Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, No 12, East Hafez Avenue, Banihashem Street, Resalat Highway, P.O Box: 19395-4644, Tehran, Iran.
Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.
Arch Gynecol Obstet. 2019 Apr;299(4):1185-1191. doi: 10.1007/s00404-019-05062-7. Epub 2019 Feb 1.
This study aimed to compare the clinical outcomes in different endometrial preparation methods prior to frozen embryo transfer (FET) in women with normal menstrual cycles.
A total of 471 eligible patients were randomly allocated into four groups of endometrial preparation prior to FET: natural cycle with spontaneous ovulation (n = 120), natural cycle with human chorionic gonadotropin (hCG) for ovulation induction (n = 117), hormone replacement cycle (HRC) (n = 113) and HRC with pre-treatment with GnRH-a (n = 121). Natural cycle with hCG also received hCG in luteal phase. The primary outcome was live birth rate. The secondary outcomes included implantation, biochemical and clinical pregnancy, ongoing pregnancy, and late miscarriage rates. Data analysis included t test, ANOVA and χ.
There were no statistically significant differences in the mean age (p = 0.31), duration (p = 0.43) and cause of infertility (p = 0.77) and the number (p = 0.33) and quality (p = 0.21) of embryos transferred between the groups. No significant differences regarding the implantation rates per embryo transfer (p = 0.97) and biochemical pregnancy rates (p = 0.90) were observed between the groups. The rates of clinical pregnancy were 34.2%, 32.5%, 31% and 36.4% in the natural cycle, natural with hCG, HRC and HRC with GnRH-a groups, respectively (p = 0.83). Ongoing pregnancy (p = 0.89) and miscarriage (p = 0.33) rates were comparable between groups. The rate of live birth was 30.8% in the natural group, 30% in the natural with hCG, 27.4% in the HRC and 31.4% in the HRC with GnRH-a groups (p = 0.91).
Four different types of endometrial preparation methods for FET cycles appear to be equally effective in terms of implantation, pregnancy, miscarriage and live birth rates in women with normal menstrual cycles.
NCT02251925.
本研究旨在比较自然周期和激素替代周期（HRC）中不同子宫内膜准备方法对正常月经周期妇女冻融胚胎移植（FET）的临床结局。
471 名符合条件的患者被随机分为 4 组进行 FET 前的子宫内膜准备：自然周期自发排卵（n=120）、自然周期 hCG 促排卵（n=117）、HRC（n=113）和 GnRH-a 预处理 HRC（n=121）。hCG 诱导排卵的自然周期也在黄体期接受 hCG。主要结局是活产率。次要结局包括着床率、生化妊娠率、临床妊娠率、持续妊娠率和晚期流产率。数据分析包括 t 检验、方差分析和 χ。
各组间平均年龄（p=0.31）、持续时间（p=0.43）和不孕原因（p=0.77）、胚胎移植数量（p=0.33）和质量（p=0.21）无统计学差异。各组间胚胎移植的着床率（p=0.97）和生化妊娠率（p=0.90）无显著差异。自然周期、自然 hCG、HRC 和 HRC+GnRH-a 组的临床妊娠率分别为 34.2%、32.5%、31%和 36.4%（p=0.83）。持续性妊娠率（p=0.89）和流产率（p=0.33）无差异。自然组的活产率为 30.8%，自然 hCG 组为 30%，HRC 组为 27.4%，HRC+GnRH-a 组为 31.4%（p=0.91）。
在正常月经周期妇女中，FET 周期的四种不同子宫内膜准备方法在着床率、妊娠率、流产率和活产率方面似乎同样有效。
NCT02251925。
