Artificial Endometrial Preparation for Frozen-Thawed Embryo Transfer with or without Pretreatment with Depot Gonadotropin Releasing Hormone Agonist in Women with Regular Menses.

• Main Authors: Elham Azimi Nekoo, Maryam Chamani, Ensieh Shahrokh Tehrani, Batool Hossein Rashidi, Fatemeh Davari Tanha, Vahid Kalantari
• Format: Article
• Language: English
• Published: Tehran University of Medical Sciences 2015-03-01
• Series: Journal of Family and Reproductive Health
• Subjects: frozen-thawed embryo transfer; GnRH agonist; artificial cycle; endometrial preparation; pregnancy outcome
• Online Access: https://jfrh.tums.ac.ir/index.php/jfrh/article/view/221
• ISSN: 1735-8949; 1735-9392

Objective: To investigate the reproductive outcome of artificial endometrial preparation with exogenous steroids for frozen-thawed embryo transfer with and without pre-treatment with depot gonadotropin releasing hormone agonist (GnRH-a) in women with regular menses. AMaterials and methods:This is a prospective randomized clinical trial conducted in two RT centers on 176 women undergoing frozen-thawed embryo transfer. All patients received oral estradiol valerate 4 mg daily from day 2 to day 5 and 6 mg per day from day 6 to the day of the pregnancy test. In day 13 of cycle, an ultrasound examination was performed. After ultrasound confirmation of endometrial thickness (≥8 mm) and no ovarian activity, progesterone in cyclogest supp (800 mg daily) was added. The dose of estradiol would be increased to 8 mg per day if the endometrial thickness was less than 8mm. Two or 3 embryos were transferred via transcervical route 48 hours after the beginning of progesterone administration. In group A (93 patients), Difereline (3.75 mg Im), as a depot GnRH agonist was administered in the midluteal phase (day 21) of previous cycle. In the other group B (n = 83) steroid supplementation was commenced without prior pituitary suppression. Chemical and clinical pregnancy rates were compared in two groups. Results:No significant differences were seen between two groups in terms of chemical pregnancy and clinical pregnancy rates. Conclusion:The findings support the artificial protocol without any pretreatment suppressive drugs to reduce the adverse side effects of GnRH agonists also to minimize the costs.