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ObjectiveTo investigate the clinical efficacy of oral dydrogesterone alone for luteal phase support in natural cycle frozen-thawed embryo transfer （NC-FET）. MethodsThe clinical data of 1 530 NC-FET cycles enrolled in our Reproductive Center from January 2019 to September 2021 were retrospectively analyzed. According to different luteal support protocols， the patients were divided into oral dydrogesterone alone （group A， n=524）， vaginal progesterone soft capsules （group B， n=401） and vaginal progesterone soft capsules combined with dydrogesterone （group C， n=605）. The clinical outcomes and cost-effectiveness ratio were compared among the three groups. The primary outcome was live birth rate. ResultsThe live birth rate was 43.13% （226/524） in group A， 39.15% （157/401） in group B， and 42.64% （258/605） in group C. There was no statistical difference among the three groups （P > 0.05）. No statistical difference was observed in the HCG positive rate， implantation rate， biochemical pregnancy rate， clinical pregnancy rate， spontaneous miscarriage rate， ectopic pregnancy rate， twin delivery rate， premature delivery rate and newborn weight among the three groups （P>0.05）. Logistic regression analysis revealed that the three luteal support regimens did not affect live birth rate. Pharmacoeconomic analysis showed that taking group B as a reference， the cost increased by 19 227.30 yuan for every 1% increase in live birth rate in group A. ConclusionsIn NC-FET cycle， oral dydrogesterone alone can achieve the same clinical outcomes as vaginal progesterone soft capsules and vaginal progesterone soft capsules combined with dydrogesterone. Compared with that of progesterone soft capsules， the cost of oral dydrogesterone alone is increased， a large sample and multicenter prospective study is needed to further confirm our results.
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Objective To analyze the clinical outcomes of progestin primed ovarian stimulation (PPOS) compared with the other three different controlled ovarian hyperstimulation (COH) protocols in fresh embryo transfer (ET) and frozen-thawed embryo transfer (FET) cycles. Methods A total of 430 oocyte pick-up cycles and 272 FET cycles were retrospectively analyzed. Number of oocytes retrieved, laboratory indexes and pregnancy outcome of FET were compared. Results The mean oocytes retrieved (11.1±7.3), fertilization rate (85.6%), cleavage rate (95.1%) and excellent embryo rate (20.2%) as well as transplantable embryo rate (4. 5 ±3.1) of the PPOS group did not show significant differences compared with the other 3 subgroups (all P<0.05) in fresh cycle. As for pregnancy outcomes in FET cycles, no statistically significant differences were observed among the four groups in embryo implantation rate (26.2%), clinical pregnancy rate (63.0%) and abortion rate (11.8%) (all P<0.05). However, embryo implantation rate, clinical pregnancy rate was higher in PPOS group compared with the other groups. Conclusion Compared with the other three ovulation stimulation programme, PPOS might be used as a new alternative for controlled ovulation stimulation protocols.
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Objective:To explore the factors affecting the pregnancy outcome of frozen-thawed embryo transfer (FET) in endometriosis (EMT) patients in order to provide reference for the clinical selection of FET strategies. Methods:A total of 329 EMT patients who received blastocyst FET at the Reproductive Medicine Center, Department of Obstetrics & Gynecology, The 900th Hospital of the Joint Logistics Support Force, PLA, from Jan. 2015 to Dec. 2017 were analyzed retrospectively. The patients were divided into three groups according to endometrial preparation protocols, ages, and endometrial thickness on the day of progesterone conversion, respectively. By endometrial preparation protocols, the three groups included gonadotropin-releasing hormone agonist (GnRH-a) down-regulation+ hormone replacement therapy (HRT) group (GnRH-a+HRT group, A1 group, n=138), HRT group (B1 group, n=52), and natural cycle (NC) group (C1 group, n=139). By ages, the three groups included 35 years old group (C2 group, n=59). By endometrial thickness on the day of progesterone conversion, the three groups included 12 mm group (C3 group, n=37). The differences in pregnancy outcomes among EMT patients with blastocyst FET were compared under different grouping factors. Results:The endometrium of A1 group was significantly thicker than that of B1 group (P=0.041), the implantation rate and clinical pregnancy rate of B1 group were significantly higher than those of C1 group (P=0.000, P=0.003). Compared with A1 group, the implantation rate of B1 group was significantly higher (P=0.023), while it was significantly lower in group C1 (P=0.027). The abortion rate of A2 group was significantly higher than that of B2 group (P=0.007). Compared with A3 group, the implantation rate of B3 group was significantly higher (P=0.041), while it was significantly lower in C3 group (P=0.026). Conclusion:HRT endometrial preparation protocol for EMT patients with blastocyst FET can improve the implantation rate and clinical pregnancy rate, and reduce the abortion rate and ectopic pregnancy rate, which may be an economical and efficient endometrial preparation protocol in clinical.
