Micah J Hill1, Kathleen A Miller, John L Frattarelli. 1. Reproductive Biology and Medicine Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Building 10, CRC, Room E1-3140, 10 Center Drive, Bethesda, Maryland 20892, USA. hillmicah@mail.nih.gov
Abstract
OBJECTIVE: To compare embryo and birth data in cryopreserved-thawed blastocyst-stage ET cycles between natural endogenous hormone cycles and exogenous hormone stimulation cycles. DESIGN: Retrospective cohort analysis. SETTING: Large academic assisted reproductive technology center. PATIENT(S): One thousand three hundred ninety-one patient cycles undergoing frozen-thawed blastocyst-stage ET cycles. MAIN OUTCOME MEASURE(S): Live-birth rate. INTERVENTION(S): The synthetic protocol used GnRH agonist followed by estrogen and P. The natural protocol used monitoring and post-transfer P. RESULT(S): The patients in the two protocols had similar baseline characteristics. Multiple linear regression showed the synthetic protocol to have a higher live-birth rate (odds ratio [OR], 1.46; 95% confidence interval [CI], 1.02-2.09). In patients having two embryos transferred, the synthetic stimulation protocol resulted in a higher live-birth rate per cycle start (32.3% vs. 20.4%; relative risk [RR], 1.58; 95% CI, 1.22-2.06). Similarly, patients with one or two embryos transferred who had additional cryopreserved blastocysts available also had a higher live-birth rate per cycle start (36.1% vs. 12.1; RR, 2.98; 95% CI, 1.16-7.63). CONCLUSION(S): The synthetic hormone protocol was associated with a higher live-birth rate when compared with a natural cycle protocol for frozen-thawed blastocyst-stage ET cycles. This improvement persisted when analysis was controlled for cycle cancellation. The synthetic stimulation protocol for frozen-thawed embryo cycles offers improved outcome results for patients. Published by Elsevier Inc.
OBJECTIVE: To compare embryo and birth data in cryopreserved-thawed blastocyst-stage ET cycles between natural endogenous hormone cycles and exogenous hormone stimulation cycles. DESIGN: Retrospective cohort analysis. SETTING: Large academic assisted reproductive technology center. PATIENT(S): One thousand three hundred ninety-one patient cycles undergoing frozen-thawed blastocyst-stage ET cycles. MAIN OUTCOME MEASURE(S): Live-birth rate. INTERVENTION(S): The synthetic protocol used GnRH agonist followed by estrogen and P. The natural protocol used monitoring and post-transfer P. RESULT(S): The patients in the two protocols had similar baseline characteristics. Multiple linear regression showed the synthetic protocol to have a higher live-birth rate (odds ratio [OR], 1.46; 95% confidence interval [CI], 1.02-2.09). In patients having two embryos transferred, the synthetic stimulation protocol resulted in a higher live-birth rate per cycle start (32.3% vs. 20.4%; relative risk [RR], 1.58; 95% CI, 1.22-2.06). Similarly, patients with one or two embryos transferred who had additional cryopreserved blastocysts available also had a higher live-birth rate per cycle start (36.1% vs. 12.1; RR, 2.98; 95% CI, 1.16-7.63). CONCLUSION(S): The synthetic hormone protocol was associated with a higher live-birth rate when compared with a natural cycle protocol for frozen-thawed blastocyst-stage ET cycles. This improvement persisted when analysis was controlled for cycle cancellation. The synthetic stimulation protocol for frozen-thawed embryo cycles offers improved outcome results for patients. Published by Elsevier Inc.
Authors: Snigdha Alur-Gupta; Margaret Hopeman; Dara S Berger; Clarisa Gracia; Kurt T Barnhart; Christos Coutifaris; Suneeta Senapati Journal: Fertil Steril Date: 2018-09 Impact factor: 7.329
Authors: E R Groenewoud; B J Cohlen; A Al-Oraiby; E A Brinkhuis; F J M Broekmans; J P de Bruin; G van den Dool; K Fleisher; J Friederich; M Goddijn; A Hoek; D A Hoozemans; E M Kaaijk; C A M Koks; J S E Laven; P J Q van der Linden; A P Manger; E Slappendel; T Spinder; B J Kollen; N S Macklon Journal: Hum Reprod Date: 2016-05-13 Impact factor: 6.918