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Endometrial preparation for frozen-thawed embryo transfer with or without pretreatment with gonadotropin-releasing hormone agonist.

Abstract：

OBJECTIVE:To test the efficacy of endometrial preparation with exogenous steroids, without pretreatment with gonadotropin-releasing hormone (GnRH) agonist, in women with normal ovarian function. DESIGN:Prospective randomized study. SETTING:Private outpatient infertility clinic. PATIENT(S):Two hundred ninety-six women undergoing frozen-thawed embryo transfer. INTERVENTION(S):In group 1 (146 patients), depot GnRH agonist was administered in the luteal phase; treatment with 17beta-estradiol transdermal patches at steadily increasing dosage from 100 to 300 microg was then given for at least 12 days. In group 2 (150 patients), endometrial preparation began on day 1 of menstrual cycle. The starting dose was 200 microg; this was increased to 300 microg after 7 days. MAIN OUTCOME MEASURE(S):Pregnancy, abortion, implantation and cancellation rates. RESULT(S):In group 2, six cycles (4%) were cancelled due to evidence of ovulation. Groups were similar in the percentage of embryos that survived freezing-thawing (77.1% in group 1 and 76.6% in group 2) and in the number of embryos transferred per patient (2.1 +/- 0.6 and 2.1 +/- 0.7, respectively). Groups 1 and 2 did not differ significantly in rates of pregnancy (19.7% and 24.1%), abortion (17.8% and 11.7%), and implantation (10.4% and 11.9%). CONCLUSION(S):Endometrial preparation for frozen-thawed embryo transfer based exclusively on steroid administration appears to be as effective as the more conventional protocol involving preliminary desensitization with a GnRH agonist. This simplified protocol reduces costs, minimizes pharmacologic treatment, and increases patient compliance.

journal_name

Fertil Steril

journal_title

Fertility and sterility

authors

Dal Prato L,Borini A,Cattoli M,Bonu MA,Sciajno R,Flamigni C

doi

10.1016/s0015-0282(02)02960-6

keywords:

subject

Has Abstract

pub_date

2002-05-01 00:00:00

pages

956-60

issue

5

eissn

0015-0282

issn

1556-5653

pii

S0015028202029606

journal_volume

77

pub_type

临床试验,杂志文章,随机对照试验

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