scholarly journals Efficacy of Natural Cycle versus GnRH-a Down Regulation Cycle of Endometrial Preparation in Minimal and Mild endometriosis Patients Undergoing Frozen-Thawed Embryo Transfer

2020 ◽  
Author(s):  
Ya Li ◽  
Jing Zhong ◽  
Songyuan Tang ◽  
Lili Wang ◽  
Ying Zhong
Keyword(s):  
Pregnancy Rate ◽  
Embryo Transfer ◽  
Birth Rate ◽  
Live Birth Rate ◽  
Natural Cycle ◽  
Down Regulation ◽  
Endometrial Preparation ◽  
Cycle Group ◽  
Frozen Thawed Embryo Transfer ◽  
Thawed Embryo Transfer

Abstract Background Minimal and mild endometriosis patients with infertility are treated by in vitro fertilization and embryo transfer/intracytoplasmic sperm injection (IVF-ET/ICSI) in recent years. However, inconsistencies in findings within and across individual studies raise concerns as to determine which method is the best treatment, especially in the frozen-thawed embryo transfer cycle (FET). We hope to compare the efficacy of natural cycle versus GnRH-a down regulation cycle endometrial preparations in minimal and mild endometriosis patients undergoing FET. Methods We retrospectively analyzed a cohort of 1170 minimal and mild endometriosis patients receiving FET at the Reproductive Medicine Centre from Chengdu Jinjiang Hospital for Maternal and Child Health Care from January 1, 2016 to December 31, 2018. They were assigned to the natural cycle group and the GnRH-a down regulation cycle group based on endometrial preparation protocols. Baseline characteristics, frozen-thawed embryo transfer cycle and pregnancy outcomes were compared between the two groups. Results There were nonsignificant differences in baseline characteristics including age, BMI, types of infertility, the duration of infertility and the delivery history between the natural cycle group and the GnRH-a down regulation cycle group (P>0.05). The biochemical pregnancy rate (63.62% v.s. 53.83%), clinical pregnancy rate (56.10% v.s. 47.49%), implantation rate (43.19% v.s. 34.88%) and live birth rate (44.31% v.s. 35.84%) in the natural cycle group were significantly higher than those in the GnRH-a down regulation cycle group (P<0.05). However, there were nonsignificant differences in the multiple birth rate, abortion rate, ectopic pregnancy rate, premature birth rate, neonatal weight and length between the two groups (P>0.05). The multivariate regression analysis showed that age, anti-Müllerian hormone (AMH), the number of transplanted high-quality blastocysts and endometrial preparation protocols were associated with the live birth rate in minimal and mild endometriosis women undergoing FET (P<0.05). Conclusion Compared with GnRH-a down regulation cycle, natural cycle endometrial preparation of FET is a prominent endometrial preparation method for improving the implantation rate, clinical pregnancy rate, and live birth rate in minimal and mild endometriosis patients, which is more cost-effective in clinical practice.

scholarly journals Twice vitrification-warming procedures has no effect on frozen-thawed embryo transfer outcomes

2021 ◽  
Author(s):  
xiaoyue Shen ◽  
Min Ding ◽  
Yuan Yan ◽  
Shanshan Wang ◽  
jianjun Zhou ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Embryo Transfer ◽  
Live Birth ◽  
Birth Rate ◽  
Live Birth Rate ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
Miscarriage Rate ◽  
Frozen Thawed Embryo Transfer ◽  
Thawed Embryo Transfer

