Pregnancy And Neonatal Outcomes Of HMG Stimulation With Or Without Letrozole In Endometrial Preparation For Frozen-Thawed Embryo Transfer In Ovulatory Women: A Large Retrospective Cohort Study

Overview

Journal Drug Des Devel Ther

Specialty Pharmacology

Date 2019 Dec 10

PMID 31814708

Citations 5

Authors

Jiaying Lin

Ningling Wang

Jialv Huang

Renfei Cai

Yong Fan

Yanping Kuang

Yun Wang

Affiliations

Soon will be listed here.

Abstract

Objective: Frozen-thawed embryo transfer enables surplus embryos derived from IVF or IVF-ICSI treatment to be stored and transferred in subsequent cycles into a more "physiologic environment". This study aimed to investigate the clinical effect of letrozole use or hMG stimulation on pregnancy and neonatal outcomes in ovulatory patients undergoing FET.

Methods: This study includes a total of 5901 FET cycles with letrozole use (n = 1569), HMG (n =1827) or letrozole + HMG (n = 2505). In the letrozole group, 2.5 mg of letrozole was administered on menstrual cycle day 3 to 5 for 3 days for patients, and then follicle growth was monitored beginning on day 10. If the follicular diameter was ≥14 mm on the 10th day, no other ovarian stimulation drugs were needed. If the follicular diameter was <14 mm on the 10th day, 150 IU human menopausal gonadotropin (hMG) was added to stimulate follicle growth every two days (hMG + letrozole group). In hMG stimulation group, a total of 150 IU of hMG was injected every two days to stimulate development of follicles from cycle day 10 to 12.

Results: Compared with the patients undergoing hMG stimulation, the group receiving letrozole or letrozole+HMG stimulation exhibits significantly higher clinical pregnancy rates per transfer (hMG: 47.02% vs letrozole: 52.07% vs letrozole+HMG: 52.26%) and implantation rates (hMG: 31.76% vs letrozole: 34.36% vs letrozole+HMG: 34.24%). In addition, the letrozole group was associated with a statistically significantly lower incidence of miscarriage (hMG: 14.78% vs letrozole: 10.53% vs letrozole+HMG: 14.13%) and ectopic pregnancies (hMG: 1.83% vs letrozole: 0.97% vs letrozole+HMG: 1.58%) than the letrozole + HMG and HMG groups. Neonatal outcomes are similar among the three groups.

Conclusion: Our data demonstrate that the letrozole use may improve clinical pregnancy outcomes and decrease the risk of ectopic pregnancies and miscarriage in ovulatory patients who receive FET cycles.

Citing Articles

Effect of different endometrial preparation methods on pregnancy outcome of FET in women with a normal menstrual cycle.

Guan H, Tang H, Li H, Song H, Zhao J, Song J J Family Med Prim Care. 2024; 13(6):2477-2484.

PMID: 39027832 PMC: 11254059. DOI: 10.4103/jfmpc.jfmpc_1719_23.

Ovulation induction regimens are associated with a higher rate of livebirth after frozen single-blastocyst transfer among women with polycystic ovary syndrome.

Niu Y, Zhao D, Wang Y, Suo L, Zou J, Wei D Front Endocrinol (Lausanne). 2022; 13:987813.

PMID: 36046783 PMC: 9423737. DOI: 10.3389/fendo.2022.987813.

Concurrent Ovarian and Tubal Ectopic Pregnancy After IVF-ET: Case Report and Literature Review.

Huang Y, Huang Q, Liu J, Guo M, Liu Y, Lai D Front Physiol. 2022; 13:850180.

PMID: 35444560 PMC: 9013932. DOI: 10.3389/fphys.2022.850180.

Systematic review update and meta-analysis of randomized and non-randomized controlled trials of ovarian stimulation versus artificial cycle for endometrial preparation prior to frozen embryo transfer in women with polycystic ovary syndrome.

Zhang Y, Wu L, Li T, Wang C, Zhang T, Chung J Reprod Biol Endocrinol. 2022; 20(1):62.

PMID: 35366912 PMC: 8976372. DOI: 10.1186/s12958-022-00931-4.

Live birth rate of twin pregnancies after frozen embryo transfer: natural cycle versus ovulation induction regimens.

Zhao D, Zhao G, Fan J, Chen H, Lopriore E, Li X Arch Gynecol Obstet. 2021; 304(3):619-626.

PMID: 33677679 DOI: 10.1007/s00404-021-06014-w.

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