Cryopreserved-thawed human embryo transfer: spontaneous natural cycle is superior to human chorionic gonadotropin-induced natural cycle

To assess whether there is a difference in the ongoing pregnancy rate after transferring frozen-thawed embryos in natural cycles with spontaneous LH-P rise compared with natural cycles controlled by hCG for final oocyte maturation and ovulation. Randomized controlled trial. Tertiary referral center....

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Vydáno v:	Fertility and sterility Ročník 94; číslo 6; s. 2054
Hlavní autoři:	Fatemi, Human Mousavi, Kyrou, Dimitra, Bourgain, Claire, Van den Abbeel, Etienne, Griesinger, Georg, Devroey, Paul
Médium:	Journal Article
Jazyk:	angličtina
Vydáno:	United States 01.11.2010
Témata:	Adult Blastocyst Chorionic Gonadotropin - adverse effects Chorionic Gonadotropin - blood Chorionic Gonadotropin - pharmacology Chorionic Gonadotropin - therapeutic use Cryopreservation Embryo Transfer - methods Female Fertilization in Vitro - methods Humans Luteinizing Hormone - blood Menstrual Cycle - blood Menstrual Cycle - drug effects Menstrual Cycle - physiology Ovulation Induction - adverse effects Pregnancy Pregnancy Rate Quality Control
ISSN:	1556-5653, 1556-5653
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Abstract	To assess whether there is a difference in the ongoing pregnancy rate after transferring frozen-thawed embryos in natural cycles with spontaneous LH-P rise compared with natural cycles controlled by hCG for final oocyte maturation and ovulation. Randomized controlled trial. Tertiary referral center. A total of 168 patients were assigned randomly to undergo frozen ET on day 3 from October 2007 until November 2008. Finally, analysis was performed in 124 patients; 61 belonged to the spontaneous LH group and 63 to the hCG group. In the spontaneous LH group the transfer was planned 5 days after the LH surge. In the hCG group, the cryopreserve ET was planned 5 days after the administration of 5000 IU of hCG, when an endometrial thickness of ≥7 mm and a follicle of ≥17 mm were present on ultrasound examination. Ongoing pregnancy rate. The study was terminated early, when a prespecified interim analysis found a significantly higher ongoing pregnancy rate in the spontaneous LH group as compared with the hCG group (31.1% vs. 14.3%; difference 16.9%, 95% confidence interval 4.4%-28.8%). The results suggest the superiority of the natural cycle as compared with the natural cycle controlled by hCG administration in cryothawed ET cycles.
AbstractList	To assess whether there is a difference in the ongoing pregnancy rate after transferring frozen-thawed embryos in natural cycles with spontaneous LH-P rise compared with natural cycles controlled by hCG for final oocyte maturation and ovulation. Randomized controlled trial. Tertiary referral center. A total of 168 patients were assigned randomly to undergo frozen ET on day 3 from October 2007 until November 2008. Finally, analysis was performed in 124 patients; 61 belonged to the spontaneous LH group and 63 to the hCG group. In the spontaneous LH group the transfer was planned 5 days after the LH surge. In the hCG group, the cryopreserve ET was planned 5 days after the administration of 5000 IU of hCG, when an endometrial thickness of ≥7 mm and a follicle of ≥17 mm were present on ultrasound examination. Ongoing pregnancy rate. The study was terminated early, when a prespecified interim analysis found a significantly higher ongoing pregnancy rate in the spontaneous LH group as compared with the hCG group (31.1% vs. 14.3%; difference 16.9%, 95% confidence interval 4.4%-28.8%). The results suggest the superiority of the natural cycle as compared with the natural cycle controlled by hCG administration in cryothawed ET cycles. To assess whether there is a difference in the ongoing pregnancy rate after transferring frozen-thawed embryos in natural cycles