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Hormone Replacement Versus Natural Cycle Protocols of Endometrial Preparation for Frozen Embryo Transfer

Authors
  • 1 Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan , (China)
  • 2 Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan , (China)
  • 3 Shandong Key Laboratory of Reproductive Medicine, Jinan , (China)
  • 4 Shandong Provincial Clinical Research Center for Reproductive Health, Jinan , (China)
  • 5 National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan , (China)
  • 6 Qingdao Women and Children’s Hospital, Qingdao , (China)
Type
Published Article
Journal
Frontiers in Endocrinology
Publisher
Frontiers Media SA
Publication Date
Sep 30, 2020
Volume
11
Identifiers
DOI: 10.3389/fendo.2020.546532
PMID: 33101194
PMCID: PMC7555052
Source
PubMed Central
Keywords
License
Unknown

Abstract

Research question Endometrial preparation is one of the most important steps for ensuring frozen embryo transfer success. However, there is no clear evidence that identifies an optimal endometrial preparation protocol for frozen embryo transfer. In addition, in studies that assessed which were the optimal endometrial preparation protocols, few analyzed the stage and the number of embryos. This study compared the pregnancy outcomes and perinatal obstetric complications of patients who were transferred two cleavage-stage (day 2 or day 3) frozen embryos with the natural cycle and those with the hormone replacement therapy cycle. Design This study was a secondary analysis of data from a multicentre randomized controlled trial designed to compare the pregnancy and perinatal outcomes after frozen versus fresh embryo transfer. In this study, a total of 908 patients who were transferred two cleavage-stage (day 2 or day 3) embryos in the original trial were analyzed. Pregnancy outcomes and perinatal obstetric complications after the natural cycle and the hormone replacement therapy cycle were compared. Result We found the endometrium in the natural group was significantly thicker than the hormone replacement therapy cycle group ( p <0.01). The implantation rate (42.6% vs 37.3% p =0.049) showed a significant difference between the natural cycle group and the hormone replacement therapy cycle group. Compared to the natural cycle group, the hormone replacement therapy cycle group was associated with an increased risk of caesarean section (72.3% vs 84.5, p =0.009). Conclusion The natural cycle protocol yielded thicker endometria, a higher implantation rate and a lower risk of caesarean section than the hormone replacement therapy protocol in the transfer of two cleavage-stage frozen embryos. The natural cycle protocol was the better endometrial preparation protocol for frozen embryo transfer.

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