ABSTRACT
Background: Estrogen and progesterone are two crucial factors for endometrial preparation in frozen embryo transfer [FET] cycles. Studies assessing different forms of estradiol in FET have published already but literature lacks enough surveys on transdermal estrogen application in reproductive medicine
Objective: To investigate the effects of trans dermal estrogen [Oestrogel] on pregnancy rates in patients that candidate for FET cycle
Materials and Methods: In this randomized clinical trial, 100 women undergoing FET cycles referred to Imam Khomeeini Hospital were enrolled in two groups, randomly. Group I received 8 mg/day estradiol valerate [E2 tablet] orally and group II were treated with 6 mg/day transdermal oestrogel gel after suppression with gonadotropin releasing hormone agonist. In both groups medication were started in the first day of menstruation cycle and continued until endometrial thickness reached 8 mm. Pregnancy rates [chemical, clinical, and ongoing], abortion rate, live birth rate, and frequency of complications were compared between two groups
Results: Chemical and clinical pregnancy rates were not significantly different between two groups [p=0.384]. The abortion rate was significantly lower in group II than group I [p=0.035]. Ongoing pregnancy and the live birth rates were significantly higher in group II [p=0.035]. The rate of complication was not different in two groups
Conclusion: Oestrogel seems to enhance ongoing pregnancy and live birth rates in comparison to estradiol valerate tablet
ABSTRACT
General concern is that the pregnancy rate is higher with GnRH-agonist as a protocol of pituitary suppression. GnRH-antagonist protocol provides a shorter period of administration and an easy flexible protocol. In this study, the outcomes of GnRH agonist and antagonist in ICSI cycles are compared in normo responder patients. In this randomized clinical trial, 300 normoresponders undergoing ICSI were randomly divided to GnRh agonist [n=150] and GnRh antagonist [n=150] groups. The main outcome measurements were chemical, clinical and ongoing pregnancy rates [PR]. The mean duration of stimulation were 9.6 +/- 1.6 and 8.2 +/- 1.6 days in agonist and antagonist groups respectively [p=0.001]. The mean number of MII oocyte retrieved in agonist and antagonist groups were 7.7 +/- 4.0 and 6.9 +/- 4.3 respectively [p=0.03]. There was no significant difference between two groups regarding mean number of gonadotrophin ampoules, follicles, occytes, total embryos and good quality embryos, OHSS incidence, and abortion rate. Chemical pregnancy rate was 35.3% in agonist and 39.3% in antagonist group. Clinical pregnancy rate was 35.3% in agonist and 34% in antagonist group. Ongoing pregnancy rate was 45 [31.3%] in agonist and 44 [29.3%] in antagonist group. There was no significant difference between two groups in pregnancy rates. In this study antagonist protocol was shown to be an easy, safe and friendly protocol in Iranian normoresponder patients, having similar outcomes with standard agonist protocol but shorter period of stimulation