scholarly journals Effect of endometrial preparation protocols on the risk of ectopic pregnancy for frozen embryo transfer

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Seung Chik Jwa ◽  
Masashi Takamura ◽  
Akira Kuwahara ◽  
Takeshi Kajihara ◽  
Osamu Ishihara
Keyword(s):  
Ectopic Pregnancy ◽  
Embryo Transfer ◽  
Hormone Replacement ◽  
Total Sample ◽  
Frozen Embryo Transfer ◽  
Early Cleavage ◽  
Endometrial Preparation ◽  
Increased Risk ◽  
Similar Risk ◽  
Natural Cycles

AbstractStudies have consistently reported a significantly reduced incidence of ectopic pregnancy (EP) for frozen-thawed embryo transfer (ET) cycles compared with fresh cycles. However, only a few studies reported an association between endometrial preparation protocols on EP and results were conflicting. A registry-based retrospective cohort study of 153,354 clinical pregnancies following frozen single ETs between 2014 and 2017 were conducted, of which 792 cases of EP (0.52%) were reported. Blastocyst embryo transfers accounted for 87% of the total sample and were significantly associated with a decreased risk for EP compared with early cleavage ET (0.90% vs. 0.46%, adjusted OR = 0.50, 95% CI, 0.41 to 0.60). Compared with natural cycles, hormone replacement cycles (HRC) demonstrated a similar risk for EP (0.53% vs. 0.47%, adjusted OR = 1.12, 95% CI, 0.89 to 1.42). Subgroup analysis with or without tubal factor infertility and early cleavage/blastocyst ETs demonstrated similar non-significant associations. Endometrial preparation protocols using clomiphene (CC) were associated with a significantly increased risk for EP (1.12%, adjusted OR = 2.34; 95% CI, 1.38 to 3.98). These findings suggest that HRC and natural cycles had a similar risk for EP. Endometrial preparation using CC was associated with an increased risk of EP in frozen embryo transfer cycles.

scholarly journals Retrospective cohort study on preparation regimens for frozen embryo transfer

2021 ◽  
Author(s):  
Monique Atkinson ◽  
Jenny Crittenden ◽  
Howard Smith ◽  
Cecilia Sjoblom Ahlstrom
Keyword(s):  
Cohort Study ◽  
Embryo Transfer ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Live Birth Rate ◽  
Frozen Embryo Transfer ◽  
Miscarriage Rate ◽  
Endometrial Preparation ◽  
Significant Difference ◽  
Natural Cycles

Objective: To examine the pregnancy outcomes from frozen embryo transfer (FET) cycles using different endometrial preparation regimens, compared to ovulation induction with letrozole (letrozole OI). Design: Retrospective cohort study. Setting: Fertility centre in Sydney, Australia. Patient(s): 6060 frozen embryo transfer cycles. Interventions: Cycles were stratified into one of four ways to achieve endometrial preparation. These were either a natural, letrozole OI, OI with follicle stimulating hormone (FSH OI) or a programmed cycle. Main Outcome Measure(s): The primary outcome was live birth rate per embryo transfer (LBR). Secondary outcomes included clinical pregnancy and biochemical pregnancy rates, adverse events including miscarriage, ectopic pregnancy, stillbirth, neonatal death and multiple births. Ovarian stimulation parameters were also analysed including time taken to reach the luteal phase and the number of blood or urine tests required for monitoring of the cycle. Results: The LBR following letrozole OI cycles was higher when compared to natural cycles (OR 1.27 (1.07 – 1.49)) and programmed cycles (OR 2.36 (1.67 – 3.34)). There was no significant difference between letrozole OI and FSH OI LBR (OR 0.99 (0.76 – 1.28)). An improved LBR with letrozole OI compared to natural cycles was maintained when only women with a normal length cycle were considered (OR 1.44 (1.10 – 1.89)). There was a significant reduction in miscarriage rates when letrozole OI was compared to programmed cycles (OR 0.46 (0.26 – 0.83)). Conclusion(s): The use of letrozole OI for endometrial preparation in an FET cycle may be associated with higher LBR and lower miscarriage rate, compared to using a programmed cycle.

scholarly journals Obstetric and perinatal outcomes in pregnancies occurring as a result of Fresh and Thawed frozen embryo transfer