Abstract Background To evaluate the frozen-thawed embryo transfer (FET) outcomes of repeated cryopreservation by vitrification of blastocysts derived from vitrified-warmed day3 embryos in patients who experienced implantation failure previously. Methods We retrospect the files of patients who underwent single frozen-thawed blastocyst transfer cycles in our reproductive medical center from January 2013 to December 2019. 127 patients transfer of vitrified-warmed blastocysts derived from vitrified-warmed day3 embryos were defined as twice-cryopreserved group. 1567 patients who transfer blastocysts that had experienced once vitrified-warmed were used as once-cryopreserved group. None of them was pregnant at the previous FET. The outcomes were compared between two groups after a 1:1 propensity score matching (PSM). Results The clinical pregnancy rate was 52.76%, live birth rate was 43.31% in twice-cryopreserved group. After PSM,108 pairs of patients were generated for comparison. The clinical pregnancy rate, live birth rate or miscarriage rate was not significantly different between two groups. Logistic regression analysis indicated that double vitrification-warming procedures did not affect FET outcomes in terms of clinical pregnancy rate (OR 0.83, 95%CI 0.47-1.42), live birth rate (OR 0.93, 95%CI 0.54-1.59), miscarriage rate (OR 0.72 95%CI 0.28-1.85). Furthermore, the pregnancy complications rate, gestational age or neonatal abnormalities rate between two groups was also comparable, while twice vitrification-warming procedures might increase the macrosomia rate (19.6% vs. 6.3%, P = 0.05). Conclusion Transfer of double vitrified-warmed embryo at cleavage stage and subsequent blastocyst stage did not affect live birth rate and neonatal abnormalities rate, but there was a tendency to increase macrosomia rate, which needs further investigation.

scholarly journals Clinical value of endometrial histological dating for personalized frozen-thawed embryo transfer (pFET) in patients with repeated implantation failure (RIF) in natural cycle

2019 ◽  
Author(s):  
Yuan Li ◽  
Xiaofeng Li ◽  
Jingnan liao ◽  
Xiangxiu Fan ◽  
Yongbin Hu ◽  
...  
Keyword(s):  
Embryo Transfer ◽  
Birth Rate ◽  
Live Birth Rate ◽  
Weighted Kappa ◽  
Good Prognosis ◽  
Natural Cycle ◽  
Clinical Value ◽  
Infertile Patients ◽  
Frozen Thawed Embryo Transfer ◽  
Thawed Embryo Transfer

Abstract Background: The displacement of window of implantation (WOI) has been proposed as an important factor contributed to RIF. However, endometrial histological dating as the diagnostic tool of endometrial receptivity has been questioned. Methods : This is a prospective intervention trial including 205 infertile patients from July 2017 to December 2017.Endometrial biopsies from 50 good prognosis patients were conducted on day 3(n=6), 5(n=6), 7(n=26), 9(n=6) or 11(n=6) of post-ovulation (PO+3/5/7/9/11) in the previous natural cycle before their conventional frozen-thawed embryo transfer (FET) cycle. The endometrial biopsies of 155 RIF patients were conducted on day of PO +7. Results: The verification of Noyes criterion for endometrial dating was conducted in different time (PO +3/+5/+7/+9/+11) from 41 good prognosis patients achieving ongoing pregnancy in the first conventional FET cycle after the endometrial biopsies. The agreement between two pathologists for endometrium dating in infertile patients was determined to be good (weighted kappa = 0.672; P < 0.001). The rate of out-of-phase dating on the day of PO+7 was significantly higher in RIF patients than good prognosis patients (31.6% vs 3.8%, P=0.003).pFET was performed in 47 RIF patients diagnosed to be out of phase, and the accumulative live birth rate was 55.7%. Conclusions: The endometrial histological dating in RIF patients in natural cycle may be a endometrial receptive biomarker for diagnosing the displacement of WOI.

scholarly journals Does estradiol orally and vaginally administered together impact live birth and neonatal outcomes in artificial frozen-thawed embryo transfer cycles: a retrospective cohort study

2020 ◽  
Author(s):  
Yuan Liu ◽  
Yixia Yang ◽  
Jian Sun ◽  
Xinting Zhou ◽  
Yanmei Hu ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Embryo Transfer ◽  
Live Birth ◽  
Birth Rate ◽  
Live Birth Rate ◽  
Clinical Pregnancy ◽  
Neonatal Outcomes ◽  
Serum Estradiol ◽  
Frozen Thawed Embryo Transfer ◽  
Thawed Embryo Transfer

