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Preparation of endometrium for frozen embryo replacement cycles: a systematic review and meta-analysis.

Abstract：

PURPOSE:The purpose of this study was to evaluate the best protocol to prepare endometrium for frozen embryo replacement (FER) cycles. METHODS:This study is a systematic review and meta-analysis. Following PubMed and OvidSP search, a total of 1166 studies published after 1990 were identified following removal of duplicates. Following exclusion of studies not matching our inclusion criteria, a total of 33 studies were analyzed. Primary outcome measure was live birth. The following protocols, including true natural cycle (tNC), modified natural cycle (mNC), artificial cycle (AC) with or without suppression, and mild ovarian stimulation (OS) with gonadotropin (Gn) or aromatase inhibitor (AI), were compared. RESULTS:No statistically significant difference for both clinical pregnancy and live birth was noted between tNC and mNC groups. When tNC and AC without suppression groups are compared, there was a statistically significant difference in clinical pregnancy rate in favor of tNC, whereas it failed to reach statistical significance for live birth. When tNC and AC with suppression groups are compared, there was a statistically significant difference in live birth rate favoring the latter. Similar pregnancy outcome was noted among mNC versus AC with or without suppression groups. Similarly, no difference in clinical pregnancy and live birth was noted when ACs with or without suppression groups are compared. CONCLUSIONS:There is no consistent superiority of any endometrial preparation for FER. However, mNC has several advantages (being patient-friendly; yielding at least equivalent or better pregnancy rates when compared with tNC and AC with or without suppression; may not require LPS). Mild OS with Gn or AI may be promising.

journal_name

J Assist Reprod Genet

journal_title

Journal of assisted reproduction and genetics

authors

Yarali H,Polat M,Mumusoglu S,Yarali I,Bozdag G

doi

10.1007/s10815-016-0787-0

subject

Has Abstract

pub_date

2016-10-01 00:00:00

pages

1287-1304

issue

eissn

1058-0468

issn

1573-7330

pii

10.1007/s10815-016-0787-0

journal_volume

pub_type

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Preparation of endometrium for frozen embryo replacement cycles: a systematic review and meta-analysis.