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Objective: To investigate the effects of three kinds of endometrial preparation (normal hormone replacement, half- and full-dose of long-acting gonadotropin-releasing hormone agonist (GnRH-a) down-regulation combined with hormone replacement) on the pregnancy outcomes in the frozen-thawed embryo transfer (FET) cycle in the patients with endometriosis (E M T), adenomyosis or repeated implantation failure (RIF) for unknown reasons, and to provide a basis for the selection of clinical endometrial preparation method. Methods: A total of 191 patients with EMT, adenomyosis or RIF for unknown reasons underwent FET treatment were selected. The patients were divided into normal hormone replacement group (n=63), half-dose GnRH-a group (n=61) and full-dose GnRH-a group (n=67) according to the endometrial preparation method. The clinical data of patients in each group such as age, body mass index (BMI), duration of infertility, the number of embryo transfer cycles, the number of embryos transferred, the endometrial thickness on the day of conversion and transplantation, the rate of high-quality embryos transferred, the intrauterine clinical pregnancy rate and the embryo implantation rate were analyzed retrospectively and compared. Results: There were no significant differences of the general clinical data of the patients in FET cycles in three groups such as age, BMI, duration of infertility, the number of embryo transfer cycles, the number of embryos transferred, the endometrial thickness on the day of conversion and transplantation, and the rate of high-quality embryos transferred (P
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Objective To explore the effects of in vitro culture time of frozen cleavage embryo after thawing on clinical pregnancy rate during frozen-thawed embryo transfer (FET) cycles. Methods The clinical data of 692 patients were analyzed; they received FET in the Department of Reproductive Medicine Center, Changhai Hospital, Navy Medical University (Second Military Medical University) from January to December in 2016. According to the days of in vitro culture between thawing and transferring, the patients were divided into three groups: no in vitro culture group, 1-day in vitro culture group and 2-day in vitro culture group. The pregnancy outcomes were compared between the three groups. Results There were no significant differences in age, body mass index, infertile duration, basic follicle-stimulating hormone (FSH) level or endometrial preparation protocol between the three groups (all P0.05). The embryo loss rates of the no in vitro culture group, the 1-day in vitro culture group and the 2-day in vitro culture group were 0.0% (0/706), 13.3% (64/481) and 43.0% (114/265), respectively, and the difference was statistically significant (P0.01). There were no significant differences in number of transfered embryo or endometrial thickness on transplantation day between the three groups (both P0.05). The good-quality embryo transfer rates in the 2-day in vitro culture group and 1-day in vitro culture group were significantly lower than that in the no in vitro culture group (both P0.01), and the clinical pregnancy rate in the 2-day in vitro culture group was significantly higher than that in the no in vitro culture group (P0.01). Conclusion In vitro culture for 1-2 days after thawing frozen cleavage embryos may increase the embryo loss rate, but it can improve the clinical pregnancy rate by screening the embryos with developmental potential.
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The clinical outcomes of five groups of infertility patients receiving frozenthawed,cleavage-stage embryo transfers with exogenous hormone protocols with or without a depot gonadotropin-releasing hormone (GnRH) agonist were assessed.A retrospective cohort analysis was performed on 1003 cycles undergoing frozen-thawed,cleavage-stage embryo transfers from January 1,2012 to June 31,2015 in the Reproductive Medicine Center of Wuhan General Hospital of Guangzhou Military Region.Based on the infertility etiologies of the patients,the 1003 cycles were divided into five groups:tubal infertility,polycystic ovary syndrome (PCOS),endometriosis,male infertility,and unexplained infertility.The main outcome was the live birth rate.Two groups were set up based on the intervention:group A was given a GnRH agonist with exogenous estrogen and progesterone,and group B (control group) was given exogenous estrogen and progesterone only.The results showed that the baseline serum hormone levels and basic characteristics of the patients were not significantly different between groups A and B.The live birth rates in groups A and B were 41.67％ and 29.29％,respectively (P＜0.05).The live birth rates in patients with PCOS in groups A and B were 56.25％ and 30.61％,respectively (P＜0.05).The clinical pregnancy,implantation and on-going pregnancy rates showed the same trends as the live birth rates between groups A and B.The ectopic pregnancy rate was significantly lower in group A than in group B.We concluded that the live birth rate was higher and other clinical outcomes were more satisfactory with GnRH agonist cotreatment than without GnRH agonist co-treatment for frozen-thawed embryo transfer.The GnRH agonist combined with exogenous estrogen and progesterone worked for all types of infertility tested,especially for women with PCOS.
