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

Peigné, Maëliss; Devouche, Émmanuel; Ferraretto, Xavier; Gricourt, S.; Luton, Dominique; Patrat, Catherine; Epelboin, Sylvie

doi:10.1016/j.ejogrb.2019.10.040

Cited by 24 publications

(20 citation statements)

References 40 publications

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“…Similarly, Zhang et al found the endometrial thickness was significantly greater in the letrozole group than in the AC group, both on the day of starting progesterone and on the day of ET [2]. However, some studies found no significant difference [14,21] or even higher endometrial thickness after the artificial preparation method [9]. Therefore, more randomized trials with higher sample size are still required to conclude and comment on this regards.…”

Section: Discussionmentioning

confidence: 99%

“…Similarly, three retrospective studies in China and one in Egypt found higher implantation, clinical, ongoing and live birth rates in letrozole stimulated cycles compared with AC [11,12,19] and natural cycles [20]. Elsewhere, Peigné et al (2019) in a retrospective study concluded that live birth rate was significantly higher with mild OS than with the AC preparation, even after adjusting for potential confounders; suggesting that the first-line endometrial preparation could be OS instead of an AC and a potential defect of the luteal phase may exist in AC preparation [21]. However, Aleyasin et al in a randomized clinical trial found no significant difference in terms of live birth rate between the letrozole plus HMG method and the artificial FET protocol [14].…”

Section: Discussionmentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

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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“…In case of a positive test, the patients were instructed to continue treatment until the 10th gestational week. 24 …”

Section: Methodsmentioning

confidence: 99%

Comparison of Stimulated Cycles with Low Dose r-FSH versus Hormone Replacement Cycles for Endometrial Preparation Prior to Frozen-Thawed Embryo Transfer in Young Women with Polycystic Ovarian Syndrome: A Single-Center Retrospective Cohort Study from China

Li¹,

Gao²,

Zhang³

et al. 2021

DDDT

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Objective The principal purpose of this study was to compare reproductive outcomes for stimulated cycles (STC) and hormone replacement cycles (HRC) for endometrial preparation before frozen-thawed embryo transfer (FET) in young women with polycystic ovary syndrome (PCOS). Methods We conducted a retrospective study of 1434 FET cycles from January, 2017 to March, 2020 in our reproductive center, in which stimulated and hormone replacement cycles were used for endometrial preparation. Pregnancy outcomes of couples undergoing routine STC-FET or HRC-FET were analyzed by propensity score matching (PSM) and multivariable logistic regression analyses. Results Data on 1234 HRC protocols (86% of the total) and 200 STC protocols (14%) were collected. After PSM, 199 patients were included in both groups, respectively. There was no significant difference in positive pregnancy rate (52.7% vs 54.8%, p=0.763 ), clinical pregnancy rate (51.8% vs 52.8%, p=0.841 ), live birth rate (45.2% vs 43.7%, p=0.762 ), pregnancy loss rate (9.7% vs 16.2%, p=0.164 ) and ectopic pregnancy rate (1.5% vs 0.5%, p=0.615 ) between STC and HRC protocols. Subsequent multivariate logistic regression analysis also yielded similar results. Conclusion STC for endometrial preparation had similar pregnancy outcomes compared with HRC protocols. Evidence is available which shows that for young women with PCOS in preparation for FET, HRC could be a reasonable choice for patients who are unwilling to accept injections. However, STC may reduce unnecessary anxiety and operational costs and offer more flexibility for patients. Eventually, we must embrace the concepts of individualization, securitization, and optimization in the clinic.

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“…They used an endometrial receptivity analysis to demonstrate that as many as 48.6% of women undergoing aFET demonstrated a displaced implantation window [33]. Previous studies suggested a benefit of using mild stimulation of induction, either with low-dose gonadotropins or aromatase inhibitors [34][35][36].…”

Section: Afet Vs Ovu-fetmentioning

confidence: 99%

Ovulatory-Based FET Cycles May Achieve Higher Pregnancy Rates in the General Population and among Anovulatory Women

Aslih

Dorzia

Atzmon

et al. 2021

JCM

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This study evaluated which endometrial preparation protocol in frozen embryo transfer (FET) cycles provides the best results for polycystic ovarian syndrome (PCOS) patients and the general population. This retrospective study of 634 FET cycles was conducted 2016–2018. Cycles were divided into Group A: Artificial endometrial preparations for FET (aFET; n = 348), Group B: Ovulatory cycle (n = 286) to compare two methods of endometrial preparation for FET. Artificial endometrial preparation with exogenous estrogen and progesterone versus natural ovulation cycles, modified natural cycles using hCG for the final triggering and letrozole-induced ovulation with hCG. Anovulatory patients were analyzed separately. Anovulatory PCOS patients had significantly higher pregnancy rates with letrozole treatment compared with aFET cycles (44% vs. 22.5%; p = 0.044). For the entire cohort, ovulatory cycles and aFET were similar in terms of patient characteristics, demographics, infertility causes, treatment protocols and number of embryos transferred. Although the mean ESHRE score of the transferred embryos was higher in the aFET group, we found higher clinical pregnancy rate in the ovulatory cycle FET (41.3% vs. 27.3%, p < 0.0001). A better pregnancy rate was found after ovulatory cycle FET. In the ovulatory cycles, the outcome of letrozole-induced and non-induced cycles were comparable. PCOS patients, as well as the general population, may benefit from ovulation induced FET cycles, with significantly better outcomes in FET in ovulatory cycles.

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

Cited by 24 publications

References 40 publications

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

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

Comparison of Stimulated Cycles with Low Dose r-FSH versus Hormone Replacement Cycles for Endometrial Preparation Prior to Frozen-Thawed Embryo Transfer in Young Women with Polycystic Ovarian Syndrome: A Single-Center Retrospective Cohort Study from China

Ovulatory-Based FET Cycles May Achieve Higher Pregnancy Rates in the General Population and among Anovulatory Women

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