Disparities in reproductive outcomes according to the endometrial preparation protocol in frozen embryo transfer

Hatoum, Inaam; Bellon, L; Swierkowski, N.; Ouazana, Marion; Bouba, S.; Fathallah, Khadija; Paillusson, B.; Bailly, M.; Boitrelle, Florence; Alter, Laura; Bergère, M.; Selva, J.; Wainer, R.

doi:10.1007/s10815-017-1078-0

Cited by 27 publications

(23 citation statements)

References 19 publications

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“…Regarding the CPR and outcomes of abnormal implantation, a lower CPR and a higher risk of early pregnancy loss were discovered in AC-FET cycles compared to SC-FET. The results were also in accordance with previous retrospective study ( 8 ). On the one hand, letrozole use in SC-FET cycles reduces serum and intraovarian estrogens by blocking the synthesis of estrogen from androgens in the ovarian granulosa cells leading to optimal endometrial development, therefore better endometrium receptivity and improved CP ( 9 ).…”

Section: Discussionsupporting

confidence: 93%

“…Our data added to the current body of evidence and was in line with the recent literatures which found adverse effect of artificial protocol used for scheduling FET on LBR (viable in Table S1) (6)(7)(8)(9). AC-FET has attracted attention as an effective protocol preparing endometrium for patients with regular or irregular menses cycles since AC-FET can reduce the need for repeated hospital visits and thus increase patient convenience (2,6,18).…”

Section: Discussionsupporting

confidence: 86%

“…Compared with previous studies, our practice based on post-hoc randomization and large sample may provide evidence-based guidence for choosing approporiate endometrium preparation protocols for FET. The inclusion of a large cohort ( n = 3,567, 2,917, 3,964 for pairwise comparisons, respectively) at a single institution meant that the protocols for assisted reproductive techniques were relatively homogeneous ( 8 ). Our findings confirmed the hypothesis that the AC was associated with lower LBR than mNC and SC while preparing endometrium for the transfer of frozen-thawed embryos.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, clinicians prefer the predictability, and reliability of AC-FET and have extended its usage to general in vitro fertilization population. More recent primary studies are beginning to challenge the comparability of AC-FET and suggest a reduced CPR and LBR compared with those in mNC-FET and SC-FET (5)(6)(7)(8)(9).…”

Section: Introductionmentioning

confidence: 99%

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Pregnancy Outcomes After Different Cycle Regimens for Frozen-Thawed Embryo Transfer: A Retrospective Study Using Propensity Score Matching

2020

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Background: Nowadays, the choice of frozen embryo transfer (FET) regimens is mainly guided by personal convenience. Clinicians prefer the predictability and reliability of artificial cycle (AC) FET and have extended its usage to general in vitro fertilization population. More recent primary studies are beginning to challenge the comparability of AC-FET and suggest reduced clinical pregnancy rate and live birth rate (LBR) compared with those in modified natural cycle (mNC) FET (ovulation triggered by human chorionic gonadotrophin) and stimulated cycle (SC) FET. Objective: To assess the pregnancy outcomes within matched mNC-FET, SC-FET, and AC-FET cycles by using propensity score matching (PSM) in a larger cohort. Methods: A total of 16,946 women who underwent their first autologous FET cycle between July 2014 and July 2017 were evaluated. PSM, using the nearest neighbor matching, were established to adjust the baseline features within the three protocols in proportion of 1:1 (mNC-FET vs. SC-FET, mNC-FET vs. AC-FET, SC-FET vs. AC-FET). Furthermore, there were 3,567, 2,917, and 3,964 cycles compared between matched mNC-FET and SC-FET, mNC-FET and AC-FET, and SC-FET and AC-FET after the PSM, respectively. Results: LBR was significant lower in the AC-FET group than that in the mNC-FET (40.0 vs. 43.3%) and SC-FET groups (40.9 vs. 46.5%). The adjusted odds ratios (95% CIs) were 1.11 (1.00, 1.24) for mNC/AC (P = 0.044) and 0.84 (0.76, 0.92) for AC/SC (P < 0.001), which indicated that the AC-FET group was associated with lowest LBR. The LBR was comparable between matched mNC-FET and SC-FET after adjusting for endometrial thickness. Moreover, a lower clinical pregnancy rate and a higher risk of early pregnancy loss were discovered in AC-FET cycles compared with those in SC-FET. Conclusion: In view of our data, AC used for scheduling FET was associated with lower LBR compared with SC and modified natural cycle. This interpretation requires Wang et al. Abnormal Implantation in AC future verification from well-designed prospective multicenter randomized clinical trials, although the comparisons in our study were conducted in the homogenous population after the PSM.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Pregnancy Outcomes After Different Cycle Regimens for Frozen-Thawed Embryo Transfer: A Retrospective Study Using Propensity Score Matching