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This systematic review aimed to evaluate the efficacy and safety of assisted hatching (AH) performed in couples with advanced maternal age.We searched for randomized controlled trials (RCTs) in electronic databases,including MEDLINE,EMBASE and CENTRAL (from inception to January 2018);in addition,we hand-searched the reference lists of included studies and similar reviews.We included RCTs comparing AH versus no treatment (control).The meta-analysis was performed by RevMan 5.3 software.The search retrieved 943 records and 8 RCTs were included,comprising 870 cycles (n=440 for AH,and n=430 for control).There was no significant difference in the rates of live birth (RR 0.88,95％ CI 0.65 to 1.18,3 RCTs,n=427,I2=0％),clinical pregnancy (RR 1.00,95％ CI 0.83 to 1.19,8 RCTs,n=870,I2=22％),implantation (RR 1.07,95％ CI 0.83 to 1.39,4 RCTs,n=1359,I2=0％),miscarriage (RR 1.13,95％ CI 0.66 to 1.94,2 RCTs,n=116,I2=0％) and multiple pregnancy (RR 0.89,95％ CI 0.31 to 2.52,1 RCT,n=97,I2=not applicable) between the treatment group and control group.No reasonable conclusions could be drawn regarding reproductive outcomes after AH in patients with advanced maternal age due to the small sample pooled in meta-analyses.Studies of high methodological quality and with adequate power are necessary to further investigate the value of AH in assisted conception of those patients.
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The clinical outcomes of five groups of infertility patients receiving frozenthawed,cleavage-stage embryo transfers with exogenous hormone protocols with or without a depot gonadotropin-releasing hormone (GnRH) agonist were assessed.A retrospective cohort analysis was performed on 1003 cycles undergoing frozen-thawed,cleavage-stage embryo transfers from January 1,2012 to June 31,2015 in the Reproductive Medicine Center of Wuhan General Hospital of Guangzhou Military Region.Based on the infertility etiologies of the patients,the 1003 cycles were divided into five groups:tubal infertility,polycystic ovary syndrome (PCOS),endometriosis,male infertility,and unexplained infertility.The main outcome was the live birth rate.Two groups were set up based on the intervention:group A was given a GnRH agonist with exogenous estrogen and progesterone,and group B (control group) was given exogenous estrogen and progesterone only.The results showed that the baseline serum hormone levels and basic characteristics of the patients were not significantly different between groups A and B.The live birth rates in groups A and B were 41.67％ and 29.29％,respectively (P＜0.05).The live birth rates in patients with PCOS in groups A and B were 56.25％ and 30.61％,respectively (P＜0.05).The clinical pregnancy,implantation and on-going pregnancy rates showed the same trends as the live birth rates between groups A and B.The ectopic pregnancy rate was significantly lower in group A than in group B.We concluded that the live birth rate was higher and other clinical outcomes were more satisfactory with GnRH agonist cotreatment than without GnRH agonist co-treatment for frozen-thawed embryo transfer.The GnRH agonist combined with exogenous estrogen and progesterone worked for all types of infertility tested,especially for women with PCOS.
