A Comparison of the Miscarriage and Live Birth Rate for Frozen Embryo Transfer According to Two Endometrial Preparations: Natural or Primed with Estrogens
| Autor: | J. W. L. Phoon, S. Mubarak, V. Viardot-Foucault, Heng Hao Tan, S. Acharyya |
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| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
0301 basic medicine
030219 obstetrics & reproductive medicine lcsh:QH471-489 miscarriage Biology medicine.disease Embryo transfer live birth Miscarriage Andrology 03 medical and health sciences 030104 developmental biology 0302 clinical medicine frozen-thawed embryo transfer medicine lcsh:Reproduction Live birth natural cycle and hrt cycle |
| Zdroj: | Fertility & Reproduction, Vol 1, Iss 1, Pp 43-49 (2019) |
| ISSN: | 2661-3174 2661-3182 |
| DOI: | 10.1142/S2661318219500038 |
| Popis: | Objective The primary objective is to compare miscarriage rates in frozen-thawed embryo transfer (FET) cycles, according to the endometrial preparation used either artificial through the administration of exogenous estrogen and progesterone or natural without any treatment, during a spontaneous ovulatory cycle. The secondary objective is to compare the live birth rates between the two endometrial preparations. Study design This is a retrospective study done at KK Women’s and Children’s Hospital Singapore. We included women who underwent FET cycles either with hormone replacement treatment (HRT) or no treatment (natural) for the endometrial preparation, regardless of their cycle number, from 1 January 2011 till 31 December 2015. Results A total of 2,752 FET cycles were included in our analysis. The natural cycle followed by vaginal progesterone support was used in 1,221 cycles and the HRT cycle with estrogen and vaginal progesterone was used in 1,531 cycles. There is a significantly higher miscarriage rate in the HRT group (38.4%) compared with the natural group (22.3%). The live birth rate is significantly higher in the natural group (22.8%) compared with the HRT group (17.3%). The multivariate analysis further shows that the HRT therapy is independently associated with an increased risk of miscarriage (adjusted odds ratio 2.05; 95% confidence interval 1.45–2.90; [Formula: see text] Conclusion We have shown in this study that the miscarriage rate is higher in the HRT FET group and that this increased miscarriage rate translates into a lower live birth rate in the HRT group. Thus, we conclude that patients with regular menstrual cycles should be offered a natural FET cycle to achieve better outcomes in terms of live birth rate and reducing the miscarriage rate. |
| Databáze: | OpenAIRE |
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