Natural cycle is superior to hormone replacement therapy cycle for vitrificated-preserved frozen-thawed embryo transfer

Xiao, Zhuoni; Zhou, Xin; Xu, Wangming; Yang, Jing; Xie, Qingzhen

doi:10.3109/19396368.2011.646047

Cited by 35 publications

(30 citation statements)

References 25 publications

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“…In agreement with our findings, some previous studies observed superior outcomes in terms of implantation, clinical pregnancy, and lower miscarriage rates when natural cycles were used [Morozov et al 2007;Orvieto et al 2016;Xiao et al 2012]. Moreover, since FET during a natural cycle is less expensive and more patient-friendly, Peeraer et al [2015] recommended NC regimen as the treatment of choice for women with regular cycles undergoing FET.…”

Section: Discussionsupporting

confidence: 81%

“…For example, natural cycles with or without human chorionic gonadotropin (HCG) induced ovulation requires minimum medication and typically carried the least risk for adverse effects and is the least costly. Several groups have reported superior results for this regimen [Morozov et al 2007;Xiao et al 2012]. For the reason of convenience, artificial cycles are often applied to patients with regular menstrual intervals.…”

Section: Introductionmentioning

confidence: 99%

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A modified natural cycle results in higher live birth rate in vitrified-thawed embryo transfer for women with regular menstruation

Guan

Fan

Styer

et al. 2016

Systems Biology in Reproductive Medicine

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(2016) A modified natural cycle results in higher live birth rate in vitrified-thawed embryo transfer for women with regular menstruation, Systems Biology in Reproductive Medicine, 62:5, 335-342, DOI: 10.1080/19396368.2016 To link to this article: https://doi.org/10. 1080/19396368.2016 There is no consensus regimen for the optimal endometrial preparation for cryopreservation and vitrified-thawed embryo transfer cycles. This is largely caused by the lack of sufficient investigation and analyses on the respective pregnancy and perinatal outcomes by different regimens. This study aimed to compare both pregnancy and perinatal outcomes between the modified natural and artificial cycles in vitrified-thawed day three embryo transfer for women with regular menstruation. A total of 1,482 vitrified-thawed day three embryo transfer cycles were reviewed including 427 modified natural cycles (NC), 132 ovulation induction cycles (OC), 794 artificial cycles (AC), and 129 GnRH agonist artificial cycles (GAC). The primary outcome that was evaluated was live birth rate. The NC regimen demonstrated a higher rate of ongoing pregnancy (43.8% vs. 30.2%, P = 0.002) and a lower rate of late abortion (2.8% vs. 14.0%, P = 0.003) than the GAC regimen as well as a higher implantation rate (31.9% vs. 27.1%, P = 0.008) and live birth rate (43.1% vs. 34.1%, P = 0.002) than the AC regimen. A significantly higher peak endometrial thickness before transfer was observed in patients using the NC and GAC regimens (10.0 ± 1.7, 9.9 ± 2.4) compared to the AC regimens (9.2 ± 1.5, P = 0.000). Multivariate logistic regression showed that the NC protocol was associated with a higher live birth rate. There were no significant differences in rates of pregnancy complications, neonatal mortality, birth defects, mean birth weight, and other perinatal outcomes among the regimens. Modified natural cycle endometrial preparation regimen for vitrified-thawed day three embryo transfer is associated with superior live birth pregnancy outcomes compared to artificial cycles. Future studies are warranted to investigate the underlying biologic mechanisms of these findings.Abbreviations ART: assisted reproductive technology; BMI: body mass index; FET: frozen-thawed embryo transfer; HCG: human chorionic gonadotropin; IVF: in-vitro fertilization; IVF-ET: in-vitro fertilization and embryo transfer; OHSS: ovarian hyperstimulation syndrome; RCTs: randomized controlled trials ARTICLE HISTORY

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Section: Discussionsupporting

confidence: 81%

Section: Introductionmentioning

confidence: 99%

A modified natural cycle results in higher live birth rate in vitrified-thawed embryo transfer for women with regular menstruation

Guan

Fan

Styer

et al. 2016

Systems Biology in Reproductive Medicine

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“…Traditionally, embryo cryopreservation was undertaken in patients with surplus embryos or patients with contraindications to transfer such as risk of OHSS or poor endometrial development and in some instances for fertility preservation. Recently, several groups have compared PR between embryos transferred during fresh-gonadotropin-stimulated-cycles versus FETs in a subsequent estrogenstimulated (synthetic) cycle [3,16] or under a natural cycle [14,17,18] with comparable conclusions. For example, a meta-analysis by Roque et al [7] included 3 trials accounting for 633 women.…”

