Volume 20, Issue 11 (November 2022)                   IJRM 2022, 20(11): 923-930 | Back to browse issues page


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Farid Mojtahedi M, Aref S, Moini A, Maleki-Hajiagha A, Kashani L. Natural cycle versus modified natural cycle for endometrial preparation in women undergoing frozen-thawed embryo transfer: An RCT. IJRM 2022; 20 (11) :923-930
URL: http://ijrm.ir/article-1-2345-en.html
1- Endocrinology and Female Infertility Unit, Arash Women's Hospital, Tehran University of Medical Sciences, Tehran, Iran.
2- Endocrinology and Female Infertility Unit, Arash Women's Hospital, Tehran University of Medical Sciences, Tehran, Iran. Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.
3- Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Research Development Center, Arash Women's Hospital, Tehran University of Medical Sciences, Tehran, Iran.
4- Endocrinology and Female Infertility Unit, Arash Women's Hospital, Tehran University of Medical Sciences, Tehran, Iran. , kashani_ladan@tums.ac.ir
Abstract:   (923 Views)
Background: Studies have evaluated different endometrial preparation methods, but the optimal frozen-thawed embryo transfer (FET) cycle strategy in terms of the in-vitro fertilization outcome is still debated.
Objective: To compare the natural versus modified natural cycles for endometrial preparation in women undergoing FET.
Materials and Methods: This study was designed as a randomized clinical trial, and it was performed at the Arash women’s hospital between August 2016-2018. 140 eligible participants were enrolled in this study and were randomly divided into 2 groups by using the block randomization method, including true natural FET (n = 70) and modified natural FET (mNFET) (n = 70) cycles. Both groups were monitored for endometrial thickness and follicular size; simultaneously spontaneous luteinizing hormone surge using urinary luteinizing hormone testing kits. The mNFET group received 5000 IU of human chorionic gonadotropin injection to trigger final follicular maturation. Luteal support by vaginal progesterone (cyclogest 400 mg twice daily) was used in true natural FET from the day of transfer until the 10th wk of pregnancy. Chemical and clinical pregnancy and abortion rates were considered as the primary outcomes.
Results: There were no differences in the participants’ baseline characteristics between groups. There was no difference in clinical pregnancy and abortion rate between groups, while the implantation rate was significantly higher in the mNFET group (29.2% vs. 17.6%; p = 0.036).
Conclusion: The results demonstrated that both types of natural cycles were similar in pregnancy outcomes, while modified cycles might be associated with a higher implantation rate.
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References
1. Ghobara T, Gelbaya TA, Ayeleke RO. Cycle regimens for frozen‐thawed embryo transfer. Cochrane Database Syst Rev 2017; 7: CD003414. [DOI:10.1002/14651858.CD003414.pub3] [PMID] [PMCID]
2. Mubarak S, Acharyya S, Viardot-Foucault V, Tan H, Phoon J. A comparison of the miscarriage and live birth rate for frozen embryo transfer according to two endometrial preparations: Natural or primed with estrogens. Fertil Reprod 2019; 1: 43-49. [DOI:10.1142/S2661318219500038]
3. Mackens S, Santos-Ribeiro S, Van De Vijver A, Racca A, Van Landuyt L, Tournaye H, et al. Frozen embryo transfer: A review on the optimal endometrial preparation and timing. Hum Reprod 2017; 32: 2234-2242. [DOI:10.1093/humrep/dex285] [PMID]
4. Wang B, Zhang J, Zhu Q, Yang X, Wang Y. Effects of different cycle regimens for frozen embryo transfer on perinatal outcomes of singletons. Hum Reprod 2020; 35: 1612-1622. [DOI:10.1093/humrep/deaa093] [PMID]
5. Dall'Agnol H, Velasco JAG. Frozen embryo transfer and preeclampsia: Where is the link? Curr Opin Obstet Gynecol 2020; 32: 213-218. [DOI:10.1097/GCO.0000000000000624] [PMID]
6. Zong L, Liu P, Zhou L, Wei D, Ding L, Qin Y. Increased risk of maternal and neonatal complications in hormone replacement therapy cycles in frozen embryo transfer. Reprod Biol Endocrinol 2020; 18: 36. [DOI:10.1186/s12958-020-00601-3] [PMID] [PMCID]
7. Ginstrom Ernstad E, Wennerholm UB, Khatibi A, Petzold M, Bergh C. Neonatal and maternal outcome after frozen embryo transfer: Increased risks in programmed cycles. Am J Obstet Gynecol 2019; 221: 126. [DOI:10.1016/j.ajog.2019.03.010] [PMID]
8. Isikoglu M, Aydinuraz B, Avci A, Ceviren AK. Modified natural protocol seems superior to natural and artificial protocols for preparing the endometrium in frozen embryo transfer cycles. Minerva Ginecol 2020; 72: 195-201. [DOI:10.23736/S0026-4784.20.04570-0] [PMID]
9. Sakkas D, Gardner DK. Evaluation of embryo quality analysis of morphology and physiology. In: Gardner DK, Weissman A, Howles CM, Shoham Z. Textbook of assisted reproductive techniques. 5th Ed. Florida, USA: CRC Press; 2018. [DOI:10.1201/9781351228244]
