Modified natural protocol seems superior to natural and artificial protocols for preparing the endometrium in frozen embryo transfer cycles

Işıkoğlu, Mete; Aydınuraz, Batu; Avci̇, Aysenur; Cevi̇ren, Ayse Kendi̇rci̇

doi:10.23736/s0026-4784.20.04570-0

Cited by 2 publications

(1 citation statement)

References 19 publications

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“…In this context, the mNC-FET approach stands out, requiring significantly fewer visits. This not only translates to cost savings but also offers patients a more convenient and practical choice [31,32]. Patients must be aware of the fact that whenever FET relies on corpus luteum formation, a natural conception may occur, in addition to potential conception by the transferred embryo(s), increasing the risk of multiple pregnancy.…”

Section: After Triggering Ovulation Additional P For All?mentioning

confidence: 99%

Ideal frozen embryo transfer regime

Castillo,

Kol

2024

Current Opinion in Obstetrics &Amp; Gynecology

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Purpose of review This review aims to compare evidence on four criteria (embryo implantation, obstetric outcomes, patient convenience, and IVF-unit efficiency) by analyzing published research on different endometrial preparation methods for frozen embryo transfer (FET). Recent findings While the artificial-FET cycle provides advantages in scheduling and implantation, it falls short in ensuring optimal obstetric outcomes. In contrast, natural-FET ensures embryo implantation conditions if ovulation is correctly identified. Supplementing with exogenous progesterone shields against low corpus luteum progesterone secretion, crucial for positive obstetric outcomes. In mNC-FET, ovulation is hCG-triggered, closely resembling natural cycles and reducing monitoring visits for enhanced patient convenience. Letrozole is a recommended option for anovulatory patients, preserving endometrial thickness. It is cost-effective, less likely to induce multifollicular development than gonadotropins, and better tolerated. In a novel approach, the natural-proliferative-phase-FET initiates progesterone in an unmediated ovulatory cycle at 7 mm endometrial thickness, combining the benefits of a natural proliferative endometrium with the convenience of scheduled artificial cycles. Summary The artificial cycle offers scheduling advantages, but may compromise obstetric outcomes. Natural FET relies on accurate ovulation timing for successful implantation. mNC-FET simplifies the process using hCG induction, minimizing clinic visits for improved convenience. Letrozole is highlighted as a cost-effective and well tolerated option in anovulatory patients. A recent innovative approach combines elements of natural and artificial cycles, showing promise for FET procedures.

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Section: After Triggering Ovulation Additional P For All?mentioning

confidence: 99%

Ideal frozen embryo transfer regime

Castillo,

Kol

2024

Current Opinion in Obstetrics &Amp; Gynecology

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Natural cycle versus modified natural cycle for endometrial preparation in women undergoing frozen-thawed embryo transfer: An RCT

Mojtahedi¹,

Aref²,

Moini³

et al. 2022

IJRM

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Background: Studies have evaluated different endometrial preparation methods, but the optimal frozen-thawed embryo transfer (FET) cycle strategy in terms of the in-vitro fertilization outcome is still debated. Objective: To compare the natural versus modified natural cycles for endometrial preparation in women undergoing FET. Materials and Methods: This study was designed as a randomized clinical trial, and it was performed at the Arash women’s hospital between August 2016-2018. Hundred and forty eligible participants were enrolled in this study and were randomly divided into 2 groups by using the block randomization method, including true natural FET (n = 70) and modified natural FET (mNFET) (n = 70) cycles. Both groups were monitored for endometrial thickness and follicular size; simultaneously spontaneous luteinizing hormone surge using urinary luteinizing hormone testing kits. The mNFET group received 5000 IU of human chorionic gonadotropin injection to trigger final follicular maturation. Luteal support by vaginal progesterone (cyclogest 400 mg twice daily) was used in true natural FET from the day of transfer until the 10th wk of pregnancy. Chemical and clinical pregnancy and abortion rates were considered as the primary outcomes. Results: There were no differences in the participants’ baseline characteristics between groups. There was no difference in clinical pregnancy and abortion rate between the 2 groups, while the implantation rate was significantly higher in the mNFET group (29.2% vs. 17.6%; p = 0.036). Conclusion: The results demonstrated that both types of natural cycles were similar in pregnancy outcomes, while modified cycles might be associated with a higher implantation rate. Key words: Embryo transfer, In vitro fertilization, Pregnancy rate, Live birth, Human chorionic gonadotropin.

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Modified natural protocol seems superior to natural and artificial protocols for preparing the endometrium in frozen embryo transfer cycles

Cited by 2 publications

References 19 publications

Ideal frozen embryo transfer regime

Ideal frozen embryo transfer regime

Natural cycle versus modified natural cycle for endometrial preparation in women undergoing frozen-thawed embryo transfer: An RCT

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