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Perinatal outcomes of neonates born from different endometrial preparation protocols after frozen embryo transfer: a retrospective cohort study

  • Li, Cheng1, 2
  • He, Yi-Chen1, 2
  • Xu, Jing-Jing1, 2
  • Wang, Yu1, 2
  • Liu, Han1, 2
  • Duan, Chen-Chi1, 2
  • Shi, Chao-Yi1, 2
  • Chen, Lei1, 2
  • Wang, Jie1, 2
  • Sheng, Jian-Zhong3
  • Huang, He-Feng1, 2, 4
  • Wu, Yan-Ting1, 2, 4
  • 1 Shanghai Jiao Tong University, No.910, Hengshan Rd., Shanghai, 200030, China , Shanghai (China)
  • 2 Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, 200030, China , Shanghai (China)
  • 3 Zhejiang University, Hangzhou, Zhejiang, China , Hangzhou (China)
  • 4 Fudan University, No.419, Fangxie Rd., Shanghai, 200000, China , Shanghai (China)
Published Article
BMC Pregnancy and Childbirth
Springer (Biomed Central Ltd.)
Publication Date
Apr 29, 2021
DOI: 10.1186/s12884-021-03791-9
Springer Nature


BackgroundPrevious studies have focused on pregnancy outcomes after frozen embryo transfer (FET) performed using different endometrial preparation protocols. Few studies have evaluated the effect of endometrial preparation on pregnancy-related complications. This study was designed to explore the association between different endometrial preparation protocols and adverse obstetric and perinatal complications after FET.MethodsWe retrospectively included all FET cycles (n = 12,950) in our hospital between 2010 and 2017, and categorized them into three groups, natural cycles (NC), hormone replacement therapy (HRT) and ovarian stimulation (OS) protocols. Pregnancy-related complications and subsequent neonatal outcomes were compared among groups.ResultsAmong all 12,950 FET cycles, the live birth rate was slightly lower for HRT cycles than for NC (HRT vs. NC: 28.15% vs. 31.16%, p < 0.001). The pregnancy loss rate was significantly higher in OS or HRT cycles than in NC (HRT vs. NC: 17.14% vs. 10.89%, p < 0.001; OS vs. NC: 16.44% vs. 10.89%, p = 0.001). Among 3864 women with live birth, preparing the endometrium using OS or HRT protocols increased the risk of preeclampsia, and intrahepatic cholestasis of pregnancy (ICP) in both singleton and multiple deliveries. Additionally, OS and HRT protocols increased the risk of low birth weight (LBW) and small for gestational age (SGA) in both singletons and multiples after FET.ConclusionCompared with HRT or OS protocols, preparing the endometrium with NC was associated with the decreased risk of pregnancy-related complications, as well as the decreased risk of LBW and SGA after FET.

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