scholarly journals The role of temporal changes in endometrial blood flow in natural and hormone replacement cycles with vitrified-warmed embryo transfer

2019 ◽  
Author(s):  
Kuniaki Ota ◽  
Toshifumi Takahashi ◽  
Satoru Shiraishi ◽  
Hideki Mizunuma
Keyword(s):  
Blood Flow ◽  
Embryo Transfer ◽  
Hormone Replacement ◽  
Follicular Phase ◽  
Natural Cycle ◽  
Uterine Blood Flow ◽  
Early Follicular Phase ◽  
Endometrial Blood Flow ◽  
Hcg Trigger ◽  
Natural Cycles

Abstract Background Uterine blood flow promotes endometrial development and subsequent implantation of fertilized eggs. We examined the temporal changes in uterine blood flow during natural and hormone replacement (HRT) cycles and clarified the relationship between uterine blood flow and assisted reproductive technology outcomes for vitrified-warmed embryo transfer (ET). Methods This was a retrospective cohort study. A total of 60 patients with vitrified-warmed ET were assigned to two groups according to the endometrial preparation: natural cycle (28 patients) or HRT cycle (32 patients). The uterine endometrial blood flow was evaluated using measurements of the radial artery resistance index (RA-RI) during the early follicular phase, the days of the human chorionic gonadotropin (hCG) trigger during a natural cycle or the start of progesterone administration during the HRT cycle, and the day of ET. We statistically and longitudinally measured and evaluated the RA-RI values of all individual patients. Results During natural cycles, the RA-RI on the day of ET was significantly higher than that during the early follicular phase. During HRT cycles, the RA-RI on the day of ET was also significantly increased compared to that during the early follicular phase. We validated the efficacy of the RA-RI values for predicting the possibility of pregnancy with vitrified-warmed ET. During natural cycles, the area under the receiver-operating characteristic curves (AUCs) for the early follicular phase, the day of hCG trigger, and the day of ET were 0.75 (95% confidence interval [CI], 0.57–0.93), 0.69 (95% CI, 0.49–0.88), and 0.60 (95% CI, 0.36–0.84), respectively. During HRT cycles, AUCs for the early follicular phase, the day of starting progesterone administration, and the day of ET were 0.60 (95% CI, 0.40–0.81), 0.60 (95% CI, 0.39–0.87), and 0.58 (95% CI, 0.37–0.79), respectively. Conclusions The uterine RA-RI increased at approximately the time of the implantation window compared to that of the early follicular phase during both natural and HRT cycles with vitrified-warmed ET. Our findings suggest that RA-RI during the early follicular phase might be effective and useful for deciding whether to choose the natural or HRT cycle for vitrified-warmed ET.

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 Pretreatment With a Long-acting GnRH Agonist in Early Follicular Phase Increases Clinical Pregnancy Rate in Frozen-thawed Embryo Transfer Cycles

2021 ◽  
Author(s):  
Bin xu ◽  
Jing Zhao ◽  
Zhaojuan Hou ◽  
Nenghui Liu ◽  
Yanping Li
Keyword(s):  
Pregnancy Rate ◽  
Embryo Transfer ◽  
Hormone Replacement ◽  
Follicular Phase ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
Early Follicular Phase ◽  
Long Acting ◽  
Frozen Thawed Embryo Transfer ◽  
Thawed Embryo Transfer

Abstract Background: It is controversial whether gonadotropin-releasing hormone agonist (GnRHa) pretreatment can benefit the pregnancy outcomes in frozen-thawed embryo transfer (FET) cycles. In most of studies, GnRHa was administered during the mid-luteal phase for pretreatment. Few studies focus on FET cycles with GnRHa administered in early follicle phase.Methods: The retrospective cohort study was conducted in a university-affiliated IVF center. 630 patients in the GnRHa FET group and 1141 patients in the hormone replacement treatment (HRT) FET without GnRHa group from October 2017 to March 2019 were included. The menstruation cycle of these patients was irregular. Results: There were no differences observed between the two groups in patient’s characteristics. However, the GnRHa FET group showed a higher percentage of endometrium with triple line pattern (94.8% vs 89.6%, p<0.001) on the day of progesterone administration, and an increased implantation rate (34.7% vs 30%, p<0.01), biochemical pregnancy rate (60.6% vs 54.3%, p = 0.009), and clinical pregnancy rate (49.8% vs 43.3%, p = 0.008), as compared to that in the HRT FET cycles with similar endometrial thickness, ectopic pregnancy rate, and early miscarriage rate. Binary logistic regression analysis showed the GnRHa FET group to be associated with an increased chance of clinical pregnancy rate compared with HRT FET without GnRHa group (P=0.014, odds ratio [OR] 1.30, 95% confidence interval [CI] 1.06-1.61).Conclusions: Pretreatment with a long-acting GnRHa in early follicular phase can improve the clinical outcome of the FET cycles. However, further randomized control trials (RCTs) will be needed to verify these results.

scholarly journals Endometrial Preparation for Frozen Embryo Transfer by Supplemented Natural Cycle versus Hormone Replacement Cycle in Regularly Cycling Women

2019 ◽  
Vol 09 (06) ◽  
pp. 827-837
Author(s):  
Suzan Samir Elsharkawy ◽  
Tamer Hanafy Mahmoud ◽  
Mervat Sheikh-Elarab Elsedeek ◽  
Eman Monier Abd Elkader Amer
Keyword(s):  
Embryo Transfer ◽  
Hormone Replacement ◽  
Frozen Embryo Transfer ◽  
Natural Cycle ◽  
Endometrial Preparation ◽  
Hormone Replacement Cycle ◽  
Replacement Cycle
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