Impact of Endometrial Preparation Protocols for Frozen Embryo Transfer on Live Birth Rates
Background It has been reported that a natural cycle (NC) is similar to or even better than hormone replacement therapy (HRT) in patients with regular cycles who undergo frozen embryo transfer (FET). Hundreds of FETs are managed yearly in our clinic. Scheduling these cycles is critical in a busy un...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Rambam Health Care Campus
2017-04-01
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| Series: | Rambam Maimonides Medical Journal |
| Subjects: | |
| Online Access: | http://www.rmmj.org.il/issues/33/710/manuscript |
| _version_ | 1818135427029139456 |
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| author | Maria Cerrillo Leyre Herrero Alfredo Guillén Mercedes Mayoral Juan Antonio García-Velasco |
| author_facet | Maria Cerrillo Leyre Herrero Alfredo Guillén Mercedes Mayoral Juan Antonio García-Velasco |
| author_sort | Maria Cerrillo |
| collection | DOAJ |
| description | Background
It has been reported that a natural cycle (NC) is similar to or even better than hormone replacement therapy (HRT) in patients with regular cycles who undergo frozen embryo transfer (FET). Hundreds of FETs are managed yearly in our clinic. Scheduling these cycles is critical in a busy unit like ours. This is why we have to prove if a NC really shows a better outcome than other endometrium preparation protocols.
Methods
Hence we carried out a prospective study between June 2011 and June 2012, which included 530 patients (570 FET cycles) randomly allocated to two study groups: Group 1 (n=280 cycles), artificial cycle (HRT); or group 2 (n=290 cycles), natural cycle. Natural cycles were later divided into two groups: 169 patients scheduled with human chorionic gonadotropin (hCG) and 121 with endogenous luteinizing hormone (LH) surge. The inclusion criteria were: age <39 years, regular menstrual cycles (26–35 days), and previous IVF cycle with embryo cryopreservation. The exclusion criteria were polycystic ovarian syndrome and endometriosis stage III/IV.
Results
No statistical differences were found in the baseline characteristics among groups, nor between implantation or ongoing pregnancy rates (30.8% HRT group; 32.7% hCG group; 34.5% LH surge group). However, a higher miscarriage rate was observed in the HRT group when compared to hCG or LH surge (21.2% versus 12.9% versus 11.1%, P<0.01). Live birth rates were similar among groups, as were perinatal outcomes, for rates of natural delivery and weight and length of newborns.
Conclusions
We conclude that scheduling FET with HRT on weekdays and avoiding work overload at weekends prove efficient and safe in cycle outcome terms. Another reason for the convenience of an HRT protocol is having fewer visits to the clinic compared to natural cycle protocols. |
| first_indexed | 2024-12-11T09:24:20Z |
| format | Article |
| id | doaj.art-d4f7778c2791416abe73e99128cf26b8 |
| institution | Directory Open Access Journal |
| issn | 2076-9172 |
| language | English |
| last_indexed | 2024-12-11T09:24:20Z |
| publishDate | 2017-04-01 |
| publisher | Rambam Health Care Campus |
| record_format | Article |
| series | Rambam Maimonides Medical Journal |
| spelling | doaj.art-d4f7778c2791416abe73e99128cf26b82022-12-22T01:13:11ZengRambam Health Care CampusRambam Maimonides Medical Journal2076-91722017-04-0182e002010.5041/RMMJ.10297Impact of Endometrial Preparation Protocols for Frozen Embryo Transfer on Live Birth RatesMaria Cerrillo0Leyre Herrero1Alfredo Guillén2Mercedes Mayoral3Juan Antonio García-Velasco4IVI-Madrid, Rey Juan Carlos University, Madrid, SpainIVI-Madrid, Rey Juan Carlos University, Madrid, SpainIVI-Madrid, Rey Juan Carlos University, Madrid, SpainIVI-Madrid, Rey Juan Carlos University, Madrid, SpainIVI-Madrid, Rey Juan Carlos University, Madrid, SpainBackground It has been reported that a natural cycle (NC) is similar to or even better than hormone replacement therapy (HRT) in patients with regular cycles who undergo frozen embryo transfer (FET). Hundreds of FETs are managed yearly in our clinic. Scheduling these cycles is critical in a busy unit like ours. This is why we have to prove if a NC really shows a better outcome than other endometrium preparation protocols. Methods Hence we carried out a prospective study between June 2011 and June 2012, which included 530 patients (570 FET cycles) randomly allocated to two study groups: Group 1 (n=280 cycles), artificial cycle (HRT); or group 2 (n=290 cycles), natural cycle. Natural cycles were later divided into two groups: 169 patients scheduled with human chorionic gonadotropin (hCG) and 121 with endogenous luteinizing hormone (LH) surge. The inclusion criteria were: age <39 years, regular menstrual cycles (26–35 days), and previous IVF cycle with embryo cryopreservation. The exclusion criteria were polycystic ovarian syndrome and endometriosis stage III/IV. Results No statistical differences were found in the baseline characteristics among groups, nor between implantation or ongoing pregnancy rates (30.8% HRT group; 32.7% hCG group; 34.5% LH surge group). However, a higher miscarriage rate was observed in the HRT group when compared to hCG or LH surge (21.2% versus 12.9% versus 11.1%, P<0.01). Live birth rates were similar among groups, as were perinatal outcomes, for rates of natural delivery and weight and length of newborns. Conclusions We conclude that scheduling FET with HRT on weekdays and avoiding work overload at weekends prove efficient and safe in cycle outcome terms. Another reason for the convenience of an HRT protocol is having fewer visits to the clinic compared to natural cycle protocols.http://www.rmmj.org.il/issues/33/710/manuscriptFrozen cyclehormonal replacement therapyIVFnatural cycle |
| spellingShingle | Maria Cerrillo Leyre Herrero Alfredo Guillén Mercedes Mayoral Juan Antonio García-Velasco Impact of Endometrial Preparation Protocols for Frozen Embryo Transfer on Live Birth Rates Rambam Maimonides Medical Journal Frozen cycle hormonal replacement therapy IVF natural cycle |
| title | Impact of Endometrial Preparation Protocols for Frozen Embryo Transfer on Live Birth Rates |
| title_full | Impact of Endometrial Preparation Protocols for Frozen Embryo Transfer on Live Birth Rates |
| title_fullStr | Impact of Endometrial Preparation Protocols for Frozen Embryo Transfer on Live Birth Rates |
| title_full_unstemmed | Impact of Endometrial Preparation Protocols for Frozen Embryo Transfer on Live Birth Rates |
| title_short | Impact of Endometrial Preparation Protocols for Frozen Embryo Transfer on Live Birth Rates |
| title_sort | impact of endometrial preparation protocols for frozen embryo transfer on live birth rates |
| topic | Frozen cycle hormonal replacement therapy IVF natural cycle |
| url | http://www.rmmj.org.il/issues/33/710/manuscript |
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