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The Effect of Tamoxifen on Thin Endometrium in Patients Undergoing Frozen—Thawed Embryo Transfer

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Abstract

Tamoxifen has played a vital role in endocrine therapy for the treatment of estrogen receptor–positive breast cancer. We examined the effect of tamoxifen in patients with a thin endometrium in frozen–thawed embryo transfer (FET) cycles and compared the improvement in endometrial thickness (EMT) and pregnancy outcomes stratified by different etiologies of thin endometrium. A total of 226 women were recruited for a new tamoxifen protocol; all had an EMT of less than 7.5 mm in previous cycles, including natural cycle (NC), hormone replacement treatment (HRT), and ovulation induction (OI) cycles. Compared with previous cycles, tamoxifen cycles showed a significantly increased EMT (from 6.11 ± 0.98 mm to 7.87 ± 1.48 mm in the NC group, from 6.24 ± 1.01 mm to 8.22 ± 1.67 mm in the HRT group, and from 6.34 ± 1.03 mm to 8.05 ± 1.58 mm in the OI group; all P <.001). Patients were further divided into 3 groups based on the causes of their thin endometrium: (1) history of intrauterine adhesion (n = 34), (2) history of uterine curettage (n = 141), and (3) polycystic ovary syndrome (PCOS; n ¼ 51). Patients with PCOS obtained the thickest EMT (9.31±1.55 mm), the lowest cycle cancellation rate (11.76%), and the highest rate of clinical pregnancy (60%) and live birth (55.56%) per transfer (P <.001). Multivariable regression analysis showed that EMT was related to live birth (odds ratio: 1.487; 95% confidence interval: 1.172-1.887). A tamoxifen protocol improves EMT in patients after NC, HRT, and OI cycles during FET. Patients with PCOS show the most benefit from tamoxifen and achieve better pregnancy outcomes.

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Authors and Affiliations

  1. Center for Reproductive Medicine, Shandong Provincial Hospital, Shandong University, Shandong, China

    Hanni Ke MD, Jingjing Jiang MD, PhD, Mingdi Xia MD, Rong Tang MD, PhD, Yingying Qin MD, PhD & Zi-Jiang Chen MD, PhD

  2. National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Jinan, China

    Hanni Ke MD, Jingjing Jiang MD, PhD, Mingdi Xia MD, Rong Tang MD, PhD, Yingying Qin MD, PhD & Zi-Jiang Chen MD, PhD

  3. The Key laboratory for Reproductive Endocrinology of Ministry of Education, Jinan, China

    Hanni Ke MD, Jingjing Jiang MD, PhD, Mingdi Xia MD, Rong Tang MD, PhD, Yingying Qin MD, PhD & Zi-Jiang Chen MD, PhD

  4. Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

    Zi-Jiang Chen MD, PhD

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  1. Hanni Ke MD
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Correspondence to Rong Tang MD, PhD.

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Ke, H., Jiang, J., Xia, M. et al. The Effect of Tamoxifen on Thin Endometrium in Patients Undergoing Frozen—Thawed Embryo Transfer. Reprod. Sci. 25, 861–866 (2018). https://doi.org/10.1177/1933719117698580

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