Comparison of the effectiveness and obstetric outcomes of various methods of preparing the endometrium for frozen embryo transfer in the natural cycles and against the hormone replacement cycles
DOI:
https://doi.org/10.37800/RM.1.2022.44-51Keywords:
thawed embryo transfer (FET), endometrium, hormone replacement therapy (HRT), natural cycle (NC)Abstract
Relevance: Increased frequency of using frozen embryo transfer (FET) in assisted reproductive technology (ART) programs makes it relevant to study the effectiveness and analyze the obstetric outcomes of various methods of endometrial preparation in such cycles.
The study aimed to determine the optimal method for preparing the endometrium for FET.
Methods: The effectiveness of endometrial preparation for FET in the natural cycle (Group 1, n=124) and hormone replacement therapy cycles (HRT) (Group 2, n=120) was analyzed in infertile patients aged 22-40 years. The assessed parameters included endometrial thickness on the day of FET, clinical pregnancy rate (CPR), spontaneous miscarriage up to 12 weeks of gestation, threatened miscarriage in the first trimester of pregnancy, gestational diabetes mellitus (GDM), isthmic-cervical insufficiency (ICI), hypertensive disorders in the third trimester of pregnancy, placenta previa, total weight gain, term and method of delivery, birth weight of children, frequency of live births.
Results: The endometrium thickness on FET day in the study groups did not significantly differ (p=0.52). The CPR was higher when using HRT vs. FET in the natural cycle (61.6% and 51.6%, respectively), but the differences were not statistically significant (p=0.057). Spontaneous miscarriage before 12 weeks of pregnancy (p=0.0096) and hypertensive disorders in the third trimester of pregnancy (p=0.0097) were significantly more often recorded in the HRT group.
The groups did not significantly differ in the frequency of threatened miscarriage (p=0.17) and GDM (p=0.26), ICI (p=0.07), placenta previa (p=0.38), total weight gain (p=0.35), term and method of delivery (p=0.35 and 0.27, respectively), birth weight of children (p=0.66 at birth with one child, p= 0.902 at birth with twins), frequency of live births (p=0.942).
Conclusion: This study showed no advantages of any method of preparing the endometrium for FET in terms of CPR. However, HRT was associated with a higher risk of miscarriage and preeclampsia. This requires an individual approach to choosing the most optimal method to prepare the endometrium and ensure high CPR and more favorable outcomes of ART programs.
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