Huberlant S, Vaast M, Anahory T, Tailland M L, Rougier N, Ranisavljevic N, Hamamah S
Département de gynécologie obstétrique et médecine de la reproduction, hopital universitaire Caremeau, place du Professeur R. Debré, 30029 Nîmes, France.
Département de gynécologie obstétrique, hopital général, 66000 Perpignan, France.
Gynecol Obstet Fertil Senol. 2018 May;46(5):466-473. doi: 10.1016/j.gofs.2018.03.006. Epub 2018 Apr 11.
To compare frozen-thawed embryo transfer (FET) outcomes in natural cycles according to ovulation induction: spontaneous versus recombinant human chorionic gonadotrophin (r-hCG) triggering.
This retrospective study included all patients monitored for natural cycle FET during one year. When serial monitoring were performed until spontaneous LH rise, patients were included in group A (n=38) whereas those receiving r-hCG for ovulation triggering formed group B (n=43). All embryos had been cryopreserved by a vitrification method following a previous IVF cycle. No luteal phase support had been given. We compared outcomes between the 2 groups.
After checking groups comparability, we didn't find significant difference for the implantation rate, clinical pregnancy rate and live birth (31% vs 45%, 32% vs 51% et 21% vs 32%, respectively for group A and B). The number of monitoring was significantly lower in group B (1,9±0,8 versus 2,5±1, P=0,006).
Although no consensus has been yet established, natural cycle seems indicated for normo-ovulating patients but the question of ovulation induction is still debated. In our study, triggering ovulation by r-hCG, respecting strict criteria, seems provide good results while reducing both protocol's constraints and cost.
根据排卵诱导方式比较自然周期冻融胚胎移植（FET）的结局：自发排卵与重组人绒毛膜促性腺激素（r-hCG）触发排卵。
这项回顾性研究纳入了一年内接受自然周期FET监测的所有患者。当进行连续监测直至自发促黄体生成素（LH）升高时，患者被纳入A组（n = 38），而接受r-hCG触发排卵的患者形成B组（n = 43）。所有胚胎均在先前的体外受精周期后通过玻璃化方法冷冻保存。未给予黄体期支持。我们比较了两组之间的结局。
在检查两组的可比性后，我们发现植入率、临床妊娠率和活产率在两组之间无显著差异（A组和B组分别为31%对45%、32%对51%以及21%对32%）。B组的监测次数显著更低（1.9±0.8对2.5±1，P = 0.006）。
尽管尚未达成共识，但自然周期似乎适用于排卵正常的患者，但排卵诱导问题仍存在争议。在我们的研究中，按照严格标准使用r-hCG触发排卵，似乎能在减少方案限制和成本的同时取得良好效果。
