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• W4387396460 abstract "Emerging data suggests the optimal means to prepare the endometrium for frozen embryo transfer (FET) in women with regular menstrual cycles is an ovulatory, natural cycle. Nevertheless, the lack of timing predictability for a natural cycle FET results in increased scheduling burden on clinic staff as well as requirement for patient flexibility. The aim of this study was to evaluate FET outcomes for women with regular menstrual cycles after natural endometrial preparation, in an effort to support clinical utilization. This single center, retrospective, maternal age-matched clinical study was a two-part investigation: Part A) first FET outcomes in women with regular menstrual cycles either undergoing modified natural (n=276; mean 35.6 years) or medicated endometrial preparation (n=1,217; mean 35.6 years); Part B) modified natural FET outcomes in women with history of a prior medicated FET cycle (n=134; mean 35.2 years). Modified natural endometrial preparation included hCG trigger, low dose estradiol patches and vaginal progesterone. Implantation with fetal heart tone (FHT), live birth and miscarriage rates following single euploid blastocyst transfer were considered as the primary outcomes. Data was analyzed using a one-way ANOVA, unpaired T-tests with Welch’s correction, Fisher’s exact and Chi-square as appropriate, with significance at p < 0.05. For first FET outcomes (Part A), implantation FHT (84.1% vs 70.3%; p < 0.0001; OR 2.23) and live birth rate (79.7% vs 64.0%; p < 0.0001; OR 2.21) after modified natural endometrial preparation were significantly higher than transfers performed in medicated cycles. This was despite the fact that transferred euploid blastocyst quality was significantly better in the medicated FET group (single D5 euploid blastocyst transferred in 66.1% of medicated FETs vs 56.5% in modified natural FETs; p < 0.001). Additionally, lower miscarriage rates trended with women following a modified natural FET cycle (3.9% vs 7.3%; p = 0.07). There were no other significant differences in women’s baseline or IVF cycle characteristics, including endometrial thickness at day of progesterone start, between the two FET groups. For women who had a prior medicated cycle and returned for a second FET with modified natural endometrial preparation (Part B), clinical outcomes were also slightly improved compared to medicated FET cycles; implantation (75.7% vs 70.3%; ns), miscarriage (6.9% vs 7.3%; ns) and live birth rate (70.9% vs 64.0%; ns). In this study, the clinical efficacy of a modified natural endometrial preparation for women with regular cycles, in either a first or second FET, were evaluated to be superior. Despite the difficulty with scheduling natural cycle FETs, the improved clinical benefit and increase in live birth rates would appear to outweigh the lack of timing predictability." @default.
• W4387396460 created "2023-10-07" @default.
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• W4387396460 date "2023-10-01" @default.
• W4387396460 modified "2023-10-07" @default.
• W4387396460 title "MODIFIED NATURAL ENDOMETRIAL PREPARATION MAXIMIZES FET OUTCOMES" @default.
• W4387396460 doi "https://doi.org/10.1016/j.fertnstert.2023.08.506" @default.
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