Infertility: Ultrasonic monitoring during replacement of frozen/thawed embryos in natural and hormone replacement cycles

Al-Shawaf, Talha; Yang, Dunsong; Al-Magid, Yaqub; Seaton, A; Iketubosin, Faye; Craft, Ian

doi:10.1093/oxfordjournals.humrep.a137983

Cited by 74 publications

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“…Multiple reports have suggested that neither implantation rate nor pregnancy rate is affected by estrogen replacement therapy in cryo-thaw cycles [6,8,9]. HRT cycles are those in which exogenous estrogen and progesterone are administered in order to control and optimize the recipient's hormonal and endometrial environment in preparation for the transfer of the cryo-thawed embryos.…”

Section: Discussionmentioning

confidence: 99%

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Natural cycle cryo-thaw transfer may improve pregnancy outcome

Morozov

Ruman

Kenigsberg

et al. 2007

J Assist Reprod Genet

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Objective: To compare natural vs. hormone replacement treatment (HRT) for cryo-thaw embryo transfer cycles in patients with frozen embryos from previous ART. Design and Settings: Retrospective chart review of 164 patients (242 cycles) who underwent natural or HRT cryo-thaw embryo transfer between January 2002 and April 2005. Main Outcome Measures: Pregnancy rates per transfer in natural and HRT cryo-thaw cycles. Results: The pregnancy rate per transfer was higher with natural cycles (36.76% vs. 22.99%, P = 0.0298). There was no statistical difference in mean age, endometrial thickness, and average embryo quality in successful cycles. Mean endometrial thickness prior to transfer was greater in natural cycles (9.95 vs. 8.89 mm, P < 0.001). Mean serum estradiol levels were higher in the HRT group prior to transfer (526.1 vs. 103.8 pg/ml, P < 0.001), and were found to be lower in women who achieved pregnancy (337.1 vs. 433.3 pg/ml, P = 0.0136). Conclusion: Hormone replacement in preparation for cryo-thaw transfer of embryos was found to be associated with decreased pregnancy rates in comparison to natural cycle cryo-thaw transfer. Greater endometrial thickness was achieved with lower serum estradiol levels in patients undergoing natural cycles, suggesting Financial disclosure: none of the above authors had any financial interests with commercial companies.

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Section: Discussionmentioning

confidence: 99%

“…Endometrial thickness has been reported to be a positive prognostic factor in cryo-thaw embryo transfers, with higher success rates when endometrial thickness is greater than 8 mm at a time of transfer [8,14]. Other studies suggest that an endometrial thickness of 10 mm or greater at the time of transfer achieves the best results [10,15].…”

Section: Discussionmentioning

confidence: 99%

Natural cycle cryo-thaw transfer may improve pregnancy outcome

Morozov

Ruman

Kenigsberg

et al. 2007

J Assist Reprod Genet

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“…In four studies comparing natural cycles with GnRH agonist-supported artificial cycles, clinical pregnancy and live births did not differ (46,(47)(48)(49). Furthermore, clinical pregnancy was determined not to differ between the artificial cycles and GnRHsupported artificial cycles (44,50,51).…”