with spontaneous LH-P rise compared with natural cycles controlled by hCG for final oocyte maturation and ovulation.OBJECTIVETo assess whether there is a difference in the ongoing pregnancy rate after transferring frozen-thawed embryos in natural cycles with spontaneous LH-P rise compared with natural cycles controlled by hCG for final oocyte maturation and ovulation.Randomized controlled trial.DESIGNRandomized controlled trial.Tertiary referral center.SETTINGTertiary referral center.A total of 168 patients were assigned randomly to undergo frozen ET on day 3 from October 2007 until November 2008. Finally, analysis was performed in 124 patients; 61 belonged to the spontaneous LH group and 63 to the hCG group.PATIENT(S)A total of 168 patients were assigned randomly to undergo frozen ET on day 3 from October 2007 until November 2008. Finally, analysis was performed in 124 patients; 61 belonged to the spontaneous LH group and 63 to the hCG group.In the spontaneous LH group the transfer was planned 5 days after the LH surge. In the hCG group, the cryopreserve ET was planned 5 days after the administration of 5000 IU of hCG, when an endometrial thickness of ≥7 mm and a follicle of ≥17 mm were present on ultrasound examination.INTERVENTION(S)In the spontaneous LH group the transfer was planned 5 days after the LH surge. In the hCG group, the cryopreserve ET was planned 5 days after the administration of 5000 IU of hCG, when an endometrial thickness of ≥7 mm and a follicle of ≥17 mm were present on ultrasound examination.Ongoing pregnancy rate.MAIN OUTCOME MEASURE(S)Ongoing pregnancy rate.The study was terminated early, when a prespecified interim analysis found a significantly higher ongoing pregnancy rate in the spontaneous LH group as compared with the hCG group (31.1% vs. 14.3%; difference 16.9%, 95% confidence interval 4.4%-28.8%).RESULT(S)The study was terminated early, when a prespecified interim analysis found a significantly higher ongoing pregnancy rate in the spontaneous LH group as compared with the hCG group (31.1% vs. 14.3%; difference 16.9%, 95% confidence interval 4.4%-28.8%).The results suggest the superiority of the natural cycle as compared with the natural cycle controlled by hCG administration in cryothawed ET cycles.CONCLUSION(S)The results suggest the superiority of the natural cycle as compared with the natural cycle controlled by hCG administration in cryothawed ET cycles.
Author	Kyrou, Dimitra Van den Abbeel, Etienne Griesinger, Georg Bourgain, Claire Devroey, Paul Fatemi, Human Mousavi
Author_xml	– sequence: 1 givenname: Human Mousavi surname: Fatemi fullname: Fatemi, Human Mousavi email: hmousavi@uzbrussel.be organization: Center for Reproductive Medicine, Department of Pathology, Dutch-Speaking Free University Brussels, Brussels, Belgium. hmousavi@uzbrussel.be – sequence: 2 givenname: Dimitra surname: Kyrou fullname: Kyrou, Dimitra – sequence: 3 givenname: Claire surname: Bourgain fullname: Bourgain, Claire – sequence: 4 givenname: Etienne surname: Van den Abbeel fullname: Van den Abbeel, Etienne – sequence: 5 givenname: Georg surname: Griesinger fullname: Griesinger, Georg – sequence: 6 givenname: Paul surname: Devroey fullname: Devroey, Paul
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SubjectTerms	Adult Blastocyst Chorionic Gonadotropin - adverse effects Chorionic Gonadotropin - blood Chorionic Gonadotropin - pharmacology Chorionic Gonadotropin - therapeutic use Cryopreservation Embryo Transfer - methods Female Fertilization in Vitro - methods Humans Luteinizing Hormone - blood Menstrual Cycle - blood Menstrual Cycle - drug effects Menstrual Cycle - physiology Ovulation Induction - adverse effects Pregnancy Pregnancy Rate Quality Control
Title	Cryopreserved-thawed human embryo transfer: spontaneous natural cycle is superior to human chorionic gonadotropin-induced natural cycle
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