Abstract Background: Previous studies have demonstrated that newborns from fresh embryo transfer have higher risk of small for gestation (SGA) rate than those from frozen-thawed embryo transfer (FET). It is suggested that supraphysiologic serum estradiol in controlled ovarian stimulation (COS) is one of reasons. Our study aims to investigate whether exogenous estradiol delivered regimens have an impact on live birth rate and neonatal outcomes in hormone replacement (HRT)-FET cycles. Methods: This was a retrospective study involving patients undergoing their first FET with HRT endometrium preparation followed by the transfer of two cleavage-staged embryos, comparing estradiol administered orally and vaginally (OVE group) versus estradiol administered orally (OE group) from January 2015 to December 2018 at our center. A total of 792 patients fulfilled the criteria, including 228 live birth singletons. The live birth rate was the primary outcome measure. Secondary outcome measures included clinical pregnancy rate, singleton birthweight, large for gestational age (LGA) rate, SGA rate, preterm delivery rate. Results: Patients in OVE group achieved higher serum estradiol level with more days of estradiol treatment. No difference in live birth (Adjusted OR 1.327; 95%CI 0.982, 1.794, p = 0.066) and clinical pregnancy rate (Adjusted OR 1.278; 95%CI 0.937, 1.743, p = 0.121) was found between OVE and OE groups. Estradiol route did not affect singletons birth weight (β = -30.962, SE = 68.723, p = 0.653), the odds of LGA (Adjusted OR 1.165; 95%CI 0.545, 2.490, p = 0.694), the odds of SGA (Adjusted OR 0.569; 95%CI 0.096, 3.369, p = 0.535) or the preterm delivery (Adjusted OR 0.969; 95%CI 0.292, 3.214, p = 0.959). Conclusion: Estrogen taken orally and vaginally together did not change live birth rate and singleton neonatal outcomes compared to estrogen taken orally, but was accompanied with relative higher serum E2 level and potential maternal undesirable risks.

P–335 Endometrial compaction 5–10% is associated with the best live birth rate in artificial frozen-thawed embryo transfer cycles

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
E Yaprak ◽  
Y E Sukur ◽  
B Ozmen ◽  
M Sonmezer ◽  
B Berker ◽  
...  
Keyword(s):  
Pregnancy Outcome ◽  
Embryo Transfer ◽  
Live Birth ◽  
Birth Rate ◽  
Endometrial Thickness ◽  
Live Birth Rate ◽  
Follicular Phase ◽  
Endometrial Preparation ◽  
Frozen Thawed Embryo Transfer ◽  
Thawed Embryo Transfer