2019 ◽  
Vol 8 (8) ◽  
pp. 3311
Author(s):  
Nishita Shah ◽  
K. Jayakrishnan
Keyword(s):  
Ectopic Pregnancy ◽  
Embryo Transfer ◽  
Gestational Hypertension ◽  
Tertiary Care ◽  
Perinatal Outcomes ◽  
Frozen Embryo Transfer ◽  
Large For Gestational Age ◽  
Research Centre ◽  
P Value ◽  
Increased Risk

Background: In vitro fertilization is a known independent risk factor for adverse perinatal outcomes. To explore obstetric and perinatal outcomes in pregnancies occurring as a result of fresh and thawed frozen embryo transfer.Methods: Retrospective observational study with 208 patients. A period of 2 years from October 2015 to October 2017. Tertiary care Fertility, Laparoscopy and research centre. All pregnancies conceived by IVF (n= 208) between the study period were included. The patients were grouped by fresh (n= 108) versus frozen (n= 100) embryo transfer. Patients conceived with donor embryo transfer were excluded. Primary outcomes were missed abortions, ectopic pregnancy, live births. Incidence singleton pregnancies and multiple gestations, preterm delivery, birth weight, an obstetric complication includes gestational hypertension, preeclampsia, gestational DM, placenta previa.Results: A total 208 patient analyzed who conceived with IVF treatments, among them 108 patients were in Fresh ET group and 100 were in Frozen ET group. The incidence of Ectopic Pregnancy was more in fresh ET as compared to Frozen ET (14.8%, 02% respectively, p value <0.05) whereas that of missed abortions were more in Frozen ET (22% versus 11.1%, p value 0.03). There were no significant differences in obstetric and perinatal outcomes in both groups.Conclusions: In this study of IVF pregnancies, adverse obstetric and neonatal outcomes did not differ between fresh and frozen embryo transfers. Literature tells that there may be an increased risk of preeclampsia and large for gestational age babies in pregnancies conceiving after frozen embryo transfer. So freeze all policy should be applied to only indicated cases and not to all because both the groups having similar outcomes.

scholarly journals Preparation of the Endometrium for Frozen Embryo Transfer: A Systematic Review

2021 ◽  
Vol 12 ◽  
Author(s):  
Sezcan Mumusoglu ◽  
Mehtap Polat ◽  
Irem Yarali Ozbek ◽  
Gurkan Bozdag ◽  
Evangelos G. Papanikolaou ◽  
...  
Keyword(s):  
Embryo Transfer ◽  
Hormone Replacement ◽  
Treatment Protocol ◽  
Frozen Embryo Transfer ◽  
Blastocyst Transfer ◽  
Natural Cycle ◽  
Serum Progesterone ◽  
Replacement Treatment ◽  
Near Future ◽  
Natural Cycles

Despite the worldwide increase in frozen embryo transfer, the search for the best protocol to prime endometrium continues. Well-designed trials comparing various frozen embryo transfer protocols in terms of live birth rates, maternal, obstetric and neonatal outcome are urgently required. Currently, low-quality evidence indicates that, natural cycle, either true natural cycle or modified natural cycle, is superior to hormone replacement treatment protocol. Regarding warmed blastocyst transfer and frozen embryo transfer timing, the evidence suggests the 6th day of progesterone start, LH surge+6 day and hCG+7 day in hormone replacement treatment, true natural cycle and modified natural cycle protocols, respectively. Time corrections, due to inter-personal differences in the window of implantation or day of vitrification (day 5 or 6), should be explored further. Recently available evidence clearly indicates that, in hormone replacement treatment and natural cycles, there might be marked inter-personal variation in serum progesterone levels with an impact on reproductive outcomes, despite the use of the same dose and route of progesterone administration. The place of progesterone rescue protocols in patients with low serum progesterone levels one day prior to warmed blastocyst transfer in hormone replacement treatment and natural cycles is likely to be intensively explored in near future.

