial cycles. We defined early pregnancy losses as biochemical pregnancies (preclinical losses) and miscarriages.
Data on 865 artificial cycles (45% of the total) and 1061 stimulated cycles (55%) were collected. Early pregnancy loss rate was significantly lower for stimulated cycles (34.2%) than for artificial cycles (56.9%), and the live birth rate was significantly higher for stimulated cycles (59.7%) than for artificial cycles (29.1%).
In frozen embryo transfer, artificial cycles were associated with more early pregnancy loss and lower live birth rate than stimulated cycles.
KeywordsFrozen embryo transfer Reproductive outcomes Endometrial preparation
Compliance with ethical standards
The study was approved by Institutional Review Board, and the study data completely excluded the identification of subjects.
Conflict of interest
The authors declare that they have no conflict of interest.
- 2.Calhaz-Jorge C, de Geyter C, Kupka MS, de Mouzon J, Erb K, Mocanu E, et al. Assisted reproductive technology in Europe, 2012: results generated from European registers by ESHRE. European IVF-Monitoring Consortium (EIM) for the European Society of Human Reproduction and Embryology (ESHRE). Hum Reprod. 2016;31:1638–52.CrossRefPubMedGoogle Scholar
- 5.Jouan C, Emonard V, Ruggeri P, Debelle L, Hincourt N, Lorquet S, et al. Pregnancy outcome following frozen embryo transfer after artificial cycle or treatment by clomiphene citrate. Gynecol Endocrinol. 2016;29:1–4.Google Scholar
- 7.Ghobara T, Vandekerckhove P. Cycle regimens for frozen-thawed embryo transfer. Cochrane Database Syst Rev. 2008;Suppl 1:CD003414.Google Scholar
- 9.Zegers-Hochschild F, Adamson GD, de Mouzon J, Ishihara O, Mansour R, Nygren K, et al. International Committee for Monitoring Assisted Reproductive Technology (ICMART) and the World Health Organization (WHO) revised glossary of ART terminology, 2009. Fertil Steril. 2009;92(Suppl 5):1520–4.CrossRefPubMedGoogle Scholar
- 16.Andersen CY, Fischer R, Giorgione V, Kelsey TW. Micro-dose hCG as luteal phase support without exogenous progesterone administration: mathematical modelling of the hCG concentration in circulation and initial clinical experience. J Assist Reprod Genet. 2016;33(Suppl 10):1311–8.CrossRefPubMedPubMedCentralGoogle Scholar