Comparison of stimulated versus modified natural cycles for endometrial preparation prior to frozen embryo transfer: a randomized controlled trial. Issue 4 (April 2020)

• Record Type: Journal Article
• Authors: Labrosse, Julie; Lobersztajn, Annina; Pietin-Vialle, Claire; Villette, Claire; Dessapt, Anne Lucie; Jung, Camille; Brussieux, Maxime; Bry-Gauillard, Helene; Pasquier, Maud; Massin, Nathalie
• Is Part Of: Reproductive biomedicine online. Volume 40:Issue 4(2020)
• Page Start: 518
• Page End: 524
• Publication Date: 2020-04
• Subjects: Endometrial preparation -- FertiQol -- Frozen embryo transfer -- Modified natural cycle -- Stimulated cycle; Human reproductive technology -- Periodicals; Human embryo -- Periodicals; Reproduction -- Periodicals; 616.692
• DOI: 10.1016/j.rbmo.2020.01.007
• Languages: English
• ISSNs: 1472-6483

Abstract

Abstract: Research question: To compare stimulated cycle (STC) versus modified natural cycle (MNC) for endometrial preparation prior to frozen embryo transfer (FET) in terms of convenience and efficacy. Design: Prospective, open-label, randomized controlled study including 119 patients aged 20–38 years, undergoing intra-conjugal IVF/intracytoplasmic sperm injection, having regular cycles, at least two day 2 or day 3 frozen embryos, for whom it was the first or second FET performed, randomized to either MNC ( n = 59) or STC ( n = 60). Monitoring consisted of ultrasound and hormonal measurements. The number of monitoring visits required was compared between the two groups. Results: STC required a significantly lower number of monitoring visits compared with MNC (3.6 ± 0.9 versus 4.4 ± 1.1, respectively, P < 0.0001), a lower number of blood tests (2.7 ± 0.8 versus 3.5 ± 1.0, respectively, P < 0.0001) and of ultrasounds (1.2 ± 0.4 versus 1.5 ± 0.6, respectively, P = 0.0039). FET during 'non-opening' hours (22.6% versus 27.5%, respectively, P = 0.32) and cancellation rates (11.7% versus 11.9%, respectively, P = 0.97) were comparable between the STC and MNC groups. No difference concerning HCG-positive rates (34.0% versus 23.1%, respectively, P = 0.22) nor live birth rates (24.5% for STC versus 23.1% for MNC, respectively, P = 0.86) was observed. Quality of life as defined by the FertiQol score was not different ( P > 0.05 for each item). Conclusion: Altogether, these findings can be used for everyday clinical practice to better inform patients when deciding on the protocol to use for FET. These results suggest that MNC is a good option for patients reluctant to have injections, but requires increased monitoring. STC may offer more flexibility for patients and IVF centres.