2020

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“…Since then, several studies have compared the reproductive outcomes of endometrial preparation with stimulated cycles using gonadotropin and clomiphene or letrozole or both, with the artificial cycles. Notably, a number of studies have shown positive results involving ovarian stimulation (OS) for endometrial preparation in frozen embryo transfer cycles in PCOS patients [2,[8][9][10][11][12], and some studies have not found any differences compared with hormonal endometrial preparation [13,14].…”

Section: Introductionmentioning

confidence: 99%

The effect of letrozole versus artificial hormonal endometrial preparation on pregnancy outcome after frozen-thawed embryos transfer cycles: a randomized clinical trial

Najarkolaei

Moini

Kashani

et al. 2020

Reprod Biol Endocrinol

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Background Considering that clinical trial studies are limited in polycystic ovary syndrome (PCOS) patients, and there is no consensus on an optimum endometrial preparation protocol for frozen embryo transfer (FET), the present study was designed as a randomized clinical trial to compare the reproductive outcomes following stimulated cycles with letrozole plus human menopausal gonadotropin (HMG) for endometrial preparation compared with routine AC-FET. Methods This randomized controlled trial was carried out on infertile PCOS patients who underwent IVF/ICSI and FET cycles in Arash Women’s Hospital affiliated to Tehran University of Medical Sciences between September 2018 and January 2020. PCOS diagnosis was based on the Rotterdam criteria. Eligible patients were randomly allocated into two groups: stimulated cycle with letrozole plus (HMG) (intervention group) and routine artificial hormonal endometrial preparation (control group). Results One hundred seventy-seven infertile patients were recruited for participation in the study. Of these, 57 women were excluded due to non-eligibility for entering the study, and a total of 120 patients were randomly assigned to two study groups. After follow up, the cycle outcomes of 57 patients in the intervention group and 59 patients in the control group were compared. The data analysis showed that the two groups did not have significant differences in fundamental and demographic characteristics. After the intervention, there were no significant differences in implantation rate, chemical, ectopic, and clinical pregnancy rates between groups. Moreover, the rates of miscarriage and ongoing pregnancy were similar between groups (P > 0.05). Conclusions We found similar pregnancy outcomes with two endometrial preparation methods. Noting that each treatment centre should select the most beneficial and cost-effective method with the least adverse effects for patients, letrozole preparations for FET could be incorporated into possible options; however, establishing this approach as first-line treatment is premature in light of current evidence, and future randomized clinical trials with larger sample sizes are required for widespread application. Trial registration The study was also registered in the Iranian Registry of Clinical Trials on March 20th, 2020. (IRCT20090526001952N12 at www.irct.ir, registered retrospectively).

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Higher live birth rate with stimulated rather than artificial cycle for frozen-thawed embryo transfer

Peigné

Devouche

Ferraretto

et al. 2019

European Journal of Obstetrics & Gynecology and Reproductiv

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Disparities in reproductive outcomes according to the endometrial preparation protocol in frozen embryo transfer

Abstract: In frozen embryo transfer, artificial cycles were associated with more early pregnancy loss and lower live birth rate than stimulated cycles.

Cited by 27 publications

References 19 publications

Pregnancy Outcomes After Different Cycle Regimens for Frozen-Thawed Embryo Transfer: A Retrospective Study Using Propensity Score Matching

Pregnancy Outcomes After Different Cycle Regimens for Frozen-Thawed Embryo Transfer: A Retrospective Study Using Propensity Score Matching

The effect of letrozole versus artificial hormonal endometrial preparation on pregnancy outcome after frozen-thawed embryos transfer cycles: a randomized clinical trial

Higher live birth rate with stimulated rather than artificial cycle for frozen-thawed embryo transfer

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