Department of Obstetrics and Gynecology, Faculty of Medicine, Ankara University, Ankara, Turkey.
Faculty of Medicine, Ankara University, Ankara, Turkey.
Int J Gynaecol Obstet. 2023 Mar;160(3):829-835. doi: 10.1002/ijgo.14366. Epub 2022 Aug 15.
To assess the impact of an estrogen replacement regimen on frozen embryo transfer (FET) cycle outcome.
In the present retrospective cohort study, data of infertile women undergoing FET with good-quality embryos were reviewed. The first group received 2 mg of estradiol hemihydrate (EH) once daily for 6 to 7 days, then twice daily for 4 to 5 days, and then three times a day until embryo transfer. The second group received EH twice daily for 7 to 8 days, then three times a day. The third group received EH three times a day constantly. The main outcome measure was live birth rate.
In total, 394 FET cycles were included. The fixed 6-mg group required the highest estradiol hemihydrate dose. The duration of estrogen treatment was significantly longer in the first group. Maximal endometrial thickness was highest in the second group (10.2 ± 1.3 mm vs. 9.6 ± 1.4 mm vs. 8.6 ± 0.9 mm, respectively; P < 0.001). The clinical pregnancy rates in the groups were 41.1%, 55.2%, and 42.2%, respectively (P = 0.035). Live birth rates were 40.8%, 50.9%, and 48.1%, respectively (P = 0.320).
In FET cycles with hormone replacement therapy, a step-up 4-mg regimen provides thicker endometrium with optimal-dose estrogen in an adequate time frame. The tendency for increased clinical pregnancy and live birth rates is remarkable.
评估雌激素替代方案对冻融胚胎移植（FET）周期结局的影响。
在本回顾性队列研究中，回顾了接受优质胚胎 FET 的不孕妇女的数据。第一组每天接受 2 毫克雌二醇半水合物（EH）一次，持续 6-7 天，然后每天两次，持续 4-5 天，然后每天三次，直到胚胎移植。第二组每天两次接受 EH 治疗 7-8 天，然后每天三次。第三组每天三次接受 EH 治疗。主要观察指标为活产率。
共纳入 394 个 FET 周期。固定 6 毫克组需要最高剂量的雌二醇半水合物。第一组雌激素治疗时间明显延长。第二组的最大子宫内膜厚度最高（分别为 10.2±1.3 毫米、9.6±1.4 毫米和 8.6±0.9 毫米；P<0.001）。各组的临床妊娠率分别为 41.1%、55.2%和 42.2%（P=0.035）。活产率分别为 40.8%、50.9%和 48.1%（P=0.320）。
在 FET 周期的激素替代治疗中，逐步增加 4 毫克的方案可在适当的时间框架内提供更厚的子宫内膜和最佳剂量的雌激素。临床妊娠率和活产率有增加的趋势。
