title: Artificial versus stimulated cycles for endometrial preparation prior to frozen-thawed embryo transfer.
abstract: The objective of this study was to compare the implantation rate, pregnancy rate and endometrial thickness of frozen-thawed embryo transfers using endometrial preparation with either an artificial cycle or stimulated cycle. This was a prospective randomized trial at a single academic IVF centre. Seventy-seven patients undergoing artificial cycles received oral oestradiol; patients with endometrium < 7 mm on day 9-10 were switched to vaginal oestradiol. Eighty-six patients undergoing stimulated cycles received recombinant FSH followed by human gonadotrophin hormone injection. Vaginal progesterone was begun 2 or 3 days prior to embryo transfer. There was no difference in implantation rate (8.5% versus 7.3%), pregnancy rate (16% versus 13%), cancellation rate (both 23%) or endometrium thickness (8.7 +/- 1.1 mm versus 8.7 +/- 1.0 mm) between artificial and stimulated cycles. Stimulated cycles had a higher incidence of thin endometrium (27% versus 5%, P < 0.01). In artificial cycles, patients switched to vaginal oestradiol had improved pregnancy rate (31%) versus patients who received oral oestradiol alone (13%) (P = 0.05). It is concluded that artificial and stimulated cycles produce comparable pregnancy rates, implantation rates, cancellation rates and endometrial thickness, although stimulated cycles have a higher incidence of thin endometrium. Vaginal oestradiol supplementation improved implantation rates.
authors.affiliation: Department of Obstetrics and Gynecology, Women and Infants' Hospital, Brown Medical School, Providence, RI, USA. kristen.wright@vtmednet.org
authors.forename: Kristen Page
authors.initials: KP
authors.lastname: Wright
authors.forename: Juliette
authors.initials: J
authors.lastname: Guibert
authors.forename: Sherry
authors.initials: S
authors.lastname: Weitzen
authors.forename: Celine
authors.initials: C
authors.lastname: Davy
authors.forename: Patricia
authors.initials: P
authors.lastname: Fauque
authors.forename: Francois
authors.initials: F
authors.lastname: Olivennes
mesh_terms: D000328:Adult; D015925:Cryopreservation; D010064:Embryo Implantation; D004624:Embryo Transfer; D004717:Endometrium / Q000000981:diagnostic imaging / Q000187:drug effects / Q000502:physiology*; D004958:Estradiol / Q000627:therapeutic use; D005260:Female; D005640:Follicle Stimulating Hormone / Q000627:therapeutic use; D006801:Humans; D011247:Pregnancy; D018873:Pregnancy Rate; D011374:Progesterone / Q000627:therapeutic use; D014463:Ultrasonography
chemical_list: D011374:Progesterone; D004958:Estradiol; D005640:Follicle Stimulating Hormone