Clinical application of down-regulating hormone replacement cycle in frozen-thawed embryo transfer in patients without endometriosis
10.3760/cma.j.cn101441-20190910-00415
- VernacularTitle:降调节联合激素替代内膜准备方案在冻融胚胎移植中非子宫内膜异位症人群的应用
- Author:
Haixiao CHEN
1
;
Jianzhi REN
1
;
Jiali CAI
1
;
Lanlan LIU
1
Author Information
1. 中国人民解放军陆军第七十三集团军医院生殖医学中心，厦门 361000
- Publication Type:Journal Article
- Keywords:
Frozen-thawed embryo transfer;
Down-regulating hormone replacement cycle;
Hormone replacement therapy;
Embryo pregnancy rate;
Live birth rate
- From:
Chinese Journal of Reproduction and Contraception
2020;40(11):881-886
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the effects of pituitary down-regulation in combination with hormone replacement therapy endometrial preparation protocol and conventional hormone replacement therapy endometrial preparation protocol on outcomes of frozen-thawed embryo transfer (FET) in patients without endometriosis.Methods:The retrospective study included 3562 FET cycles was carried out between January 2012 and December 2017 in Reproductive Medicine Center, 73rd Group Army Hospital of PLA. Among them, 807 cycles were under hormone replacement therapy in combination with pituitary down-regulation with gonadotropin-releasing hormone agonist (GnRH-a) (experimental group) and 2755 cycles were under conventional hormone replacement therapy (control group). Association between endometrial preparation protocols and pregnancy and live birth was analyzed with multivariate logistic regression.Results:In experimental group, the maternal age [(31.19±4.58) years old] and endometrial thickness [(8.95±1.75) mm] were higher than those in control group [(29.84±4.23) years old, (8.46±1.41) mm, all P<0.001], the proportion of cycles with at least one good-quality embryo transferred (9.2%) was lower than that in control group (19.5%, P<0.001). The pregnancy rate (55.3%) was higher than that in control group (51.3%, P=0.045). The live birth rate showed an increasing trend in experimental group in comparison with that in control group, but the difference was not statistically significant ( P=0.78). In multivariate logistic regression with adjustment of confounding factors including maternal age, duration of infertility, endometrial thickness on the day of endometrial transition, number of embryos transferred, blastocyst transfer and at least one good-quality embryo transferred, the odds ratio ( OR) for pregnancy comparing experimental group with control group was 1.209 (95% CI=1.023-1.429) and OR for live birth was 1.246 (95% CI=1.053-1.474). Conclusion:Pituitary down-regulation in combination with hormone replacement therapy as endometrial preparation protocol for FET may achieve higher pregnancy rate and live birth rate than conventional hormone replacement protocol.