Abstract Study question What is the effect of endometrial compaction on live birth rate in frozen-thawed embryo transfer (FET) cycles? Summary answer In FET cycles with artificial endometrial preparation, the chance for live birth was significantly higher in cycles with endometrial compaction. What is known already Most studies conclude that thinner the endometrium poorer the pregnancy outcome. These studies mostly include measurements in the follicular phase. Since endometrial thickness indicates receptivity, one may expect the endometrial thickness measured on ET day to be more important to predict the outcome. However, few studies assessed endometrial thickness on ET day and unlike follicular phase studies conflicting results were obtained regarding pregnancy outcome. The change in endometrial thickness may be more valuable to predict the pregnancy outcome rather than a single measurement. Study design, size, duration Retrospective observational cohort study. 283 FET cycles in which all patients underwent artificial endometrial preparation were reviewed. Participants/materials, setting, methods: The inclusion criteria were artificial endometrial preparation, age between 20–38 years. The same protocol was applied to all patients for the endometrial preparation.The change of endometrial thickness between the end of estrogen phase and embryo transfer day was recorded. Any decrement is defined as endometrial compaction. The patients were grouped according to the changes of endometrial thicknesses as compaction and non-compaction. Main results and the role of chance Among 283 cycles, 89 had endometrial compaction and 194 did not have compaction. The clinical pregnancy, implantation and live birth rates were significantly higher in the compaction group when compared to non-compaction group (P values 0.007, 0.009, and 0.039, respectively). In order to evaluate the results according to the degree of compaction, we divided the patients into 5% compaction slices. The live birth rate was significantly higher in the 5–10% compaction group (P = 0.016). A multivariable logistic regression analysis was performed to examine the independent effects of different variables on live birth chance.In FET cycles with artificial endometrial preparation, the chance for live birth was significantly higher in cycles with endometrial compaction (OR: 2.352, 95% confidence interval {CI} 1.297–4.264, P = 0.005). A receiver operating characteristic (ROC) curve analysis was performed to evaluate whether there was a certain threshold of endometrial thickness at the end of estrogen phase for endometrial compaction to occur. The sensitivity and specificity of 9.25 mm at the end of estrogen phase calculated from the ROC curve were 76.4% and 58.8%, respectively (area under the curve: 0.701, 95% CI 0.640–0.763; P &lt; 0.001). Limitations, reasons for caution The main limitations of the study were its retrospective nature, relatively small sample size and utilization of different ultrasound techniques at different measurements (using transvaginal ultrasound at the end of the estrogen phase and transabdominal ultrasound on ET day). Wider implications of the findings: Recently a cohort study they found that endometrial compaction results in better pregnancy outcomes, similar to our findings. But, this is the first study to suggest a threshold value (9.2) for endometrial thickness before the commencement of progesterone in regards to increase the chance of compaction. Trial registration number Not applicable

scholarly journals Is Human Chorionic Gonadotropin Trigger Beneficial for Natural Cycle Frozen-Thawed Embryo Transfer?

2021 ◽  
Vol 8 ◽  
Author(s):  
Dan-Dan Gao ◽  
Li Li ◽  
Yi Zhang ◽  
Xiao-Xuan Wang ◽  
Jing-Yan Song ◽  
...  
Keyword(s):  
Live Birth ◽  
Chorionic Gonadotropin ◽  
Human Chorionic Gonadotropin ◽  
Birth Rate ◽  
Live Birth Rate ◽  
Natural Cycle ◽  
Endometrial Preparation ◽  
Frozen Thawed Embryo Transfer ◽  
Natural Cycles ◽  
Thawed Embryo Transfer

Objective: The aim of this study is to investigate, in ovulatory patients, whether there is a difference in reproductive outcomes following frozen-thawed embryo transfer (FET) in natural cycles (NC) compared to modified natural cycles (mNC).Methods: This retrospective cohort study, performed at the public tertiary fertility clinic, involved all infertile patients undergoing endometrial preparation prior to FET in NC and mNC from January, 2017 to November, 2020. One thousand hundred and sixty-two patients were divided into two groups: mNC group (n = 248) had FET in a NC after ovulation triggering with human chorionic gonadotropin (hCG); NC group (n = 914) had FET in a NC after spontaneous ovulation were observed. The primary outcome was live birth rate. All pregnancy outcomes were analyzed by propensity score matching (PSM) and multivariable logistic regression analyses.Results: The NC group showed a higher live birth rate [344/914 (37.6%) vs. 68/248 (27.4%), P = 0.003; 87/240 (36.3%) vs. 66/240 (27.5%), P = 0.040] than the mNC group before and after PSM analysis. Multivariable analysis also showed mNC to be associated with a decreased likelihood of live birth compared with NC [odds ratio (OR) 95% confidence interval (CI) 0.71 (0.51–0.98), P = 0.039].Conclusion: For women with regular menstrual cycles, NC-FET may have a higher chance of live birth than that in the mNC-FET cycles. As a consequence, it's critical to avoid hCG triggering as much as possible when FETs utilize a natural cycle strategy for endometrial preparation. Nevertheless, further more well-designed randomized clinical trials are still needed to determine this finding.

