title: Endometrial preparation protocol of the frozen-thawed embryo transfer in patients with polycystic ovary syndrome.
abstract: OBJECTIVE
  To assess which is the optimal protocol in terms of endometrial preparation prior to frozen-thawed embryo transfer (FET) in women with polycystic ovarian syndrome (PCOS) and to explore the effect in stimulated cycle with the addition of vaginal 17-β oestradiol.
  
  
  METHODS
  Five hundred and seventy-six patients with PCOS were prepared for FET using artificial cycle induced with oestradiol and progesterone supplementation (n = 291) and stimulated cycle induced by human menopausal gonadotrophin (HMG) within or without the addition of vaginal 17-β oestradiol (n = 285). Then the FET was performed in a receptive endometrium.
  
  
  RESULTS
  Endometrial thickness was similar (9.03 ± 1.65 vs. 9.12 ± 1.58, P > 0.05) in artificial and stimulated cycle. The two protocols resulted in clinical pregnancy rate (41.0 % vs. 41.6 %, P > 0.05), ongoing pregnancy rate (36.6 % vs. 34.7 %, P > 0.05), live birth rate (30.0 % vs. 31.7 %, P > 0.05), which were not statistically different. Nevertheless, the cancelled cycle rate made a significant difference (2.2 % vs. 5.4 %, P < 0.05). There is no significant difference in the clinical pregnancy rate in HMG, HMG added with vaginal oestradiol and HMG switch to vaginal oestradiol group (42.6 %, 41.1 %, and 33.3 %, respectively).
  
  
  CONCLUSIONS
  The mean endometrial thickness, clinical pregnancy rate, ongoing pregnancy rate, live birth rate and implantation rate were similar in artificial and stimulated cycle for endometrial preparation prior to FET in PCOS. It was fine to add vaginal 17-β oestradiol to stimulated cycle when necessary. However, stimulated cycles had a significantly higher cancelled cycle rate. We should follow the principles of individualization, securitization and optimization in endometrial preparation of the FET in patients with PCOS.
authors.affiliation: Kunming Medical University, Yunnan, People's Republic of China.
authors.forename: Jianmei
authors.initials: J
authors.lastname: Yu
authors.forename: Yanping
authors.initials: Y
authors.lastname: Ma
authors.forename: Ze
authors.initials: Z
authors.lastname: Wu
authors.forename: Yonggang
authors.initials: Y
authors.lastname: Li
authors.forename: Li
authors.initials: L
authors.lastname: Tang
authors.forename: Yunxiu
authors.initials: Y
authors.lastname: Li
authors.forename: Bo
authors.initials: B
authors.lastname: Deng
mesh_terms: D000328:Adult; D001723:Birth Rate; D015925:Cryopreservation; D010064:Embryo Implantation; D004624:Embryo Transfer / Q000379:methods*; D004717:Endometrium / Q000187:drug effects; D004958:Estradiol / Q000494:pharmacology*; D005260:Female; D006801:Humans; D008596:Menotropins / Q000494:pharmacology; D011085:Polycystic Ovary Syndrome / Q000150:complications*; D011247:Pregnancy; D018873:Pregnancy Rate; D011374:Progesterone / Q000494:pharmacology; D011446:Prospective Studies
chemical_list: D011374:Progesterone; D004958:Estradiol; D008596:Menotropins