Center for Reproductive Medicine and Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, China.
Center for Molecular Reproductive Medicine, Nanjing University, Nanjing, China.
Front Endocrinol (Lausanne). 2023 Jun 14;14:1192696. doi: 10.3389/fendo.2023.1192696. eCollection 2023.
Hormone replacement therapy (HRT) is one of the most used endometrial preparation protocols for frozen embryo transfer (FET) due to the convenience of its administration and stability of pregnancy outcomes. There are several HRT cycles accompanied by the development of dominant follicles. However, the relationship between dominant follicle development and clinical outcomes in HRT-FET cycles remains unclear.
We carried out a retrospective cohort study of 13251 cycles at our reproductive medicine center from 2012 to 2019. Total cycles were divided into two groups according to whether there was dominant follicular development. In addition, we conducted a secondary analysis that used propensity-score matching to reduce confounding variables. A univariate and multivariable logistic regression model was further employed to analyze the effect of dominant follicle development in HRT cycles on clinical pregnancy outcomes.
There was no significant correlation between dominant follicle development in HRT-FET cycles and the clinical pregnancy rate (adjusted OR = 1.162, 95% CI: 0.737-1.832, P = 0.52). In addition, there was a positive correlation between the basic follicle-stimulating hormone (FSH) level and the development of dominant follicles, while there was a negative correlation between antral follicle count (AFC), menstrual cycle length and the development of dominant follicles in HRT cycles.
The development of dominant follicles in HRT-FET cycles does not affect the clinical pregnancy rate, early miscarriage rate and live birth rate. Therefore, it is not necessary to immediately cancel the FET cycle immediately when dominant follicle development is monitored in the HRT-FET cycle.
由于激素替代疗法（HRT）给药方便且妊娠结局稳定，是最常用于冻融胚胎移植（FET）的子宫内膜准备方案之一。HRT 周期中有几个伴随优势卵泡发育的周期。然而，HRT-FET 周期中优势卵泡发育与临床结局的关系尚不清楚。
我们对 2012 年至 2019 年在我们的生殖医学中心进行的 13251 个周期进行了回顾性队列研究。根据是否存在优势卵泡发育，将总周期分为两组。此外，我们进行了二次分析，使用倾向评分匹配来减少混杂变量。进一步采用单变量和多变量逻辑回归模型分析 HRT 周期中优势卵泡发育对临床妊娠结局的影响。
HRT-FET 周期中优势卵泡发育与临床妊娠率之间无显著相关性（调整后的 OR = 1.162，95%CI：0.737-1.832，P = 0.52）。此外，HRT 周期中基础卵泡刺激素（FSH）水平与优势卵泡发育呈正相关，而窦卵泡计数（AFC）和月经周期长度与优势卵泡发育呈负相关。
HRT-FET 周期中优势卵泡的发育并不影响临床妊娠率、早期流产率和活产率。因此，在 HRT-FET 周期中监测到优势卵泡发育时，不必立即取消 FET 周期。
