Reproductive Medicine Center, Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China.
Center for Molecular Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China.
Hum Reprod. 2019 Aug 1;34(8):1479-1484. doi: 10.1093/humrep/dez096.
Does oestrogen dose tapering during the luteal phase affect the clinical outcome after hormone replacement treatment-frozen-thawed embryo transfer (HRT-FET) cycles?
Our results suggest that tapering oestrogen doses during the luteal phase results in similar clinical outcomes to those obtained with the traditional luteal phase support (LPS).
Traditional LPS with oestrogen and progesterone is considered necessary in HRT-FET cycles. However, case reports have shown successful clinical pregnancies and live births in the absence of oestrogen administration after embryo transfers.
STUDY DESIGN, SIZE, DURATION: This was a retrospective study on 6035 HRT-FET cycles extending over 7 years from January 2011 to June 2018 at the reproductive medicine centre of Xiangya Hospital.
PARTICIPANTS/MATERIALS, SETTING, METHODS: We compared the clinical outcomes of 1632 HRT-FET cycles with tapered oestrogen doses from 12 days after embryo transfer (study group) to those of 4403 HRT-FET cycles maintained on constant oestrogen doses during the luteal phase (control group) in the case of positive serum HCG test.
We found similar biochemical pregnancy rates (52.1% vs. 51.9, P = 0.864), clinical pregnancy rates (44.9% vs. 43.2%, P = 0.249), implantation rates (29.8% vs. 29.3%, P = 0.591) and miscarriage rates (16.0% vs. 14.6%, P = 0.379) between the studied groups.
LIMITATIONS, REASONS FOR CAUTION: Retrospective, design-associated biases are possible. In addition, some baseline characteristics differed between groups. Finally, we did not compare live birth rates between groups.
Our study showing similar outcomes between traditional LPS and oestrogen tapering during the luteal phase indicates that oestrogen may be cautiously tapered during the luteal phase after HRT-FET cycles.
STUDY FUNDING/COMPETING INTEREST(S): This work was supported by the National Natural Science Foundation of China (grant no. 81401269) and the class General Financial Grant from the China Postdoctoral Science Foundation (grant no. 2017M620360). The authors declare that they have no competing interests.
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黄体期雌激素剂量递减是否会影响激素替代治疗-冷冻胚胎移植（HRT-FET）周期后的临床结局？
我们的结果表明，黄体期雌激素剂量递减可获得与传统黄体期支持（LPS）相似的临床结局。
传统的 LPS 用雌激素和孕激素被认为是 HRT-FET 周期所必需的。然而，病例报告显示，在胚胎移植后不给予雌激素的情况下，也能成功获得临床妊娠和活产。
研究设计、规模、持续时间：这是一项回顾性研究，纳入了 2011 年 1 月至 2018 年 6 月在湘雅医院生殖医学中心进行的 6035 个 HRT-FET 周期，历时 7 年。
参与者/材料、设置、方法：我们比较了在血清 hCG 检测阳性的情况下，1632 个 HRT-FET 周期中雌激素剂量从胚胎移植后 12 天开始递减（研究组）与 4403 个 HRT-FET 周期中黄体期持续使用固定雌激素剂量（对照组）的临床结局。
我们发现两组的生化妊娠率（52.1% vs. 51.9，P=0.864）、临床妊娠率（44.9% vs. 43.2%，P=0.249）、着床率（29.8% vs. 29.3%，P=0.591）和流产率（16.0% vs. 14.6%，P=0.379）相似。
局限性、谨慎对待的原因：存在回顾性、设计相关的偏倚。此外，两组间存在一些基线特征差异。最后，我们没有比较两组间的活产率。
我们的研究表明，传统 LPS 和黄体期雌激素递减之间的结局相似，这表明在 HRT-FET 周期后，雌激素在黄体期可以谨慎地进行递减。
研究基金/竞争利益：本研究得到了国家自然科学基金（grant no. 81401269）和中国博士后科学基金面上资助（grant no. 2017M620360）的支持。作者声明没有竞争利益。
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