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This systematic review aimed to evaluate the efficacy and safety of assisted hatching (AH) performed in couples with advanced maternal age.We searched for randomized controlled trials (RCTs) in electronic databases,including MEDLINE,EMBASE and CENTRAL (from inception to January 2018);in addition,we hand-searched the reference lists of included studies and similar reviews.We included RCTs comparing AH versus no treatment (control).The meta-analysis was performed by RevMan 5.3 software.The search retrieved 943 records and 8 RCTs were included,comprising 870 cycles (n=440 for AH,and n=430 for control).There was no significant difference in the rates of live birth (RR 0.88,95％ CI 0.65 to 1.18,3 RCTs,n=427,I2=0％),clinical pregnancy (RR 1.00,95％ CI 0.83 to 1.19,8 RCTs,n=870,I2=22％),implantation (RR 1.07,95％ CI 0.83 to 1.39,4 RCTs,n=1359,I2=0％),miscarriage (RR 1.13,95％ CI 0.66 to 1.94,2 RCTs,n=116,I2=0％) and multiple pregnancy (RR 0.89,95％ CI 0.31 to 2.52,1 RCT,n=97,I2=not applicable) between the treatment group and control group.No reasonable conclusions could be drawn regarding reproductive outcomes after AH in patients with advanced maternal age due to the small sample pooled in meta-analyses.Studies of high methodological quality and with adequate power are necessary to further investigate the value of AH in assisted conception of those patients.
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Objective Previous studies regarding the effects of tamoxifen ( TAM) on the thin endometrium are rare .The aim of this study was to explore the effects of TAM on patients with thin endometrium undergoing frozen thawed embryo transfer ( FET ) . Methods One hundred and thirty three patients with thin endometri-um undergoing FET treatment were recruited from January 2014 to June 2016, who canceled embryo transfer ( ET) or after FET due to thin endometrium in natural cycle or hormone replacement therapy cycle .Patients were randomly divided into letrozole ( LE,n=72) group or tamoxifen (TAM,n=61) group.All of the patients started to have oral pills of Estradiol Valerate 4 mg/d on the third day of menstruating cycles , then 6mg/d on the eighth day ,after 10~12 days then having ultrasonic monitoring of endometrial thickness and blood estradiol (E2), progesterone levels, It′s called endometrial preparation for hormone replacement cycle .To letrozole, tamoxifen group,the way of endometrial preparation were as follows:patients started to have oral pills of LE 2.5mg/d,TAM 40 mg/d on the third day of menstruating cycles for 5 days, then having ultrasonic monitoring and used drug of human chorionic gonadotropic hormone ,It′s called HCG day .After the dominant follicle ovulation then took progesterone intramuscular injection 40 mg/d, oral progesterone 20 mg/d to change endometrium ,then to transplant cleavage embryos or blastocysts after taking 3 or 5 days of progesterone , It′s called embryo transplanting day .The way of TAM endometrium preparation was called TAM cycle .The general data , hormone levels and clinical out-come between two groups were analyzed . Results The serum estradiol level of LE group both on HCG and transfer day [(1193.80± 629.64)ng/L vs (2776.30±157.34)ng/L;(1195.90±820.30)ng/L vs (2129.40±1208.71) ng/L,P=0.000] were statistically lower, serum luteinizing hormone level were statistically higher than TAM group [(20.48±15.50)IU/L vs (10.59±8.34)IU/L,P<0.05];im-plantation rate of LE group were statistically lower than TAM (39.32%vs 45.83%,P=0.001).The endometrial thickness and serum E 2 and P levels in TAM cycles were significantly higher compared with those in hormone replacement therapy cycle [(8.49±1.36)mm vs (6.43±0.96)mm,P=0.018]. Conclusion Tam compared LE with patients of thin endometrium undergoing FET can increased en -dometrial thickness and improve implantation rate ,thus Providing a new solution to thin endometrium .
