Comparable ongoing pregnancy and pregnancy loss rates in natural cycle and artificial cycle frozen embryo transfers with intensive method-specific luteal phase support; a retrospective cohort study.

Autor: Ozgur K; Antalya IVF Centre, Antalya, 07080, Turkey., Tore H; Antalya IVF Centre, Antalya, 07080, Turkey., Berkkanoglu M; Antalya IVF Centre, Antalya, 07080, Turkey; Istanbul Atlas University, School of Medicine, Department of Gynecology and Obstetrics, Istanbul 34408, Turkiye., Bulut H; Antalya IVF Centre, Antalya, 07080, Turkey; Antalya Bilim University, School of Medicine, Department of Health Science, Antalya 07190, Turkiye., Donmez L; Akdeniz University, School of Medicine, Department of Public Health, Antalya, 07058, Turkiye., Coetzee K; Antalya IVF Centre, Antalya, 07080, Turkey. Electronic address: kevincoetzee61@yahoo.co.nz.
Jazyk: angličtina
Zdroj: Journal of gynecology obstetrics and human reproduction [J Gynecol Obstet Hum Reprod] 2024 Sep; Vol. 53 (7), pp. 102797. Date of Electronic Publication: 2024 May 11.
DOI: 10.1016/j.jogoh.2024.102797
Abstrakt: Study Objective: The absence of corpus lutea in artificial cycle (AC) frozen embryo transfers (FET) may increase the chances of pregnancy loss. In this retrospective cohort study, the efficacy of AC endometrial preparation was compared natural cycle (NC) endometrial preparation in terms of ongoing pregnancy.
Methods: One thousand six hundred and eighteen consecutive vitrified-warmed blastocyst FET performed between December 2021 and November 2022 were included, with 1023 compared after exclusions according to the endometrial preparation method; 293 NC-FET, 143 modified NC-FET, 204 unprogrammed AC-FET, and 383 oral contraceptive pill (OCP) programmed AC-FET. Intensive method-specific luteal phase support (LPS) was administered in NC- (human chorionic gonadotropin and micronized vaginal progesterone), mNC- (micronized vaginal progesterone), and in AC-FET (micronized vaginal progesterone, intramuscular progesterone, and oral dydrogesterone).
Results: Clinician choice of endometrial preparation method resulted in the NC- or AC-FET groups having distinct differences, with female age, antral follicle count and body mass index as well as the percentage of DOR or PCOS diagnosed patients significantly different. The unadjusted ongoing pregnancy and total pregnancy loss rates for NC-, mNC-, AC-, and ocp-AC-FET were 61.8 %, 55.2 %, 57.4 %, and 58.5 %, and 19.2 %, 24.0 %, 23.5 % and 23.8 %, respectively. In multivariate logistic regressions to predict the dependent outcomes of ongoing pregnancy and total pregnancy loss, none of the FET methods were selected as independent predictors.
Conclusion: Patients undergoing NC- and AC-FET with method-specific progesterone LPS had comparable ongoing pregnancy rates as well as total pregnancy loss rates, with NC-FET ranked first in the regression analysis.
Competing Interests: Declaration of competing interest The authors declare no conflict of interest associated with the publication of the study.
(Copyright © 2024 Elsevier Masson SAS. All rights reserved.)
Databáze: MEDLINE
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