Aleyasin Ashraf, Aghahosseini Marzieh, Safdarian Leili, Noorzadeh Maryam, Fallahi Parvin, Rezaeian Zahra, Hoseinimosa Sedighe
Department of Obstetrics and Gynecology, Infertility Unit, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Fertility and Infertility Center, Shariati Hospital, Tehran, Iran.
Int J Reprod Biomed. 2017 Feb;15(2):83-86.
There are different methods in endometrial preparation for frozen-thawed embryo transfer (FET).
The purpose of this study was to compare the live birth rate in the artificial FET protocol (estradiol/ progesterone with GnRH-agonist) with stimulated cycle FET protocol (letrozole plus HMG).
This randomized clinical trial included 100 women (18-42 years) randomly assigned to two groups based on Bernoulli distribution. Group I received GnRH agonist [Bucerelin, 500μg subcutaneously] from the previous midlutea lcycle, Then estradiol valerat [2 mg/ daily orally] was started on the second day and was increased until the observation of 8mm endometrial thickness. Finally progesterone [Cyclogest, 800 mg, vaginally] was started. Group II received letrozole on the second day of the cycle for five days, then HMG 75 IU was injected on the7 day. After observing [18 mm folliclhCG10000 IU was injected for ovulation induction. Trans cervical embryo transfer was performed in two groups. The main outcome was the live birth rate. The rate of live birth, implantation, chemical, and clinical pregnancy, abortion, cancellation and endometrial thickness were compared between two groups.
Implantation rate was significantly higher in group I. Live birth rate was slightly increased in group I without significant difference (30% vs. 26%). The rate of chemical and clinical pregnancy was similar in two groups. The abortion rate was lower in letrozole protocol but the difference was not statistically significant. The mean endometrial thickness was not different between two groups.
Letrozole plus HMG method cannot improve pregnancy outcomes in frozen-thawed embryo transfer but it has only one injection compare to daily injections in artificial method.
冻融胚胎移植（FET）的子宫内膜准备有不同方法。
本研究旨在比较人工FET方案（雌二醇/孕酮联合GnRH激动剂）与促排卵周期FET方案（来曲唑加HMG）的活产率。
本随机临床试验纳入100名年龄在18至42岁之间的女性，根据伯努利分布随机分为两组。第一组从上次黄体中期开始皮下注射GnRH激动剂（布舍瑞林，500μg），然后在第二天开始口服戊酸雌二醇（2mg/天），并逐渐增加剂量，直至观察到子宫内膜厚度达到8mm。最后开始阴道使用黄体酮（Cyclogest，800mg）。第二组在周期的第二天服用来曲唑5天，然后在第7天注射HMG 75IU。观察到[18mm卵泡后注射hCG 10000IU进行促排卵。两组均进行经宫颈胚胎移植。主要结局指标为活产率。比较两组的活产率、着床率、生化妊娠率、临床妊娠率、流产率、取消率和子宫内膜厚度。
第一组的着床率显著更高。第一组的活产率略有增加，但无显著差异（30%对26%）。两组的生化妊娠率和临床妊娠率相似。来曲唑方案的流产率较低，但差异无统计学意义。两组的平均子宫内膜厚度无差异。
来曲唑加HMG方法不能改善冻融胚胎移植的妊娠结局，但与人工方法的每日注射相比，它只需一次注射。