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[Objective]To investigate the relationship of baseline antimullerian hormone(AMH)and live birth rate of IVF/ICSI and further explore the prognostic effect of AMH on live birth rate.[Methods]All non-polycystic ovary patients who underwent their first embryo transfers in our unit and had basal serum AMH evaluated between 2010 and 2015 were evaluated in this retrospective study. Patients were grouped according to their AMH level,i.e. low AMH group with AMH less than 1.1 ng/mL(n = 485),middle AMH group with AMH between 1.1 ng/mL and 7.0 ng/mL (n = 1 989),and high AMH group with AMH higher than 7.0 ng/mL (n=468). For age subgroup analysis,patients were stratified as follow:group A(age≤29 years),group B(30~34 years),group C(35~39 years)and group D(over 40 years). We compared clinical outcomes between AMH groups in different age groups usingunivariate and multivariate analysis. ROC analysis was utilized to assess predictive value of AMH on live birth rate.[Results](1)In both fresh and frozen embryo transfers,baseline AMH was significantly related to clinical outcomes. The lower AMH was,the lower implantation rate,clinical pregnancy rate,and live birth rate. However,higher miscarriage rate was observed. All difference reached statistically significant.(2)In age subgroup analysis,we demonstrated AMH was related to live birth rate in patients in group A,B, and C,regardless of fresh or frozen embryo transferred. In those over 40 years,AMH was related to live birth rate in frozen cycles (P < 0.05)but not fresh cycles(P = 0.092). The further multivariate analysis confirmed the above results after controlling po?tential confounding variables.(3)The AUC of ROC analysis for AMH predicting live birth rate were 0.647,0.633 for fresh and fro?zen cycles respectively.[Conclusion]Baseline AMH as one of excellent ovarian reserve markers ,was significantly related to live birth rate in fresh or frozen cycles. Baseline AMH was an independent prognostic factor of live birth rate,but its predictive value on live birth rate was of limited clinical value.
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Objective To investigate the application value of two kinds of endometrial preparation in patients with thin endometrium of frozen thawed embryo transfer cycle.Methods A retrospective analysis of the clinical data of 82 cycle of 76 patients was carried out.According to the difference of the endometrial preparation,the two groups were divided into two groups.One group was progynova group (42 cycles),and the other group was femonston group (40 cycles).Baseline information,endometrial status and pregnancy outcome were compared between the two groups.Results There was no significant difference in baseline data (age,years of infertility,body mass index,basal hormone level) between the two groups.There was no significant difference in endometrial thickness[progynova group (5.52 ± 0.74) mm,femonston group (5.33 ± 0.66) mm,t =1.290,P =0.203],endometrial volume (progynova grouP ＜ 2mL and ≥ 2mL 38 patients and 4 patients,that of femonston group 36 cases and 4 cases,x2 =0.005,P =0.942),endometrial type (progynova group A,B,C type 35 cases,7 cases,0 case,those of emonston group 34 cases,6 cases,0 case,x2 =0.043,P =0.836) and blood flow (progynova group Ⅰ + Ⅱ and Ⅲ 34 cases and 8 cases,those of femonston group 35 cases and 5 cases,x2 =0.658,.P =0.417) between the two groups before treatment.After administration,endometrial thickness [progynova group (6.90 ± 0.62) mm,femonston group (7.60 ± 0.63) mm,t =5.04,P =0.000],neointimal growth [progynova group (1.67 ± 0.48) mm,femonston group (3.20 ± 0.61) mm,t =12.74,P =0.000],ratio of endometrial volume more than or equal to 2 mL [progynova group 52.38 ％ (22/42),femonston group 80.00％ (32/40),x2 =6.95,P =0.008],and ratio of endometrial blood flow type Ⅲ [progynova group 38.10％ (16/42),femonston group 70.00％ (28/40),x2 =8.387,P =0.004] of femonston group were higher than those of progynova group.The dosage[progynova group (112.43 ± 16.39)mg,femonston group (78.85 ± 10.17)mg,t =11.08,P =0.000] was lower than that of progynova group,and the difference was statistically significant.There was no significant difference in the two groups in endometrial type (progynova group A,B,C 30 cases,12 cases and 0 case,those of femonston group 28,12 and 0,x2 =0.020,P =0.887) after the treatment.There was no significant difference in the number of transplanted embryos (progynova group 1.78 ± 0.47,femonston group 1.77 ± 0.42,t =0.108,P =0.914),high quality embryo rate [progynova group 74.67 ％ (56/75),femonston group 73.24 ％ (52/71),x2 =0.039,P =0.844],implantation rate [progynova group 14.67 ％ (11/75),femonston group 16.90％ (12/71),x2 =0.137,P =0.711],biochemical pregnancy rate[progynova group 38.10％ (16/42),femonston group 40.00％ (16/40),x2 =0.031,P =0.860] and clinical pregnancy rate [progynova group 28.57 ％ (12/42),femonston group 32.50％ (13/40),x2 =0.149,P =0.699] between the two groups.Conclusion Femonston with less dosage,better improvement of the endometrial thickness,endometrial volume,endometrial blood flow of patients with thin endometrium of patients can obtain similar pregnancy outcomes compared with progynova.
