Journal of Family and Reproductive Health 2015. 9(1):1-4.

Artificial Endometrial Preparation for Frozen-Thawed Embryo Transfer with or without Pretreatment with Depot Gonadotropin Releasing Hormone Agonist in Women with Regular Menses.
Elham Azimi Nekoo, Maryam Chamani, Ensieh Shahrokh Tehrani, Batool Hossein Rashidi, Fatemeh Davari Tanha, Vahid Kalantari


Objective: To investigate the reproductive outcome of artificial endometrial preparation with exogenous steroids for frozen-thawed embryo transfer with and without pre-treatment with depot gonadotropin releasing hormone agonist (GnRH-a) in women with regular menses.

AMaterials and methods:This is a prospective randomized clinical trial conducted in two RT centers on 176 women undergoing frozen-thawed embryo transfer. All patients received oral estradiol valerate 4 mg daily from day 2 to day 5 and 6 mg per day from day 6 to the day of the pregnancy test. In day 13 of cycle, an ultrasound examination was performed. After ultrasound confirmation of endometrial thickness (≥8 mm) and no ovarian activity, progesterone in cyclogest supp (800 mg daily) was added. The dose of estradiol would be increased to 8 mg per day if the endometrial thickness was less than 8mm. Two or 3 embryos were transferred via transcervical route 48 hours after the beginning of progesterone administration. In group A (93 patients), Difereline (3.75 mg Im), as a depot GnRH agonist was administered in the midluteal phase (day 21) of previous cycle. In the other group B (n = 83) steroid supplementation was commenced without prior pituitary suppression. Chemical and clinical pregnancy rates were compared in two groups.

Results:No significant differences were seen between two groups in terms of chemical pregnancy and clinical pregnancy rates.

Conclusion:The findings support the artificial protocol without any pretreatment suppressive drugs to reduce the adverse side effects of GnRH agonists also to minimize the costs.


frozen-thawed embryo transfer; GnRH agonist; artificial cycle; endometrial preparation; pregnancy outcome

Full Text:



El-Toukhy T1, Taylor A, Khalaf Y, Al-Darazi K, Rowell P, Seed P, et al. .Pituitary suppression in ultrasound- onitored frozen embryo replacement cycles. A randomised study. Hum Reprod 2004; 19:874-9.

Ghobara T, Vandekerckhove P.Cycle regimens for frozen- hawed embryo transfer. Cochrane Database Syst Rev 2008; 23: CD003414.

Gelbaya TA1, Nardo LG, Hunter HR, Fitzgerald CT, Horne G, Pease EE,et al.Cryopreserved-thawed embryo transfer in natural or down-regulated hormonally controlled cycles: a retrospective study. Fertil Steril 2006; 85:603-9.

Weissman A, Horowitz E, Ravhon A, Steinfeld Z, Mutzafi R, Golan A, et al. Spontaneous ovulation versus HCG triggering for timing natural-cycle frozenthawed embryo transfer: a randomized study. Reprod Biomed Online 2011 23: 484-9.

Dal Prato L, Borini A, Cattoli M, Bonu MA, Sciajno R, Flamigni C.. Endometrial preparation for frozenthawed embryo transfer with or without pretreatment with gonadotrophin-releasing hormone agonist. Fertil Steril 2002; 77: 956-60.

Lee JR, Choi YS, Jee BC, Ku SY, Suh Cs, Kim Kc, et al.Cryopreserved blastocyst transfer: impact of gonadotropin-releasing hormone agonist versus antagonist in the previous oocyte retrieval cycles. Fertil Steril 2007; 88:1344-9 .

al-Shawaf T, Yang D, al-Magid Y, Seaton A, Iketubosin F, Craft I. Ultrasonic monitoring during replacement of FET in natural and hormone

replacement cycles. Hum. Reprod.1993; 8: 2068-74. 8. Hill MJ, Miller KA, Frattarelli JL.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. Fertil Steril 2010; 93:416-22.

Zhihong N, Yun F, Yijuan S, Estrogen level monitoring in artificial frozen-thawed embryo transfer cycles using step-up regime without pituitary suppression: is it necessary?. J Exp Clin Assist Reprod 2008; 5: 4.

Glujovsky D, Pesce R, Fiszbajn G, Sueldo C, Hart RJ, Ciapponi A..Endometrial preparation for women undergoing embryo transfer with frozen embryos or embryos derived from donor oocytes. CochraneDatabase Syst Rev 2010; 20: CD006359.

Yang X, Dong X, Huang K, Wang L, Xiong T, Ji L, Zhang H. The effect of accompanying dominant follicle development/ovulation on the outcomes of frozenthawed blastocyst transfer in HRT cycle.Int J Clin Exp Pathol 2013; 6: 718-23.

Prato LD, Borini A.Best protocol for frozen-thawed embryo transfer—cost benefit analysis needed. Fertil Steril 2006; 85: 1554-5.

Davar R, Eftekhar M ,Naeimeh T. Transfer of Cryopreserved-Thawed Embryos in a Cycle Using Exogenous Steroids with or Without Prior Gonadotropihin- eleasing Hormone Agonist. J Med Sci 2007; 7: 880-3.

Dal Prato L, Borini A, Cattoli M, Bonu MA, Sciajno R, Flamigni C.Endometrial preparation for frozen-thawed embryo transfer with or without pretreatment with gonadotropin-releasing hormone agonist. Fertil Steril 2002; 77: 956-60.


  • There are currently no refbacks.

Creative Commons Attribution-NonCommercial 3.0

This work is licensed under a Creative Commons Attribution-NonCommercial 3.0 Unported License which allows users to read, copy, distribute and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited properly.