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在计划性冷冻胚胎移植周期中短期(七天)与标准(十四天)雌激素给药的比较:一项回顾性队列研究。

Short (seven days) versus standard (fourteen days) oestrogen administration in a programmed frozen embryo transfer cycle: a retrospective cohort study.

作者信息

Jiang Wen-Jing, Song Jing-Yan, Sun Zhen-Gao

机构信息

The First Clinical College, Shandong University of Traditional Chinese Medicine, Jinan, China.

Reproductive and Genetic Centre of Integrated Medicine, The Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China.

出版信息

J Ovarian Res. 2022 Mar 21;15(1):36. doi: 10.1186/s13048-022-00967-5.

Abstract

RESEARCH QUESTION

What influence does seven days of oestrogen administration versus fourteen days have on the reproductive outcomes of frozen-thawed embryo transfer (FET) in programmed endometrial preparation cycles?

DESIGN

In a retrospective study, conducted at a university-affiliated tertiary hospital, a total of 2628 infertile patients (4142 FET cycles) were divided into one of two groups between January 2014 and December 2020: group A (n = 1406, seven days of oestrogen before progesterone (P4) supplementation) and group B (n = 2716, fourteen days of oestrogen before P4 supplementation). The primary outcome was cumulative live birth rate (CLBR). Secondary outcomes were other pregnancy-related outcomes, maternal and neonatal complications.

RESULTS

No significant difference in CLBR was observed when comparing seven versus fourteen days of oestrogen administration before starting P4 supplementation (47.6% vs. 48.8%, P = 0.537). Furthermore, multivariable logistic regression analysis revealed that oestrogen administration in programmed FET cycles (7 days vs. 14 days) was not significantly associated with CLBR (OR 1.04, 95% CI 0.89-1.23). The risks of maternal and neonatal complications were comparable between the two groups.

CONCLUSIONS

Variation in the duration of oestradiol supplementation before P4 initiation does not impact FET reproductive outcomes. For infertile women who desire to conceive as soon as feasible, short (seven days) oestrogen administration in a programmed FET cycle may be a suitable alternative.

摘要

研究问题

在程序化子宫内膜准备周期中,与14天雌激素给药相比,7天雌激素给药对冻融胚胎移植(FET)的生殖结局有何影响?

设计

在一所大学附属三级医院进行的一项回顾性研究中,2014年1月至2020年12月期间,共有2628名不孕患者(4142个FET周期)被分为两组之一:A组(n = 1406,在补充孕激素(P4)前给予7天雌激素)和B组(n = 2716,在补充P4前给予14天雌激素)。主要结局是累积活产率(CLBR)。次要结局是其他与妊娠相关的结局、孕产妇和新生儿并发症。

结果

在开始补充P4前比较7天与14天雌激素给药时,未观察到CLBR有显著差异(47.6%对48.8%,P = 0.537)。此外,多变量逻辑回归分析显示,程序化FET周期中(7天对14天)的雌激素给药与CLBR无显著关联(OR 1.04,95%CI 0.89 - 1.23)。两组之间孕产妇和新生儿并发症的风险相当。

结论

在开始补充P4前雌二醇补充持续时间的变化不会影响FET的生殖结局。对于希望尽快受孕的不孕女性,在程序化FET周期中短期(7天)给予雌激素可能是一种合适的选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5d9d/8939227/f7fe797e0a5b/13048_2022_967_Fig1_HTML.jpg

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