scholarly journals Gonadotropin-releasing Hormone Agonist Down Regulation Combined With Hormone Replacement Therapy Improves the Reproductive Outcome in the Frozen-thawed Embryo Transfer Cycle of Elderly Patients With Idiopathic Recurrent Implantation Failure

2021 ◽  
Author(s):  
Dan Pan ◽  
Jie Yang ◽  
Ni Zhang ◽  
Lei Wang ◽  
Na Li ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Live Birth ◽  
Birth Rate ◽  
Hormone Replacement ◽  
Live Birth Rate ◽  
Down Regulation ◽  
Replacement Treatment ◽  
Cycle Group ◽  
Frozen Thawed Embryo Transfer ◽  
Thawed Embryo Transfer

Abstract BackgroundTo determine whether Gonadotropin-releasing hormone (GnRH) agonist down regulation combined with hormone replacement treatment (HRT) can improve the reproductive outcomes in the frozen thawed embryo transfer (FET) cycle of elderly patients with idiopathic recurrent implantation failure (RIF). MethodsThis is a retrospective cohort study analyzing 594 elderly patients (aged 36~43 years old) undergoing third cleavage embryo or blastocyst transfer over nearly 5-year period (January 2015–November 2020) at Northwest Women’s and Children’s Hospital after IVF-ICSI cycles. Patients with known endometriosis or adenomyosis were excluded from the study.According to different endometrial preparation protocols, patients were divided into three groups: natural cycle group (NC, n=62), hormone replacement treatment cycle group (HRT, n=194) and GnRH agonist down regulation combined with HRT cycle group (GnRHa-HRT, n=290).Live birth rate was primary outcome while clinical pregnancy rate, miscarriage rate, on going pregnancy rate were secondary outcomes. ResultsLive birth rate in the GnRHa-HRT group (31.90%) was significantly higher than that in the HRT (21.65%) or NC (16.13%) groups (P<0.0001). Logistic regression model adjusting for the potential confounders showed that patients in the GnRHa-HRT group have significantly higher live birth rate compared with those in the HRT group (OR, 2.708; 95%CI,1.251-5.864, P=0.011). However, live birth rate was not significantly different between GnRHa-HRT and NC groups (OR, 1.509; 95% CI,0.657-3.463, P=0.332), which could be due to the small sample size in the NC group.ConclusionsGnRHa-HRT protocol improves live birth rate in FET cycles of elderly patients with RIF. We hypothesize that GnRHa-HRT protocol enhances implantation related factors and promotes optimal endometrium receptivity, leading to the improved live birth rate. These findings are also useful for further investigating the underlying mechanism of GnRHa-HRT protocol in improving the reproductive outcomes of elderly patients with RIF.Trial registration:The research protocol was approved by the hospital institutional ethics committee (2021002).

scholarly journals Pretreatment with a GnRH agonist and hormone replacement treatment protocol could not improve live birth rate for PCOS women undergoing frozen-thawed embryo transfer cycles

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xitong Liu ◽  
Juanzi Shi ◽  
Haiyan Bai ◽  
Wen Wen
Keyword(s):  
Propensity Score ◽  
Pregnancy Rate ◽  
Embryo Transfer ◽  
Live Birth ◽  
Birth Rate ◽  
Hormone Replacement ◽  
Live Birth Rate ◽  
Replacement Treatment ◽  
Frozen Thawed Embryo Transfer ◽  
Thawed Embryo Transfer

