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.

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 < 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 Impact of Luteinized Unruptured Follicles on Clinical Outcomes of Natural Cycles for Frozen/Thawed Blastocyst Transfer

2021 ◽  
Vol 12 ◽  
Author(s):  
Song Li ◽  
Lokwan Liu ◽  
Tian Meng ◽  
Benyu Miao ◽  
Mingna Sun ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Clinical Outcomes ◽  
Live Birth ◽  
Birth Rate ◽  
Live Birth Rate ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
Frozen Thawed Embryo Transfer ◽  
Natural Cycles ◽  
Thawed Embryo Transfer

ObjectiveTo investigate the impact of luteinized unruptured follicles (LUF) on clinical outcomes of frozen/thawed embryo transfer (FET) of blastocysts.MethodsIn this retrospective cohort study, 2,192 patients who had undergone blastocyst FET treatment with natural cycles from October 2014 to September 2017 were included. Using propensity score matching, 177 patients diagnosed with LUF (LUF group) were matched with 354 ovulating patients (ovulation group). The LUF group was further stratified by the average LH peak level of 30 IU/L. Clinical pregnancy rate and live birth rate were retrospectively analyzed between the LUF and ovulation groups, as well as between LUF subgroups.ResultsAfter propensity score matching, general characteristics were similar in the LUF and ovulation groups. Clinical pregnancy rate in the LUF group was significantly lower than that in the ovulation group (47.46 vs. 58.76%, respectively, adjusted P = 0.01, OR 0.60, 95% CI 0.42–0.87). However, no significant difference was detected in live birth rate, although it was lower in the LUF group (43.50 vs. 50.00%, adjusted P = 0.19, OR 0.76, 95% CI 0.51–1.14). In the LUF subgroup analysis, both clinical pregnancy rate (43.02 vs. 62.30%, adjusted P = 0.02, OR 0.45, 95% CI 0.23–0.87) and live birth rate (37.21 vs. 59.02%, adjusted P = 0.01, OR 0.40, 95% CI 0.20–0.78) in the LH <30 IU/L subgroup were significantly lower than those in the LH ≥30 IU/L subgroup.ConclusionLUF negatively affected clinical outcomes of frozen/thawed embryo transfer of blastocysts, particularly when the LH surge was inadequate.

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 Progesterone Intramuscularly or Vaginally Administration May Not Change Live Birth Rate or Neonatal Outcomes in Artificial Frozen-Thawed Embryo Transfer Cycles

2020 ◽  
Vol 11 ◽  
Author(s):  
Yuan Liu ◽  
Yu Wu
Keyword(s):  
Preterm Delivery ◽  
Live Birth ◽  
Birth Rate ◽  
Live Birth Rate ◽  
Neonatal Outcomes ◽  
Progesterone Level ◽  
Delivery Rate ◽  
Serum Progesterone ◽  
Frozen Thawed Embryo Transfer ◽  
Thawed Embryo Transfer

BackgroundsPrevious studies suggested that singletons from frozen-thawed embryo transfer (FET) were associated with higher risk of large, post-date babies and adverse obstetrical outcomes compared to fresh transfer and natural pregnancy. No data available revealed whether the adverse perinatal outcomes were associated with aberrantly high progesterone level from different endometrium preparations in HRT-FET cycle. This study aimed to compare the impact of progesterone intramuscularly and vaginally regimens on neonatal outcomes in HRT-FET cycles.MethodsA total of 856 HRT-FET cycles from a fertility center from 2015 to 2018 were retrospectively analyzed. All patients had their first FET with two cleavage-staged embryos transferred. Endometrial preparation was performed with sequential administration of estrogen followed by progesterone intramuscularly 60 mg per day or vaginal gel Crinone 90 mg per day. Pregnancy outcomes including live birth rate, singleton birthweight, large for gestational age (LGA) rate, small for gestational age (SGA) rate, and preterm delivery rate were analyzed. Student’s t test, Mann-Whitney U-test, Chi square analysis, and multivariable logistic regression were used where appropriate. Differences were considered significant if p &lt; 0.05.ResultsNo significant difference of live birth rate was found between different progesterone regimens (Adjusted OR 1.128, 95% CI 0.842, 1.511, p = 0.420). Neonatal outcomes like singleton birthweight (p = 0.744), preterm delivery rate (Adjusted OR 1.920, 95% CI 0.603, 6.11, p = 0.269), SGA (Adjusted OR 0.227, 95% CI 0.027, 1.934, p = 0.175), and LGA rate (Adjusted OR 0.862, 95% CI 0.425, 1.749, p=0.681) were not different between two progesterone regimens. Serum P level &gt;41.82 pmol/L at 14 day post-FET was associated with higher live birth rate than serum P level ≤41.82 pmol/L in HRT-FET cycles when progesterone was intramuscularly delivered (Adjusted OR 1.690, 95% CI 1.002, 2.849, p = 0.049). But singleton birthweight, preterm delivery rate, SGA and LGA rate were not different between these two groups.ConclusionsRelatively higher serum progesterone level induced by intramuscular regimen did not change live birth rate or neonatal outcomes compared to vaginal regimen. Monitoring serum progesterone level and optimizing progesterone dose of intramuscular progesterone as needed in HRT-FET cycles has a role in improving live birth rate without impact on neonatal outcomes.

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 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.

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