Tahereh Madani1, Fariba Ramezanali1, Azar Yahyaei1, Fatemeh Hasani2, Narges Bagheri Lankarani3, Ladan Mohammadi Yeganeh4. 1. Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, No 12, East Hafez Avenue, Banihashem Street, Resalat Highway, P.O Box: 19395-4644, Tehran, Iran. 2. Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran. 3. Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran. 4. Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, No 12, East Hafez Avenue, Banihashem Street, Resalat Highway, P.O Box: 19395-4644, Tehran, Iran. ladankh2004@yahoo.com.
Abstract
PURPOSE: This study aimed to compare the clinical outcomes in different endometrial preparation methods prior to frozen embryo transfer (FET) in women with normal menstrual cycles. METHODS: A total of 471 eligible patients were randomly allocated into four groups of endometrial preparation prior to FET: natural cycle with spontaneous ovulation (n = 120), natural cycle with human chorionicgonadotropin (hCG) for ovulation induction (n = 117), hormone replacement cycle (HRC) (n = 113) and HRC with pre-treatment with GnRH-a (n = 121). Natural cycle with hCG also received hCG in luteal phase. The primary outcome was live birth rate. The secondary outcomes included implantation, biochemical and clinical pregnancy, ongoing pregnancy, and late miscarriage rates. Data analysis included t test, ANOVA and χ2. RESULTS: There were no statistically significant differences in the mean age (p = 0.31), duration (p = 0.43) and cause of infertility (p = 0.77) and the number (p = 0.33) and quality (p = 0.21) of embryos transferred between the groups. No significant differences regarding the implantation rates per embryo transfer (p = 0.97) and biochemical pregnancy rates (p = 0.90) were observed between the groups. The rates of clinical pregnancy were 34.2%, 32.5%, 31% and 36.4% in the natural cycle, natural with hCG, HRC and HRC with GnRH-a groups, respectively (p = 0.83). Ongoing pregnancy (p = 0.89) and miscarriage (p = 0.33) rates were comparable between groups. The rate of live birth was 30.8% in the natural group, 30% in the natural with hCG, 27.4% in the HRC and 31.4% in the HRC with GnRH-a groups (p = 0.91). CONCLUSION: Four different types of endometrial preparation methods for FET cycles appear to be equally effective in terms of implantation, pregnancy, miscarriage and live birth rates in women with normal menstrual cycles. CLINICAL TRIAL REGISTRATION NUMBER: NCT02251925.
RCT Entities:
PURPOSE: This study aimed to compare the clinical outcomes in different endometrial preparation methods prior to frozen embryo transfer (FET) in women with normal menstrual cycles. METHODS: A total of 471 eligible patients were randomly allocated into four groups of endometrial preparation prior to FET: natural cycle with spontaneous ovulation (n = 120), natural cycle with human chorionic gonadotropin (hCG) for ovulation induction (n = 117), hormone replacement cycle (HRC) (n = 113) and HRC with pre-treatment with GnRH-a (n = 121). Natural cycle with hCG also received hCG in luteal phase. The primary outcome was live birth rate. The secondary outcomes included implantation, biochemical and clinical pregnancy, ongoing pregnancy, and late miscarriage rates. Data analysis included t test, ANOVA and χ2. RESULTS: There were no statistically significant differences in the mean age (p = 0.31), duration (p = 0.43) and cause of infertility (p = 0.77) and the number (p = 0.33) and quality (p = 0.21) of embryos transferred between the groups. No significant differences regarding the implantation rates per embryo transfer (p = 0.97) and biochemical pregnancy rates (p = 0.90) were observed between the groups. The rates of clinical pregnancy were 34.2%, 32.5%, 31% and 36.4% in the natural cycle, natural with hCG, HRC and HRC with GnRH-a groups, respectively (p = 0.83). Ongoing pregnancy (p = 0.89) and miscarriage (p = 0.33) rates were comparable between groups. The rate of live birth was 30.8% in the natural group, 30% in the natural with hCG, 27.4% in the HRC and 31.4% in the HRC with GnRH-a groups (p = 0.91). CONCLUSION: Four different types of endometrial preparation methods for FET cycles appear to be equally effective in terms of implantation, pregnancy, miscarriage and live birth rates in women with normal menstrual cycles. CLINICAL TRIAL REGISTRATION NUMBER: NCT02251925.
Authors: Xitong Liu; Wen Wen; Tao Wang; Ting Sun; Ting Wang; Na Zhang; Dan Pan; He Cai; Jinlin Xie; Xiaojuan Liu; Zan Shi; Rui Wang; Xiaofang Li; Na Lu; Rong Pan; Li Tian; Bin Meng; Haiyan Bai; Hanying Zhou; Pengfei Qu; Doudou Zhao; Ben W Mol; Wentao Li; Juanzi Shi Journal: BMJ Open Date: 2022-10-14 Impact factor: 3.006