10. Mousavi Fatemi H, Kyrou D, Bourgain C, Van den Abbeel E, Griesinger G, Devroey P. Cryopreserved-thawed human embryo transfer: Spontaneous natural cycle is superior to human chorionic gonadotropin-induced natural cycle. Fertil Steril 2010; 94: 2054-2058. [DOI:10.1016/j.fertnstert.2009.11.036] [PMID]
11. Mumusoglu S, Polat M, Ozbek IY, Bozdag G, Papanikolaou EG, Esteves SC, et al. Preparation of the endometrium for frozen embryo transfer: A systematic review. Front Endocrinol 2021; 12: 688237. [DOI:10.3389/fendo.2021.688237] [PMID] [PMCID]
12. Wu H, Zhou P, Lin X, Wang S, Zhang S. Endometrial preparation for frozen-thawed embryo transfer cycles: A systematic review and network meta-analysis. J Assist Reprod Genet 2021; 38: 1913-1926. [DOI:10.1007/s10815-021-02125-0] [PMID] [PMCID]
13. Huberlant S, Vaast M, Anahory T, Tailland ML, Rougier N, Ranisavljevic N, et al. [Natural cycle for frozen-thawed embryo transfer: Spontaneous ovulation or triggering by HCG]. Gynecol Obstet Fertil Senol 2018; 46: 466-473. (in French) [DOI:10.1016/j.gofs.2018.03.006] [PMID]
14. Mackens S, Stubbe A, Santos-Ribeiro S, Van Landuyt L, Racca A, Roelens C, et al. To trigger or not to trigger ovulation in a natural cycle for frozen embryo transfer: A randomized controlled trial. Hum Reprod 2020; 35: 1073-1081. [DOI:10.1093/humrep/deaa026] [PMID]
15. Huber WJ, Sauerbrun‐Cutler MT, Krueger PM, Sharma S. Novel predictive and therapeutic options for better pregnancy outcome in frozen embryo transfer cycles. Am J Reprod Immunol 2021; 85: e13300. [DOI:10.1111/aji.13393]
16. Madani T, Ramezanali F, Yahyaei A, Hasani F, Bagheri Lankarani N, Mohammadi Yeganeh L. Live birth rates after different endometrial preparation methods in frozen cleavage-stage embryo transfer cycles: A randomized controlled trial. Arch Gynecol Obstet 2019; 299: 1185-1191. [DOI:10.1007/s00404-019-05062-7] [PMID]
17. Levi Setti PE, Cirillo F, De Cesare R, Morenghi E, Canevisio V, Ronchetti C, et al. Seven years of vitrified blastocyst transfers: Comparison of 3 preparation protocols at a single ART center. Front Endocrinol 2020; 11: 346. [DOI:10.3389/fendo.2020.00346] [PMID] [PMCID]
18. Weissman A, Ravhon A, Horowitz E, Levran D. Re: Cryopreserved-thawed human embryo transfer: Spontaneous natural cycle is superior to human chorionic gonadotropin-induced natural cycle. Fertil Steril 2010; 94: e33. [DOI:10.1016/j.fertnstert.2010.03.003] [PMID]
19. Litwicka K, Mencacci C, Arrivi C, Varricchio MT, Caragia A, Minasi MG, et al. HCG administration after endogenous LH rise negatively influences pregnancy rate in modified natural cycle for frozen-thawed euploid blastocyst transfer: A pilot study. J Assist Reprod Genet 2018; 35: 449-455. [DOI:10.1007/s10815-017-1089-x] [PMID] [PMCID]
20. Mizrachi Y, Horowitz E, Ganer Herman H, Farhi J, Raziel A, Weissman A. Should women receive luteal support following natural cycle frozen embryo transfer? A systematic review and meta-analysis. Hum Reprod Update 2021; 27: 643-650. [DOI:10.1093/humupd/dmab011] [PMID]
21. Montagut M, Santos-Ribeiro S, De Vos M, Polyzos NP, Drakopoulos P, Mackens S, et al. Frozen-thawed embryo transfers in natural cycles with spontaneous or induced ovulation: The search for the best protocol continues. Hum Reprod 2016; 31: 2803-2810. [DOI:10.1093/humrep/dew263] [PMID]
22. Groenewoud ER, Cohlen BJ, Macklon NS. Programming the endometrium for deferred transfer of cryopreserved embryos: Hormone replacement versus modified natural cycles. Fertil Steril 2018; 109: 768-774. [DOI:10.1016/j.fertnstert.2018.02.135] [PMID]
23. Reichman DE, Stewart CR, Rosenwaks Z. Natural frozen embryo transfer with hCG booster leads to improved cycle outcomes: A retrospective cohort study. J Assist Reprod Genet 2020; 37: 1177-1182. [DOI:10.1007/s10815-020-01740-7] [PMID] [PMCID]
24. Chi Yan Lee V, Hang Wun Li R, Shu Biu Yeung W, Pak Chung HO, Yu Ng EH. A randomized double-blinded controlled trial of hCG as luteal phase support in natural cycle frozen embryo transfer. Hum Reprod 2017; 32: 1130-1137. [DOI:10.1093/humrep/dex049] [PMID]
25. Lee Y-J, Kim Ch-H, Kim D-Y, Ahn J-W, Kim S-H, Chae H-D, et al. Human chorionic gonadotropin-administered natural cycle versus spontaneous ovulatory cycle in patients undergoing two pronuclear zygote frozen-thawed embryo transfer. Obstet Gynecol Sci 2018; 61: 247-252. [DOI:10.5468/ogs.2018.61.2.247] [PMID] [PMCID]
26. Weiss A, Baram S, Geslevich Y, Goldman S, Nothman S, Beck-Fruchter R. Should the modified natural cycle protocol for frozen embryo transfer be modified? A prospective case series proof of concept study. Eur J Obstet Gynecol Reprod Biol 2021; 258: 179-183. [DOI:10.1016/j.ejogrb.2021.01.004] [PMID]

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