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Endometrial preparation protocol of the frozen-thawed embryo transfer in patients with polycystic ovary syndrome

  • Gynecologic Endocrinology and Reproductive Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

To assess which is the optimal protocol in terms of endometrial preparation prior to frozen-thawed embryo transfer (FET) in women with polycystic ovarian syndrome (PCOS) and to explore the effect in stimulated cycle with the addition of vaginal 17-β oestradiol.

Methods

Five hundred and seventy-six patients with PCOS were prepared for FET using artificial cycle induced with oestradiol and progesterone supplementation (n = 291) and stimulated cycle induced by human menopausal gonadotrophin (HMG) within or without the addition of vaginal 17-β oestradiol (n = 285). Then the FET was performed in a receptive endometrium.

Results

Endometrial thickness was similar (9.03 ± 1.65 vs. 9.12 ± 1.58, P > 0.05) in artificial and stimulated cycle. The two protocols resulted in clinical pregnancy rate (41.0 % vs. 41.6 %, P > 0.05), ongoing pregnancy rate (36.6 % vs. 34.7 %, P > 0.05), live birth rate (30.0 % vs. 31.7 %, P > 0.05), which were not statistically different. Nevertheless, the cancelled cycle rate made a significant difference (2.2 % vs. 5.4 %, P < 0.05). There is no significant difference in the clinical pregnancy rate in HMG, HMG added with vaginal oestradiol and HMG switch to vaginal oestradiol group (42.6 %, 41.1 %, and 33.3 %, respectively).

Conclusions

The mean endometrial thickness, clinical pregnancy rate, ongoing pregnancy rate, live birth rate and implantation rate were similar in artificial and stimulated cycle for endometrial preparation prior to FET in PCOS. It was fine to add vaginal 17-β oestradiol to stimulated cycle when necessary. However, stimulated cycles had a significantly higher cancelled cycle rate. We should follow the principles of individualization, securitization and optimization in endometrial preparation of the FET in patients with PCOS.

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Conflict of interest

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Kunming Medical University, Yunnan, People’s Republic of China

    Jianmei Yu

  2. Department of Reproduction and Genetics, Reproductive Medical Centre, The First People’s Hospital of Yunnan Province, No. 157 Jin Bi Road, Kunming, 650032, People’s Republic of China

    Jianmei Yu, Yanping Ma, Ze Wu, Yonggang Li, Li Tang, Yunxiu Li & Bo Deng

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  1. Jianmei Yu
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Correspondence to Yanping Ma.

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Yu, J., Ma, Y., Wu, Z. et al. Endometrial preparation protocol of the frozen-thawed embryo transfer in patients with polycystic ovary syndrome. Arch Gynecol Obstet 291, 201–211 (2015). https://doi.org/10.1007/s00404-014-3396-0

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  • DOI: https://doi.org/10.1007/s00404-014-3396-0

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