A flexible protocol for artificial preparation of the endometrium without prior gonadotropin-releasing hormone agonist suppression in women with functioning ovaries undergoing frozen-thawed embryo transfer cycles.
OBJECTIVE
To present our experience with a flexible and convenient protocol for artificial endometrial preparation without prior GnRH agonist suppression in patients with functioning ovaries undergoing frozen ET.


METHODS
Case series.


METHODS
An IVF unit in a university hospital.


METHODS
All patients who underwent IVF with embryo cryopreservation from December 1997 to June 1998 and requested transfer of their frozen-thawed embryos.


METHODS
Controlled endometrial preparation for ET entailed the use of a fixed dose of 6 mg/d of micronized E2 started on day 1 of the cycle, followed by concomitant administration of micronized P placed in the vagina.


METHODS
Hormonal and endometrial profiles throughout the cycle, pregnancy rate per ET, implantation rate, and pregnancy outcome.


RESULTS
Of 185 treatment cycles in 140 patients, 8 cycles (4.3%) were canceled. In another 2 cycles, no embryos were suitable for transfer. For the remaining 175 ET cycles, the calculated pregnancy rate and implantation rate were 21.7% and 9%, respectively. The proliferative phase could be extended up to 20 days but was a mean (+/-SD) of 15+/-1.9 days.


CONCLUSIONS
For patients with functioning ovaries, controlled endometrial preparation for the transfer of frozen-thawed embryos can be done successfully by using oral E2 from day 1 of the cycle followed by P preparation. Prior suppression with GnRH agonist is not necessary.
Simon
A
A
Department of Obstetrics and Gynecology, Hadassah University Hospital, Mount Scopus, Jerusalem, Israel.
Hurwitz
A
A
Pharhat
M
M
Revel
A
A
Zentner
B S
BS
Laufer
N
N
D000328:Adult; D015925:Cryopreservation; D010064:Embryo Implantation; D004624:Embryo Transfer / Q000379:methods*; D004958:Estradiol / Q000008:administration & dosage*; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists; D006801:Humans; D010053:Ovary / Q000502:physiology*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011374:Progesterone / Q000008:administration & dosage*; D011446:Prospective Studies; D014621:Vagina / Q000187:drug effects
D007987:Gonadotropin-Releasing Hormone; D011374:Progesterone; D004958:Estradiol