FIVCLINIC, Hospital Clinic de Barcelona, Barcelona, Spain.
Institut d'Investigacions Biomediques August Pi i Sunyer, Barcelona, Spain.
Gynecol Endocrinol. 2019 Oct;35(10):873-877. doi: 10.1080/09513590.2019.1600668. Epub 2019 Apr 11.
To analyze global outcomes in frozen-thawed embryo transfer according to endometrial preparation with natural cycle and artificial cycle taking into account the developmental stage of the embryo. Retrospective cohort study, held in a tertiary-care university hospital with 1265 cycles for frozen-thawed embryo transfer of 860 patients, performed between January 2014 and December 2017. A total of 1097 embryo transfers were performed: 163 transfers in natural cycle (N), 531 in artificial cycle: transdermal estrogens and 403 with oral estrogens. Demographical factors were similar in the three groups studied. When comparing the number of embryos transferred, the quality and the stage of embryos within the three groups there were no differences. Implantation rates were significantly higher in natural cycle. When adjusted depending on the developmental stage, blastocyst embryos transferred in natural cycle preparation had the highest implantation rate. Multiple pregnancies were also higher in natural cycle preparation. There were no significant difference between the groups in the clinical pregnancy rate, ongoing pregnancy, live birth, and miscarriages. Our results suggest that a natural cycle endometrial preparation assessing the disappearance of the dominant follicle by ultrasound increases implantation rates, especially when transferring blastocysts.
分析根据胚胎发育阶段，采用自然周期和人工周期准备的冷冻-解冻胚胎移植的全球结局。这是一项回顾性队列研究，在一家三级保健大学医院进行，共有 860 名患者的 1265 个冷冻-解冻胚胎移植周期，时间为 2014 年 1 月至 2017 年 12 月。共进行了 1097 次胚胎移植：自然周期（N）组 163 次，人工周期：经皮雌激素组 531 次，口服雌激素组 403 次。三组研究中的人口统计学因素相似。在比较三组之间的胚胎移植数量、质量和胚胎阶段时，没有差异。自然周期的着床率明显更高。当根据发育阶段进行调整时，在自然周期准备中移植的囊胚胚胎具有最高的着床率。自然周期准备中的多胎妊娠也更高。各组间的临床妊娠率、持续妊娠、活产和流产率无显著差异。我们的结果表明，通过超声评估优势卵泡消失的自然周期子宫内膜准备可提高着床率，尤其是在移植囊胚时。
