Clinical effectiveness following endometrial preparation of letrozole for frozen-thawed embryo transfer in patients with endometriosis: a randomized controlled trial
10.3760/cma.j.cn101441-20210709-00303
- VernacularTitle:子宫内膜异位症患者冻融胚胎移植周期应用来曲唑行内膜准备方案有效性的随机对照研究
- Author:
Xiang LU
1
;
Lu LI
1
;
Junling CHEN
1
;
Wenbi ZHANG
1
;
Xiaoxi SUN
1
Author Information
1. 上海集爱遗传与不育诊疗中心，复旦大学附属妇产科医院，上海 200011
- Publication Type:Journal Article
- Keywords:
Endometriosis;
Embryo transfer;
Letrozole;
Gonadotropin-releasing hormone agonist;
Hormone replacement;
Clinical pregnancy rate
- From:
Chinese Journal of Reproduction and Contraception
2022;42(10):1038-1045
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate clinical effectiveness of endometrial preparation of letrozole stimulation protocol for frozen-thawed embryo transfer (FET) in patients with endometriosis.Methods:In this prospective, controlled randomized trail, a total of 143 endometriosis women who undergwent FET in Shanghai Ji Ai Genetics and IVF Institute from January 2019 to December 2020 were randomly assigned to two groups according to computer digital: 69 patients received letrozole stimulation protocol (letrozole group) and 74 patients received hormone replacement therapy with gonadotropin-releasing hormone agonist (GnRH-a-HRT group). Clinical data between two groups were compared and the primary outcome was clinical pregnancy rate.Results:There were no significant differences in the number of embryos transferred, the proportion of blastocysts transferred, high-quality embryo rate and duration of endometrial preparation (all P>0.05). Peak estradiol levels [(417.8±102.7) ng/L], endometrial thickness on transfer day [(10.2±1.6) mm] and drug cost [(3 259.2±134.3) yuan] in GnRH-a-HRT group were significantly higher than those in letrozole group [(188.5±44.8) ng/L, P<0.001; (8.9±1.4) mm, P=0.007; (356.9±79.9) yuan, P<0.001]. The numbers of ultrasound scan (3.8±0.9) and venous samplings (2.8±0.9) in letrozole group were more than those in GnRH-a-HRT group (2.4±0.4, P=0.041; 1.4±0.4, P=0.022). The implantation rate, the clinical pregnancy rate, the twin pregnancy rate and the ectopic pregnancy rate were similar in both groups (all P>0.05). No significant difference was found in the miscarriage rate although miscarriage rate in GnRH-a-HRT group seemed higher than that of letrozole group (all P>0.05). Conclusion:Endometrial preparation of letrozole stimulation protocol for FET in patients with endometriosis showed similar pregnancy outcomes when compared with GnRH-a-HRT protocol. The drug cost is more economical in letrozole stimulation protocol.
