A GnRH agonist and exogenous hormone stimulation protocol has a higher live-birth rate than a natural endogenous hormone protocol for frozen-thawed blastocyst-stage embryo transfer cycles: an analysis of 1391 cycles
To compare embryo and birth data in cryopreserved-thawed blastocyst-stage ET cycles between natural endogenous hormone cycles and exogenous hormone stimulation cycles.
Design
Retrospective cohort analysis.
Setting
Large academic assisted reproductive technology center.
Patient(s)
One thousand three hundred ninety-one patient cycles undergoing frozen-thawed blastocyst-stage ET cycles.
Main Outcome Measure(s)
Live-birth rate.
Intervention(s)
The synthetic protocol used GnRH agonist followed by estrogen and P. The natural protocol used monitoring and post-transfer P.
Result(s)
The patients in the two protocols had similar baseline characteristics. Multiple linear regression showed the synthetic protocol to have a higher live-birth rate (odds ratio [OR], 1.46; 95% confidence interval [CI], 1.02–2.09). In patients having two embryos transferred, the synthetic stimulation protocol resulted in a higher live-birth rate per cycle start (32.3% vs. 20.4%; relative risk [RR], 1.58; 95% CI, 1.22–2.06). Similarly, patients with one or two embryos transferred who had additional cryopreserved blastocysts available also had a higher live-birth rate per cycle start (36.1% vs. 12.1; RR, 2.98; 95% CI, 1.16–7.63).
Conclusion(s)
The synthetic hormone protocol was associated with a higher live-birth rate when compared with a natural cycle protocol for frozen-thawed blastocyst-stage ET cycles. This improvement persisted when analysis was controlled for cycle cancellation. The synthetic stimulation protocol for frozen-thawed embryo cycles offers improved outcome results for patients.
Key Words
In vitro fertilization
cryopreserved
blastocyst
natural cycle
synthetic cycle
embryo transfer
Cited by (0)
M.J.H. has nothing to disclose. K.A.M. has nothing to disclose. J.L.F. has nothing to disclose.
The views expressed in this manuscript are those of the authors and do not reflect the official policy or position of the Department of the Army, Department of Defense, or the U.S. Government.