Abstract Background The ideal protocols of endometrial preparation for polycystic ovary syndrome (PCOS) patients are lacking and need further declaration. Our objective was to compare the clinical outcomes of frozen-thawed embryo transfer (FET) with and without pretreatment gonadotropin-releasing hormone agonist (GnRHa) in PCOS patients. Methods In this retrospective cohort study, we used propensity score matching (PSM) to compare the live birth rate between patients who underwent FET with hormone replacement treatment (HRT) and patients with GnRHa pretreatment (GnRHa + HRT). Patients using GnRHa + HRT (n = 514) were matched with 514 patients using HRT. Results The live birth rate was higher in the GnRHa + HRT group compared with the HRT group with no significant difference (60.12% vs 56.03%, p = 0.073). The clinical pregnancy rate (75.29% vs 70.62%), miscarriage rate (14.20% vs 13.81%) and ectopic pregnancy rate (0.39% vs 0.19%) were similar between the two groups. The preterm birth rate in GnRHa + HRT was higher than HRT (20.23% vs 13.04%). No difference was found in live birth between GnRHa +HRT and HRT before adjusting for covariates (crude OR 1.22, 95%CI, 0.99–1.51, p = 0.062) and after PSM (OR 1.47, 95%CI, 0.99–2.83, p = 0.068). In addition, there is a marginally difference after adjusting for covariates (aOR 1.56, 95%CI, 1.001–2.41, p = 0.048), this finding with p-value close to 0.05 represent insufficient empirical evidence. Similar results were obtained after propensity score matching in the entire cohort. Conclusions GnRHa pretreatment could not improve the live birth rate in women with PCOS.

scholarly journals A modified natural cycle results in higher live birth rate in vitrified-thawed embryo transfer for women with regular menstruation

2016 ◽  
Vol 62 (5) ◽  
pp. 335-342 ◽  
Author(s):  
Yichun Guan ◽  
Hongfang Fan ◽  
Aaron K. Styer ◽  
Zhiying Xiao ◽  
Zhen Li ◽  
...  
Keyword(s):  
Embryo Transfer ◽  
Live Birth ◽  
Birth Rate ◽  
Live Birth Rate ◽  
Natural Cycle ◽  
Thawed Embryo Transfer

scholarly journals Comparison of stimulated cycles with low dose r-FSH versus hormone replacement cycles for endometrial preparation prior to frozen-thawed embryo transfer in young women with polycystic ovarian syndrome: A propensity scores matching analysis from 1434 patients

2021 ◽  
Author(s):  
Li Li ◽  
Dan-Dan Gao ◽  
Yi Zhang ◽  
Jing-Yan Song ◽  
Zhen-Gao Sun
Keyword(s):  
Pregnancy Rate ◽  
Embryo Transfer ◽  
Young Women ◽  
Pregnancy Outcomes ◽  
Polycystic Ovary ◽  
Hormone Replacement ◽  
Endometrial Preparation ◽  
Significant Difference ◽  
Frozen Thawed Embryo Transfer ◽  
Thawed Embryo Transfer

Abstract Objective The principal purpose of this study was to compare reproductive outcomes for stimulated cycles (STC) and hormone replacement cycles (HRC) for endometrial preparation before frozen-thawed embryo transfer (FET) in young women with polycystic ovary syndrome (PCOS). Methods We conducted a retrospective study of 1434 FET cycles from January, 2017 to March, 2020 in our reproductive center, in which stimulated and hormone replacement cycles were used for endometrial preparation. Pregnancy outcomes of couples undergoing routine STC-FET or HRC-FET were analyzed before and after propensity score matching (PSM). Results Data on 1234 HRC protocols (86% of the total) and 200 STC protocols (14%) were collected. After PSM, 199 patients were included in both groups, respectively. There was no significant difference in positive pregnancy rate (52.7% vs. 54.8%, p = 0.763), clinical pregnancy rate (51.8% vs. 52.8%, p = 0.841), live birth rate (45.2% vs. 43.7%, p = 0.762), pregnancy loss rate (9.7% vs. 16.2%, p = 0.164) and ectopic pregnancy rate (1.5% vs. 0.5%, p = 0.615) between STC protocols and HRC protocols. Conclusion STC for endometrial preparation had similar pregnancy outcomes compared with HRC protocols by excluding heterogeneous factors after PSM. Evidence is available which shows that for young women with PCOS who were undergoing in-vitro fertilization, HRC could be a reasonable choice for patients who are unwilling to accept injections. Additionally, STC may offer more flexibility for young PCOS patients and reproductive centres.

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