comparison of the effects of transdermal estradiol and estradiol valerate on endometrial receptivity in frozen-thawed embryo transfer cycles: a randomized clinical trial

Background: The purpose of this study was to determine the optimal endometrial preparation protocol by comparing the clinical outcome of two methods of endometrial preparation in frozen-thawed embryo transfer [FET] cycles, including that is, oral estradiol and 17 beta-estradiol transdermal patch

Methods: In this randomized controlled trial, women underwent either conventional IVF or intracytoplasmic sperm injection [ICSI] who had at least two top-quality embryos appropriate for cryopreservation and frozen embryos from previous cycles. In the study group [n=45], 17-B estradiol transdermal patches 100 microg were applied from the second day of the cycle and continued every other day. Then, each patch was removed after four days. In the control group [n=45], oral estradiol valerate 6 mg was started at the same time and continued daily

Results: There was a significant difference in estradiol level on the day of progesterone administration and the day of embryo transfer between the two groups [p=0.001 in both], but no significant difference was observed between them in biochemical and clinical pregnancy rates [32.6% vs. 33.3%, p=1.000 and 30.2% vs. 33.3%, p=0.810, respectively]

Conclusion: It is suggested that estradiol transdermal patches be used instead of oral estradiol in FET cycles. Due to the reduced costs, drug dose, and emotional stress as well as the simplicity of the protocol for patients

Results from adding recombinant LH for assisted reproductive technology treatment: a randomized control trial

Based on classical two-cell, two-gonadotropin theory, in the follicle, follicle-stimulating hormone [FSH] and luteinizing hormone [LH] put on their main effects on the granulosa and theca cells. LH is essential for androgens production. Androgens are used for estradiol production by granulosa cells. Profound suppression of LH concentrations in some normogonadotropic patients can cause several adverse effects. The main clinical purpose of this study was that normoresponder women treated with controlled ovarian super ovulation for IVF or ICSI may benefit from co-administration of rLH. 40 patients who were candidates for assisted reproductive technology [ART] were randomly selected. In all patients long luteal protocol was used for ovulation induction. Patients were randomly divided into two groups: Group 1 [n=20] with standard long protocol [GnRH agonist] and r-FSH alone, Group 2 [n=20] with standard long protocol [GnRH agonist] and r-FSH with r-LH. Results were statistically analyzed and compared in two groups. The number of retrieved oocytes, mature oocytes, cleaved embryos, transferred embryos, estradiol levels in Human chorionic gonadotropin [hCG] administration day, implantation rate and clinical pregnancy rate in group 2 were higher but not significantly different. Administration of rLH in late follicular phase had no beneficial effect on outcomes in young women with mean age of 31 years. Maybe a greater sample size should be used to see the effects more accurately; also it is possible that rLH will be useful in older patients