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Objective To investigate how to optimize the protocol of embryo cryopreservation to improve the success of frozen-thawed embryo transfer (FET), reduce multiple pregnancy rate and increase the cumulative pregnancy rate from one oocyte retrieval process. Methods The clinical data of 1 166 FET cycles were retrospectively analyzed and separated into different groups:445 for vitrification and 721 for slow-freezing. The vitrification group was divided into single embryo (28 cy?cles), double embryos (71 cycles) and triple embryos (346 cycles). 0-1 optimal embryo was called O0-1 group (235 cycles), 2 optimal embryos were called O2 group (80 cycles), 3 optimal embryos were called O3 group (130 cycles). The difference preg?nancy outcomes (implantation rate, clinical pregnancy, abortion rate and live-birth rate) were compared between groups. Results (1) There were significantly higher embryo survival rate(98.3%vs 73.1%), embryo recovery rate without damaging (83.3%vs 62.1%), implantation rate(36.8%vs 29.9%), clinical pregnancy(57.1%vs 44.0%) and live-birth rate(47.9%vs 34.5%) in vitrification group than those of slow freezing group(P0.05). Conclusion Vitrification technology can improve the clinical pregnancy and live-birth rate, and decrease multiple preg?nancy rate. Two optimal embryos in one tube are supposed to be the preferred method for embryo cryopreservation.
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OBJECTIVE: It is well known that fresh blastocyst transfer results in better pregnancy outcomes with a smaller number of transferred embryos compared with cleavage stage embryo transfer. However, in terms of frozen-thawed blastocyst transfer, only a few studies are available. We aimed to evaluate clinical outcomes of frozen-thawed embryo transfer (FET) with blastocysts. METHODS: Retrospective analysis of FET cycles with blastocysts (B-FET) between Jan 2007 and June 2009 was performed. Age-matched FET cycles with cleavage stage embryos (C-FET) during the same period were collected as controls. A total of 58 B-FET cycles were compared with 172 C-FET cycles and also compared with those of post-thaw extended culture blastocysts from frozen pronuclear stage embryos (22 cycles). RESULTS: There was no difference in the patient characteristics of each group. The embryos' survival rates after thawing were comparable (>90%) and there was no difference in the implantation rate or clinical and ongoing pregnancy rate among the three groups. CONCLUSION: In FET, blastocyst transfers may not present better pregnancy outcomes than cleavage stage embryo transfers. A further large-scale prospective study is needed.
Subject(s)
Female , Humans , Pregnancy , Blastocyst , Embryo Transfer , Embryonic Structures , Pregnancy Outcome , Pregnancy Rate , Retrospective Studies , Survival RateABSTRACT
OBJECTIVE: This study was carried out to know whether cryopreservation of sibling 2PN zygotes could increase the cumulative delivery rates in the patients who had less than 10 fertilized zygotes. METHODS: A retrospective analysis was performed in 138 in vitro fertilization-embryo transfer (IVF-ET) cycles with less than 10 fertilized zygotes during January 2003 to December 2007 in Cheil General Hospital. These cycles were divided into two groups. In Group I (n=86), all fertilized embryos were cultured to transfer on day 3 without cryopreserved embryos at the 2PN stage. In Group II (n=52), among fertilized zygotes, some sibling zygotes were frozen at the 2PN stage, the remainder were cultured to transfer. Clinical outcomes in fresh ET cycles and cumulative ongoing pregnancy rates after subsequent frozen-thawed (FT)-ET cycles were compared. RESULTS: There were no significant differences in female mean age, number of retrieved oocytes and total fertilized embryos between two groups. Number of cultured embryos was significantly lower in Group II (5.2+/-0.5) than in Group I (8.4+/-0.7) (p<0.01). Also, number of transferred embryos was significantly lower in Group II (3.3+/-0.6) compared with Group I (3.6+/-0.6) (p<0.01). beta-hCG positive rates and delivery rates (51.2 vs. 46.2% and 41.9 vs. 34.6%, respectively) after fresh ET were slightly higher in Group I than in Group II. However, the differences were not statistically significant. Also, the cumulative delivery rates after subsequent FT-ET cycles were not significantly different between Group I (48.8%) and Group II (50.0%). CONCLUSION: This study showed that cryopreservation of sibling 2PN zygotes from patients who had less than 10 zygotes in the fresh ET cycles did not increase cumulative delivery outcomes. But, it could provide an alternative choice for patients due to offering more chance for embryo transfers if pregnancy was failed in fresh IVF-ET cycles.
