November 26th, 2022

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Title:
Evaluation of Embryo Transfer Outcomes with Different Endometrial Preparation Protocols in Frozen-Thawed Embryo Transfer Cycles
Authors:  Yan Xia, M.D., Ph.D., Bing Lian, M.D., Shi-fen Li, M.D., Dan-huan Lin, M.D., Meng-li Zhang, M.D., Lu Liu, M.D., and Chun-rong Qin, M.D., Ph.D.
  OBJECTIVE: To evaluate whether different endometrial preparation protocols influenced pregnancy outcomes in patients undergoing frozen-thawed embryo transfer cycles.

STUDY DESIGN: In total, 3,145 patients with infertility undergoing in vitro fertilization or intracytoplasmic sperm injection treatment were included. Depending on the endometrial preparation protocol used, patients were divided into the natural cycle (NC), controlled ovarian stimulation (COS), and hormone replacement therapy (HRT) groups; these protocols have been used extensively in the freeze-thaw transfer cycle to improve different endometrial conditions.

RESULTS: For patients aged <36 years, the probabilities of ongoing pregnancy and live birth were 36% and 38% lower, respectively, in the HRT group than in the NC group. Moreover, patients aged <36 years in the HRT group had higher probabilities of ongoing pregnancy and live birth with double high-quality embryo transfers than with non–high-quality embryo transfers. For patients aged ≥36 years, the probabilities of ongoing pregnancy and live birth were lower by 48% and 46%, respectively, in the HRT group than in the NC group. Moreover, there were no significant differences in the probabilities of ongoing pregnancy and live birth according to the number of high-quality embryos transferred. For patients with non–high-quality embryo transfers, the probabilities of ongoing pregnancy and live birth were lowered by 35% and 38%, respectively.

CONCLUSION: Different endometrial preparation protocols for patients of different ages may result in different pregnancy outcomes. Younger patients using their NC for endometrial preparation have higher probabilities of ongoing pregnancy and live birth than those undergoing HRT. For older patients, the number of high-quality embryo transfers influences the ongoing pregnancy rate and live birth rate.
Keywords:  assisted reproductive technologies, controlled ovarian stimulation, embryo transfer, endometrium preparation, frozen-thawed embryo transfer, hormone replacement therapy, in vitro fertilization, infertility
   
   
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