Agonist depot versus OCP programming of frozen embryo transfer: a retrospective analysis of freeze-all cycles

Abstract

Purpose In segmented ART treatment or so-called 'freeze-all' strategy fresh embryo transfer is deferred, embryos cryopreserved, and the embryo transferred in a subsequent frozen embryo transfer (FET) cycle. The purpose of this cohort study was to compare a GnRHa depot with an oral contraceptive pill (OCP) programming protocol for the scheduling of an artificial cycle FET (AC-FET) after oocyte pick-up (OPU). Methods This retrospective cohort study was conducted on prospectively performed segmented ART cycles performed between September 2014 and April 2015. The pregnancy, treatment duration, and cycle cancellation outcomes of 170 OCP programmed AC-FET cycles were compared with 241 GnRHa depot programmed AC-FET cycles. Results No significant difference was observed in the per transfer pregnancy and clinical pregnancy rates between the OCP and GnRHa groups, 72.0 versus 77.2 %, and 57.8 versus 64.3 %, respectively. Furthermore, the early pregnancy loss rate was non-significantly different between the OCP and GnRH protocol groups, 19.8 versus 16.7 %, respectively. However, nine (5.29 %) cycles were cancelled due to high progesterone in the OCP protocol group, while no cycles were cancelled in the GnRHa protocol group and the time taken between OPU and FET was 19 days longer (54.7 vs 35.6 days) in the OCP protocol compared to the GnRHa protocol. Conclusions The results of this AC-FET programming study suggests that the inclusion of GnRHa depot cycle programming into a segmented ART treatment will ensure pregnancy, while significantly reducing treatment duration and cycle cancellation.

Effect of pretreatment with oral contraceptives and progestins on IVF outcomes in women with polycystic ovary syndrome

“…We found that rates of pregnancy and live birth after FET were not affected by OCs used for scheduling endometrial preparation, though it was related to a thinner endometrium. This finding was consistent with another study, which found no effect of OCs used for scheduling FET cycle on pregnancy rate (Ozgur et al, 2016). The underlying mechanism was unclear.…”

Frozen embryo transfer can be performed in the cycle immediately following the freeze-all cycle

“…Standard protocols were used for endometrial preparation, with the start of endometrial preparation programmed with the administration of GnRH agonist (≈ 1.88 mg of a 3.75 mg Lucrin Depot®, Abbott Laboratories Ltd., Istanbul, Turkey) or oral contraceptive pill (OCP, Ginera®, 75 μg Gestodene, 30 μg ethinyloestradiol, Bayer, Istanbul, Turkey) [27,28]. Cycles with the shortest time interval between oocyte retrieval and ET (≈ 36 days) were those in which a Lucrin Depot® was administered 7 days after oocyte retrieval and endometrial preparation was started 10 days later with oral estrogen administration [27]. Estrogen (Estrofem, Novo Nordisk, Bagsvaerd, Denmark) was taken orally in a step-up regimen: 2 mg/day from day 1 to 6, 4 mg/day from day 7 to 10, and 8 mg/day from day 11 to 14.…”

The effect of fresh IVF cycle characteristics on frozen embryo transfer (FET) outcomes

“…Embryo cryopreservation technology has undergone significant improvements since its introduction, leading to better outcomes from frozen embryo transfers (FET). The progress seen in embryo cryopreservation has encouraged its routine use in ART centers (Ozgur et al, 2016).…”