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

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Cheng Li ◽  
Yi-Chen He ◽  
Jing-Jing Xu ◽  
Yu Wang ◽  
Han Liu ◽  
...  
Keyword(s):  
Embryo Transfer ◽  
Live Birth ◽  
Hormone Replacement ◽  
Perinatal Outcomes ◽  
Live Birth Rate ◽  
Frozen Embryo Transfer ◽  
Perinatal Complications ◽  
Endometrial Preparation ◽  
Cholestasis Of Pregnancy ◽  
Risk Of Preeclampsia

Abstract Background Previous 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. Methods We 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. Results Among 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. Conclusion Compared 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.

scholarly journals Hormone replacement therapy may increase the risk of early miscarriage during frozen embryo transfer cycles in patients with a history of cesarean section: a retrospective cohort study

2021 ◽  
Author(s):  
Run-xin Gan ◽  
Yuan Li ◽  
Juan Song ◽  
Quan Wen ◽  
Guang-xiu Lu ◽  
...  
Keyword(s):  
Embryo Transfer ◽  
Retrospective Cohort ◽  
Outcome Measure ◽  
Hormone Replacement ◽  
Frozen Embryo Transfer ◽  
Miscarriage Rate ◽  
Endometrial Preparation ◽  
History Of ◽  
Early Miscarriage ◽  
Singleton Pregnancies

Objective: To investigate the efficacies of three cycle regimens in women receiving FET with a history of CS: natural cycle (NC) treatment, hormone replacement therapy (HRT) and treatment with gonadotropin-releasing hormone agonist (GnRH-a) + HRT). Design: Retrospective cohort study. Setting: University-affiliated center. Population: Patients (N = 6,159) with a history of CS who fulfilled the inclusion criteria were enrolled in the study from January 2014 to December 2019. Methods: Reproductive outcomes of patients in the NC (n = 4,306) versus HRT (n = 1,007) versus GnRH-a + HRT groups (n = 846) were compared. Main Outcome Measure: The main outcome measure was the live birth rate per embryo transfer (ET). Results: The unadjusted odds of the miscarriage rate of singleton pregnancies were also significantly higher in the HRT-group compared with the NC-group (25.5% versus 20.4%, respectively). After adjusting for possible confounding factors, the early miscarriage rate and the miscarriage rate of singleton pregnancies remained significantly higher in the HRT-group than the NC-group. The clinical pregnancy rates in the NC-, HRT- and GnRH-a + HRT-groups of women with a history of CS was 48.8%, 48% and 47.1%, respectively, and the live birth rates were 37%, 34.1% and 35.7%, respectively. Conclusion(s): In women undergoing FET with a history of CS, HRT for endometrial preparation was associated with a higher early miscarriage rate, albeit after statistical adjustment for confounding factors. Funding: The National Science Foundation of China (81501328). Key Words: Caesarean section, endometrial preparation, frozen embryo transfer, miscarriage

scholarly journals Frozen embryo transfer: Endometrial preparation by letrozole versus hormone replacement cycle: A randomized clinical trial

2019 ◽  
Author(s):  
Alamtaj Samsami ◽  
Leila Ghasmpour ◽  
Sara Davoodi ◽  
Shaghayegh Moradi Alamdarloo ◽  
Jamshid Rahmati ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Embryo Transfer ◽  
Hormone Replacement ◽  
Clinical Pregnancy ◽  
Frozen Embryo Transfer ◽  
Estradiol Valerate ◽  
Normal Cycle ◽  
Endometrial Preparation ◽  
Significant Difference ◽  
The Mean

Background: The endometrial preparation with stimulating natural cycles for frozen embryo transfer (FET) have benefits like lower cost and ease of use. Objective: Comparing the clinical outcome of letrozole versus hormone replacement (HR) for endometrial preparation in women with normal menstrual cycles for FET in artificial reproduction techniques. Materials and Methods: A total of 167 participants who had frozen embryos and regular ovulatory cycles were randomly divided into two groups for endometrial preparation. One group (82 women) was stimulated with letrozole 5mg/day and the other group (85 women) was hormonally stimulated by oral estradiol valerate (2 mg three times a day). All participants were followed serially by ultrasonography. Any patient who did not reach optimal endometrial thickness was excluded from the study. Implantation, biochemical and clinical pregnancy and abortion rate were reported. Results: There was no significant difference in the mean age, duration, and primary or secondary infertility, cause of the infertility, number, and quality of transferred embryos between the groups. The mean estradiol level on the day of transfer was 643 ± 217 in the HR group and 547 ± 212 in the letrozole group (P = 0.01), which was significantly different. The clinical pregnancy rate was 38.7 in the letrozole group, higher than the HR group (25.3) but not significantly different (P=0.06). Conclusion: For endometrial preparation in women with a normal cycle, letrozole yields higher pregnancy rate although it is not significant; due to its cost, ease in use, and lower side effects, letrozole is a good choice. Key words: Letrozole, Hormone replacement, Endometrial, Preparation, Frozen, Embryo.

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