Centre for Reproductive Medicine, Co. Ltd., Next Generation Clinic, St Petersburg, Russia; Centre for Reproductive Medicine, Co. Ltd., Next Generation Clinic, Moscow, Russia.
University of Melbourne, Faculty of Medicine and Health Sciences, Parkville, Victoria, Australia; Reproductive Biology Unit, Royal Women's Hospital, Melbourne, Victoria, Australia.
Reprod Biomed Online. 2024 Nov;49(5):104350. doi: 10.1016/j.rbmo.2024.104350. Epub 2024 Jul 2.
Is there any difference in clinical outcomes between the progesterone-modified natural cycle (P4mNC) and hormone replacement therapy (HRT) endometrial preparation protocols after single euploid blastocyst frozen embryo transfer (FET) cycles?
A retrospective cohort study was performed at a single, private, high-volume fertility centre. Patients who underwent single euploid blastocyst FET between January 2017 and December 2019 were included. A total of 1933 FET cycles were reviewed, and 723 FET cycles from 548 patients met the inclusion criteria. Two groups were compared according to endometrial preparation: 327 P4mNC-FET and 396 HRT-FET cycles. The primary outcome was the live birth rate. The secondary outcomes included the clinical pregnancy rate and the miscarriage rate.
There were no differences in the clinical pregnancy rate (50.2% versus 47.0%, P = 0.688), miscarriage rate (9.8% versus 14.5%, P = 0.115) and live birth rate (45.0% versus 39.6%, P = 0.331) between the P4mNC-FET and HRT-FET groups after covariate adjustments.
There were no differences in the clinical outcomes between the P4mNC-FET and HRT-FET cycles. These results indicate that P4mNC-FET cycles produce clinical outcomes comparable to those of more traditional HRT-FET while allowing greater flexibility in the timing of embryo transfer.
在单囊胚冷冻胚胎移植（FET）周期后，孕激素改良自然周期（P4mNC）和激素替代疗法（HRT）子宫内膜准备方案的临床结局是否存在差异？
这是一项在单一、私人、高容量的生育中心进行的回顾性队列研究。纳入了 2017 年 1 月至 2019 年 12 月期间接受单囊胚 FET 的患者。共回顾了 1933 个 FET 周期，548 名患者的 723 个 FET 周期符合纳入标准。根据子宫内膜准备情况将患者分为两组：327 个 P4mNC-FET 组和 396 个 HRT-FET 组。主要结局为活产率。次要结局包括临床妊娠率和流产率。
调整协变量后，P4mNC-FET 组和 HRT-FET 组的临床妊娠率（50.2%与 47.0%，P=0.688）、流产率（9.8%与 14.5%，P=0.115）和活产率（45.0%与 39.6%，P=0.331）无差异。
在 P4mNC-FET 组和 HRT-FET 组之间，临床结局没有差异。这些结果表明，P4mNC-FET 周期在胚胎移植时间上具有更大的灵活性，同时可以产生与更传统的 HRT-FET 相当的临床结局。