Section: Which Methods Is Preferable?mentioning

confidence: 99%

Methods for endometrial preparation in frozen-thawed embryo transfer cycles

Kalem

Gürgan

2016

J Turkish German Gynecol Assoc

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Review 168 IntroductionFrozen-thawed (FT) embryo transfer is a procedure used for the storage and transfer of excess embryos obtained during in vitro fertilization (IVF)-intracytoplasmic sperm injection (ICSI) cycles. In recent years, improvements in laboratory conditions and limitations on the number of embryos to be transferred have led to a progressive increase in FT embryo transfer cycles. Another preferred practice to prevent multiple pregnancies in IVF cycles is to transfer a single embryo and freeze all surplus embryos (1). However, the best solution for endometrial preparation in these cycles is still a matter of debate (2). Frozen-thawed embryo transfer prevents embryo waste and increases the probability of pregnancy in a single stimulated cycle. Protocols applied in FT cycles aim for endometrial preparation only and are therefore simpler than complicated protocols that aim to develop many follicles. As the treatment for subfertility increases, so does the importance of FT embryo transfer; however, there is no consensus about which method is the best (3, 4). Pregnancy rates following FT embryo transfer have been found to be higher than those following fresh embryo transfer (5). Further, FT embryo transfer increases the cumulative pregnancy rate and decreases the cost; in addition, it is easy to perform and can be applied in a shorter time duration when compared to repetitive fresh embryo transfers (5). Using frozen excess embryos obtained as a result of the time-totime implementation of in vitro maturation (IVM) in patients with polycystic ovaries, successful pregnancies have been achieved (6). Therefore, studies have concentrated on factors affecting the success rate of FT embryo transfer cycles.Various cycle protocols are used for the preparation of the endometrium in an FT embryo transfer cycle. In one of these procedures, the transfer time is determined either by the natural course of a cycle [i.e., in an ovulatory patient exhibiting a natural (spontaneous) cycle] or by inducing ovulation during the course of a natural cycle. The second procedure involves the artificial preparation of the endometrium through the administration of exogenous estrogen and progesterone, which can be performed with or without the association of a gonadotropin-releasing hormone agonist. In the third procedure, the cycle is stimulated by gonadotropins and ovulation is induced by recombinant-human chorionic gonadotropin (rHcg) or hCG; however, this practice is no longer applied (7,8). Embryo transfer in a natural (spontaneous) cycleBoth embryo and endometrial development have to be synchronized in FT embryo transfer cycles in order to maximize the pregnancy rate (9). This synchronization can be achieved in several ways. The easiest is the endocrinological preparation of the endometrium during the natural cycle using the patient's own follicular sex steroids. In this application, the timing for embryo transfer (ET) is determined by either investigating the spontaneous luteinizing hormone (LH) surge or by the administration o...

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“…In the natural cycle protocol, patients with normal ovulatory cycles were serially monitored during the follicular phase for serum estradiol, luteinizing hormone and progesterone levels, and transvaginal sonography (TVS) was performed to determine the number and size of the leading follicles and endometrial thickness until ovulation occurred. When LH surge was observed in the serum, coupled with signs of ovulation by transvaginal sonography, thawing and transferring of embryos was planned according to their developmental stage at freezing [17]. Patients in the natural cycle protocol did not receive any medication in order to induce ovulation.…”

Section: Freeze-thaw Embryo Transfer Protocolsmentioning

confidence: 99%

Oxidative markers in cryopreservation medium from frozen-thawed embryos: a possible tool for improved embryo selection in in vitro fertilization?

Wiener-Megnazi

Lahav-Baratz

Blais

et al. 2016

J Assist Reprod Genet

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Purpose The present study evaluated the association between oxidative parameters in embryo cryopreservation medium and laboratory and clinical outcomes. Methods This prospective laboratory study was conducted in an IVF unit in a university-affiliated hospital with 91 IVF patients undergoing a frozen-thawed embryo transfer cycle. Following thawing, 50 μL of embryo cryopreservation medium was retrieved from each cryotube and tested by the thermochemiluminescence (TCL) assay. TCL amplitudes after 50 (H1), 150 (H2), and 280 s (H3) were recorded in counts per second (CPS) and the TCL ratio determined for comparison with implantation and pregnancy rates. Results A total of 194 embryos were transferred in 85 frozenthaw cycles. Twenty-one pregnancies (24.7 %) occurred. Implantation and overall and clinical pregnancy rates were higher when the median TCL H1 amplitude was <32 CPS compared to ≥32 CPS (14.6 vs. 5.3 %, 37.5 vs. 17 %, 28.1 vs. 9.4 %, respectively). No pregnancies occurred when the H1 amplitude was ≥40 CPS. Logistic regression multivariate analysis found that only the median TCL H1 amplitude was associated with the occurrence of pregnancy (OR = 2.93, 95 % CI 1.065-8.08). The TCL ratio inversely correlated with the duration of embryo cryopreservation (r = −0.37).Conclusions The results indicate that thawed embryos may express oxidative processes in the cryopreservation medium, and higher oxidative levels are associated with lower implantation rates. These findings may aid in the improved selection of frozen-thawed embryos for IVF.

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Infertility: Ultrasonic monitoring during replacement of frozen/thawed embryos in natural and hormone replacement cycles

Cited by 74 publications

References 0 publications

Natural cycle cryo-thaw transfer may improve pregnancy outcome

Natural cycle cryo-thaw transfer may improve pregnancy outcome

Methods for endometrial preparation in frozen-thawed embryo transfer cycles

Oxidative markers in cryopreservation medium from frozen-thawed embryos: a possible tool for improved embryo selection in in vitro fertilization?

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