Endometrial Preparation for Women Undergoing Embryo Transfer Frozen-Thawed Embryo Transfer With and Without Pretreatment With Gonadotropin Releasing Hormone Agonists

  • Shohreh Movahedi Department of Infertility of Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
  • Ashraf Aleyasin Department of Infertility of Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
  • Marzieh Agahoseini Department of Infertility of Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
  • Leili Safdarian Department of Infertility of Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
  • Sahar Abroshan Department of Obstetrics and Gynecology, Tehran University of Medical Sciences, Tehran, Iran
  • Sepideh Khodaverdi Department of Obstetrics and Gynecology, Fellowship in Minimally Invasive Gynecology Surgery (FMIGS),Endometriosis Research Center of Rasoul Akram Hospital, Iran University of Medical Sciences , Tehran, Iran
  • Parvin Fallahi Department of Infertility, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
Keywords: Endometrial Preparation, Embryo Transfer, Frozen-Thawed, Gonadotropin, Hormone Agonists, Women

Abstract

Objective: To evaluate the efficacy of endometrial preparation by exogenous steroids, with and without pretreatment by the use of GnRH agonist.Materials and methods: This randomized interventional study was conducted on 100 women who underwent a FTET that were randomly assigned to receive GnRH agonist (buserelin) in the luteal phase or no receive this medication. In both groups endometrial preparation was achieved by the use of estradiol valerate pill started from the second day of the menstruation and used every day, with an initial dose of 2mg/d and every 3 days increased to 4 mg/d and 6 mg/d, respectively. Endometrial thickness was evaluated by vaginal ultrasound. Forty eight hours after beginning of progesterone administration 2 to 3 embryos surviving in freezing procedure were transferred.Results: the two groups were similar in mean age, body mass index, duration of infertility, type of infertility, number of embryos transferred and endometrial thickness on the day of beginning progesterone therapy. Comparing outcome of FTET between the two groups scheduled for receiving GnRH agonist showed no significant difference in the rate of implantation (6.7% versus 10.0%), the rate of chemical pregnancy (21.7% versus 22.5%), clinical pregnancy rate (15.0% versus 17.5%), and also ongoing pregnancy (13.3% versus 12.5%).Conclusion: Endometrial preparation for FTET using GnRH agonists appears to be as effective as FTET without administrating these agonists.

References

Kalem Z, Kalem MN, Gürgan T.Methods for endometrial preparation in frozen-thawed embryo transfer cycles. J Turk Ger Gynecol Assoc 2016; 17:168-72.

Groenewoud ER, Cantineau AE, Kollen BJ, Macklon NS, Cohlen BJ.What is the optimal means of preparing the endometrium in frozen-thawed embryo transfercycles? A systematic review and meta-analysis. Hum Reprod Update 2013; 19:458-70.

Berin I, McLellan ST, Macklin EA, Toth TL, Wright DL.Frozen-thawed embryo transfer cycles: clinical outcomes of single and double blastocyst transfers.J Assist Reprod Genet 2011; 28:575-81.

Ashrafi M, Jahangiri N, Hassani F, Akhoond MR, Madani T.The factors affecting the outcome of frozen-thawed embryo transfer cycle. Taiwan J Obstet Gynecol 2011; 50:159-64.

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

Benshushan A, Ezra Y, Simon A, Mordel N, Lewin A, Laufer N.The effect of gonadotropin-releasing hormone agonist on embryo quality and pregnancy rate following cryopreservation. FertilSteril 1993; 59:1065-9.

Ramos J, Caligara C, Tocino A, Rodriguez I, Carranza F, Fernandez m. Sanchez.” Prospective randomized study to compare frozen-thawed embryo transfer cycles outcome in women with functioning ovaries and hrt for endometrium preparation with or without prior GnRHa suppression.” FertilSteril 2007; 88 (Suppl.): 114-15.

Dal Prato L, Borini A. Best protocol for frozen-thawed embryo transfer cost benefit analysis needed. Fertil Steril 2006; 86: 1554-5.

Griesinger M, Weig A, Schroer K, Diedrich, Kolibianakis DM. Mid-cycle serum levels of endogenous LH are not associated with the likelihood of pregnancy in artificial frozen-thawed embryo transfer cycles without pituitary suppression. Hum Reprod 2007; 22: 2589-93.

Rienzi L, Nagy ZP, Ubaldi F, Lacobelli M, Anniballo R, Tesarik J, et al. Laser assisted removal of necrotic blastomeres from cryopreserved embryos that were partially damaged. FertilSteril 2002; 77:1196-120.

Karlstrom P, Bergh T, Forsberg A, Sandkvist U, Wikland M. Prognostic factors for the success rate of embryo freezing. Hum Reprod 1997; 12:1263-66.

Harper MJ. The implantation window. Baillieres Clin Obstet Gynaecol 1992; 6:351-71.

Tabibzadeh S. Molecular control of the implantation window. Hum Reprod Update 1998; 4:465-71.

El-Toukhy T, Taylor A, Khalaf Y, Al Darazi K, Rowell P, Seed P, Braude P. Pituitary suppression in ultrasound-monitored frozen embryo replacement cycles. A randomized study. Hum Reprod 2004;19:874-9.

Nekoo EA, Chamani M, Tehrani ES, Rashidi BH, Tanha FD, Kalantari V. Artificial Endometrial Preparation for Frozen-Thawed Embryo Transfer with or without Pretreatment with Depot Gonadotropin Releasing Hormone Agonist in Women with Regular Menses. J FamReprod Health 2015;9:1–4.

AzimiNekoo E, Chamani M, ShahrokhTehrani E, Hossein Rashidi B, Davari Tanha F3, Kalantari V4.Artificial Endometrial Preparation for Frozen-Thawed Embryo Transfer with or without Pretreatment with Depot Gonadotropin Releasing Hormone Agonist in Women with Regular Menses.J Family Reprod Health 2015; 9:1-4.

Dal Prato L1, 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.

Glujovsky D, Pesce R, Fiszbajn G, Sueldo C, and Hart RJ, Ciapponi A. Endometrial preparation for women undergoing embryo transfer with frozen embryos or embryos derived from donor oocytes. Cochrane Database 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 frozen-thawed blastocyst transfer in HRT cycle. Int J Clin Exp Pathol 2013; 6:718–23

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

Cohen J, DeVane GW, Elsner CW, Kort HI, Massey JB, Norbury SE. Cryopreserved zygotes and embryos and endocrinologic factors in the replacement cycle. FertilSteril 1988; 50:61-7

Abdalla HI, Brooks AA, Johnson MR, Kirkland A, Thomas A, Studd JW. Endometrial thickness: a predictor of implantation in ovum recipients? Hum Reprod 1994; 9:363-5.

Published
2019-02-05
How to Cite
1.
Movahedi S, Aleyasin A, Agahoseini M, Safdarian L, Abroshan S, Khodaverdi S, Fallahi P. Endometrial Preparation for Women Undergoing Embryo Transfer Frozen-Thawed Embryo Transfer With and Without Pretreatment With Gonadotropin Releasing Hormone Agonists. J Fam Reprod Health. 12(4):191-196.
Section
Original Articles