Volodarsky-Perel Alexander, Eldar-Geva Talia, Holzer Hananel E G, Schonberger Oshrat, Reichman Orna, Gal Michael
IVF Unit, Division of Obstetrics and Gynecology, Shaare Zedek Medical Center, Jerusalem, Israel.
IVF Unit, Division of Obstetrics and Gynecology, Shaare Zedek Medical Center, Jerusalem, Israel; The Hebrew University School of Medicine, Jerusalem, Israel.
Reprod Biomed Online. 2017 Mar;34(3):267-273. doi: 10.1016/j.rbmo.2016.11.013. Epub 2016 Dec 16.
The optimal time to perform cryopreserved embryo transfer (CET) after a failed oocyte retrieval-embryo transfer (OR-ET) cycle is unknown. Similar clinical pregnancy rates were recently reported in immediate and delayed CET, performed after failed fresh OR-ET, in cycles with the gonadotrophin-releasing hormone (GnRH) antagonist protocol. This study compared outcomes of CET performed adjacently (<50 days, n = 67) and non-adjacently (≥50 to 120 days, n = 62) to the last OR-day of cycles with the GnRH agonist down-regulation protocol. Additional inclusion criteria were patients' age 20-38 years, the transfer of only 1-2 cryopreserved embryos, one treatment cycle per patient and artificial preparation for CET. Significantly higher implantation, clinical pregnancy and live birth rates were found in the non-adjacent group than in the adjacent group: 30.5% versus 11.3% (P = 0.001), 41.9% versus 17.9% (P = 0.003) and 32.3% versus 13.4% (P = 0.01), respectively. These results support the postponement of CET after a failed OR-ET for at least one menstrual cycle, when a preceding long GnRH-agonist protocol is used.
在卵母细胞采集-胚胎移植（OR-ET）周期失败后进行冷冻胚胎移植（CET）的最佳时间尚不清楚。最近有报道称，在使用促性腺激素释放激素（GnRH）拮抗剂方案的新鲜OR-ET失败后的即刻和延迟CET中，临床妊娠率相似。本研究比较了在使用GnRH激动剂下调方案的周期中，与最后一次OR日相邻（<50天，n = 67）和不相邻（≥50至120天，n = 62）进行CET的结果。其他纳入标准为患者年龄20-38岁、仅移植1-2枚冷冻胚胎、每位患者一个治疗周期以及为CET进行人工准备。结果发现，不相邻组的着床率、临床妊娠率和活产率显著高于相邻组：分别为30.5%对11.3%（P = 0.001）、41.9%对17.9%（P = 0.003）和32.3%对13.4%（P = 0.01）。这些结果支持在使用先前的长效GnRH激动剂方案时，OR-ET失败后将CET推迟至少一个月经周期。