Subject(s)
Female , Humans , Pregnancy , Cryopreservation , Embryo Transfer , Embryonic Structures , Hospitals, General , Oocytes , Pregnancy Rate , Retrospective Studies , Siblings , ZygoteABSTRACT
OBJECTIVE: Low-dose aspirin have been proposed to improving endometrial receptivity and pregnancy rate in COH-IVF by increasing endometrial perfusion. However, the effect of low-dose aspirin in COH-IVF could be negligible because there have been large quantity of other important factors responsible for changing endometrial perfusion accompanied by COH procedure. In contrast, in frozen-thawed embryo transfer cycles which were not accompanied by COH procedure, the effects of low-dose aspirin in endometrial blood flow seems to be more certain than in COH-IVF cycles. In this study, we analyzed the effect of low-dose aspirin treatment on implantation and pregnancy rates in patients undergoing frozen-thawed embryo transfer METHODS: From January 2003 to December 2003, total 264 cycles from 264 patients who attended infertility clinic at Samsung Cheil Hospital were enrolled in this study. All cases included in this study, embryos were frozen and thawed at the pronuclear stage and three days after incubation, at least 2 or more good quality embryos were transferred into uterus. In study group, low dose aspirin (100 mg/day) was administrated from the first or second date of menstrual day to 9 days after embryo transfer. On the other hand, control group did not take any medicine except estradiol valerate for endometrial priming. Several variables including implantation and pregnancy rates were compared in both groups. After then, each groups were stratified by endometrial thickness checked at embryo transfer (ET) day such as (28 mm versus 0.05) After we analyzed same variables stratified by endometrial thickness checked at embryo transfer day, we could not found any significant difference between study and control groups. CONCLUSIONS: Low-dose aspirin treatment seems to have no advantage of improving implantation and pregnancy rates in patients undergoing frozen-thawed embryo transfer.
Subject(s)
Humans , Pregnancy , Aspirin , Embryo Transfer , Embryonic Structures , Estradiol , Hand , Infertility , Perfusion , Pregnancy Rate , UterusABSTRACT
OBJECTIVE: To evaluate the difference of implantation rate (IR) and clinical pregnancy rate (CPR) between two protocols of endometrial preperation in women undergoing frozen-thawed embryo transfer (FET) cycles. METHODS: This study was performed during the different time periods: A retrospective study from January 2000 to June 2001 (phase I) and a prospective study from July 2001 to March 2002 (phase II). All the patients received estradiol valerate (6 mg p.o. daily) starting from day 1 or 2 of the menstrual cycle without pituitary down regulation. Progesterone was administered around day 14 after sonographic confirmation of endometrial thickness > or = 7 mm and no growing follicle. In Group A (n=88, 99 cycles) of phase I, progesterone was administered i.m. at a dose of 50 mg daily from one day prior to thawing of pronuclear (PN) stage frozen embryo or three days prior to thawing of 6-8 cell stage frozen embryo and then each stage embryos were trasnsferred 2 days or 1 day later after thawing. In Group B (n=246, 299 cycles) of phase I, patients recieved progesterone 100 mg i.m. from one day earlier than group A; two days prior to PN embryo thawing, four days prior to of 6-8 cell embryo thawing. During the phase II, to exclude any differences in embryo transfer procedures, in Group 1 (n=23, 28 cycles) of phase II embryo was transfered by one who have used the progesterone protocol since the phase I. In Group 2 (n=122, 139 cycles) of phase II embryo was transfered by one who use the progesterone protocol from the phase II. RESULTS: When compared across the phase and group, there were no significant differences in the characteristics. During the phase I, there were significant increase in IR (14.4% vs 5.9%, p=0.001) and CPR (28.3% vs 14.5%, p=0.000) in group A. During the phases II, IR (11.8% vs 10.6%) and CPR (27.6% vs 27.3%) show no differences between two groups. CONCLUSIONS: In FET cycles, IR and CPR are increased significantly by the change of dosage and timing of progesterone administraton. And the timing is considered to be more important factor because the dosage of progesterone did not affect implantation window in previous studies. Therefore, we suggest that progesterone administration in FET cycle should begin from one day prior to PN stage embryo thawing and three days prior to 6-8 cell stage embryo thawing.