Endometrial preparation methods prior to frozen embryo transfer: a retrospective cohort study comparing true natural cycle, ovulation induction, hormone replacement treatment and GnRHa pretreatment.

IF 2.8 2区医学 Q1 OBSTETRICS & GYNECOLOGY

BMC Pregnancy and Childbirth Pub Date : 2025-03-28 DOI:10.1186/s12884-025-07211-0

Jiaoqi Mei, Nana Liu, Yuxiang Liu, Min Li

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引用次数: 0

Abstract

Purpose: To compare pregnancy outcomes of four endometrial preparation methods prior to frozen embryo transfer (FET).

Methods: A total of 3,030 programmed cycles were analyzed: 302 with natural cycle (NC), 131 with ovulation induction (OI), 1,078 with hormone replacement treatment (HRT), and 1,519 with GnRHa pretreatment (GnRHa + HRT). Primary outcomes investigated were positive human chorionic gonadotropin (hCG), chemical pregnancy, clinical pregnancy, abortion, and live birth. Additionally, the impact of age, body mass index (BMI), embryo number, high-quality embryo, and endometrial thickness on pregnancy outcomes were analyzed.

Results: The positive hCG rates for NC, OI, HRT, and GnRHa + HRT groups were 63.4%, 62.6%, 68.3%, and 71.7%, respectively (P = 0.004). Clinical pregnancy rates were 50.4%, 54%, 57.5%, and 61.8%, respectively (P = 0.004). Live birth rates were 38.2%, 45%, 46.5%, and 50.9%, respectively (P = 0.007). No significant differences were found in abortion and chemical pregnancy rates among the four protocols. NC showed significantly higher positive hCG (p = 0.044), live birth (p = 0.005), and clinical pregnancy rates (p = 0.010) compared to other methods. Compared to HRT, GnRHa + HRT displayed significantly higher live birth (p = 0.027) and clinical pregnancy rates (p = 0.027). Multiple logistic regression showed that the number of embryos and high-quality embryos increased HCG positivity, clinical pregnancy, and live birth rates, while age reduced these rates. BMI increased the abortion rate, and endometrial thickness increased the live birth rate. Chemical pregnancy was unaffected by these factors.

Conclusion: NC offers improved outcomes compared to other methods. Additionally, specific factors such as embryo quality and embryo number significantly influence pregnancy outcomes.

Clinical trial number: Not applicable.

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来源期刊

BMC Pregnancy and Childbirth OBSTETRICS & GYNECOLOGY-

CiteScore

4.90

自引率

6.50%

发文量

845

审稿时长

3-8 weeks

期刊介绍： BMC Pregnancy & Childbirth is an open access, peer-reviewed journal that considers articles on all aspects of pregnancy and childbirth. The journal welcomes submissions on the biomedical aspects of pregnancy, breastfeeding, labor, maternal health, maternity care, trends and sociological aspects of pregnancy and childbirth.