Section: Discussionmentioning

confidence: 99%

Reproductive outcome is optimized by genomic embryo screening, vitrification, and subsequent transfer into a prepared synchronous endometrium

Rodriguez-Purata

Lee

Whitehouse

et al. 2016

J Assist Reprod Genet

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Purpose The aim of this study is to compare implantation and live birth rates (LBR) between fresh euploid embryo transfers versus cryo-all cycles with a subsequent embryo transfer into a prepared endometrium. Material and Methods This is a retrospective cohort study. Patients who underwent an IVF cycle with PGS with trophectoderm biopsy from January 2011 to July 2015 were included. Patients were divided into three groups: "Fresh Only," "Frozen Embryo Transfer ('FET) Only," and "Fresh ET then FET." For "Fresh Only" group (n = 345), PGS results were received within 24 h. For "FET Only" group (n = 514), results were expected after 24 h, and embryos were cryopreserved after biopsy; only FET was performed in this group (no fresh transfer). For "FET with a previous fresh ET" (n = 139) group, patients underwent a fresh ET with a subsequent FET, in which the same cohort of embryos was utilized. The main outcome measures were pregnancy rate (PR), clinical PR, implantation rate (IR), LBR, and early pregnancy loss rate. Results IRs were statistically higher in the "FET Only" group when compared to the "Fresh Only" group (59.5 vs. 50.6 %, p < 0.01) and the "FET with a previous fresh ET" (59.5 vs. 50.6 %, p < 0.05). LBR was statistically significant in the "FET Only" group when compared to the "Fresh Only" group (57.6 vs. 46.5 %, p < 0.005) but not when compared to "FET with a previous fresh ET" group (57.6 vs. 47.7 %, p = 0.07). Conclusions This analysis suggests euploid embryos to be more likely to implant and achieve a LBR in a synthetic FET cycle than in a fresh cycle.

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“…A total of eight studies, all being retrospective cohort studies [35,36,[38][39][40][41][42][43], making a total of 8762 ET cycles, were included.…”

Section: Tnc Versus Ac Without Suppressionmentioning

confidence: 99%

Preparation of endometrium for frozen embryo replacement cycles: a systematic review and meta-analysis

Yaralı́

Polat

Mümüşoğlu

et al. 2016

J Assist Reprod Genet

109

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Purpose The purpose of this study was to evaluate the best protocol to prepare endometrium for frozen embryo replacement (FER) cycles. Methods This study is a systematic review and meta-analysis. Following PubMed and OvidSP search, a total of 1166 studies published after 1990 were identified following removal of duplicates. Following exclusion of studies not matching our inclusion criteria, a total of 33 studies were analyzed. Primary outcome measure was live birth. The following protocols, including true natural cycle (tNC), modified natural cycle (mNC), artificial cycle (AC) with or without suppression, and mild ovarian stimulation (OS) with gonadotropin (Gn) or aromatase inhibitor (AI), were compared. Results No statistically significant difference for both clinical pregnancy and live birth was noted between tNC and mNC groups. When tNC and AC without suppression groups are compared, there was a statistically significant difference in clinical pregnancy rate in favor of tNC, whereas it failed to reach statistical significance for live birth. When tNC and AC with suppression groups are compared, there was a statistically significant difference in live birth rate favoring the latter. Similar pregnancy outcome was noted among mNC versus AC with or without suppression groups. Similarly, no difference in clinical pregnancy and live birth was noted when ACs with or without suppression groups are compared. Conclusions There is no consistent superiority of any endometrial preparation for FER. However, mNC has several advantages (being patient-friendly; yielding at least equivalent or better pregnancy rates when compared with tNC and AC with or without suppression; may not require LPS). Mild OS with Gn or AI may be promising.

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Natural cycle is superior to hormone replacement therapy cycle for vitrificated-preserved frozen-thawed embryo transfer

Cited by 35 publications

References 25 publications

A modified natural cycle results in higher live birth rate in vitrified-thawed embryo transfer for women with regular menstruation

A modified natural cycle results in higher live birth rate in vitrified-thawed embryo transfer for women with regular menstruation

Reproductive outcome is optimized by genomic embryo screening, vitrification, and subsequent transfer into a prepared synchronous endometrium

Preparation of endometrium for frozen embryo replacement cycles: a systematic review and meta-analysis

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