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Randomized Controlled Trial
. 2021 Sep 20:12:730059.
doi: 10.3389/fendo.2021.730059. eCollection 2021.

A Novel Promising Endometrial Preparation Protocol for Frozen-Thawed Embryo Transfer: A Randomized Controlled Trial

Jian-Chun Li  1   2 , Yan-Hong Wang  2 , Li-Ying Peng  3 , Yun Zhou  2 , Shi-Bin Chao  2   4
Affiliations
Randomized Controlled Trial

A Novel Promising Endometrial Preparation Protocol for Frozen-Thawed Embryo Transfer: A Randomized Controlled Trial

Jian-Chun Li et al. Front Endocrinol (Lausanne). .

Abstract

Background: In recent years frozen-thawed embryo transfer (FET) has played an increasingly important role in ART, but there is limited consensus on the most effective method of endometrial preparation (EP) for FET. Inspired by significantly higher implantation rate and clinical pregnancy rate of the depot GnRH-a protocol, we proposed a novel EP protocol named down-regulation ovulation-induction (DROI) aimed to improve pregnancy outcomes of FET.

Methods: This was a single-center, randomized controlled pilot trial. A total of 307 patients with freeze-all strategy scheduled for first FET were enrolled in the study. A total 261 embryos were transferred in DROI-FET group including 156 patients and 266 embryos were transferred in mNC-FET group including 151 patients. Reproductive outcomes were compared between the two groups.

Results: The basic characteristics of patients, and the average number, quality and stage of embryos transferred were comparable between the two groups. Our primary outcome, implantation rate(IR) in DROI-FET group, was significantly higher than that of the mNC-FET group (54.41% versus 35.71%, P<0.01). The clinical pregnancy rate (CPR) and ongoing pregnancy rate (OPR) in DROI-FET group was also higher than that in mNC-FET group (69.87% versus 50.33%, P<0.01; 64.10% versus 42.38%, P<0.01).

Conclusions: Compared to existing endometrial preparation methods, the DROI protocol might be the more efficient and promising protocol.

Keywords: down regulation ovulation induction; embryo implantation; endometrial preparation; endometrial receptivity; frozen-thawed embryo transfer; in vitro fertilization.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow chart of down-regulation ovulation-induction procedure. One depot of 3.75 mg leuprorelin acetate was injected at the 2nd or 3rd day of the menstrual cycle, in which ovarian stimulation with 75–150 IU Gns would start 35–42 days later along with confirmation of pituitary downregulation. Gonadotropin stimulation continued until endometrial thickness ≥7 mm. A dose of HCG 5000-1000 IU was injected at 9:00 p.m. and ET was arranged 5 days later for D3 embryos or 7 days later for blastocysts. Progesterone supplement was initiated 2 days after ovulatory trigger as fresh ET. (LA, leuprorelin acetate; GN, Gonadotropin; HCG,Human Chorionic Gonadotropin; MC, Mnstrual Cycle; D0, theoretical oocyte retrieval day).
Figure 2
Figure 2
Flowchart showing of enrollment and randomization of study patients.
See this image and copyright information in PMC

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