A modest increase in serum progesterone levels on the day of human chorionic gonadotropin (hCG administration may influence pregnancy rate and pregnancy loss in in vitro fertilization-embryo transfer (IVF-ET) patients

Purpose Our purpose was to study the effect of a modest increase in preovulatory serum progesterone (P₄) levels in hyperstimulated patients and its association with pregnancy rate and pregnancy loss following in vitro fertilization (IVF) and embryo transfer (ET).Patients Only patients with mechanical factor and three transferred embryos were included in the present study. They were divided into two groups according to two critical breakpoints for P₄ serum levels on the day of hCG administration: serum P₄ below 0.6 ng/ml in 28 cycles (group I) and >0.6 ng/ml in 80 cycles (group II).Setting The setting was the IVF program at Carmel Medical Center, Haifa, Israel.Results The pregnancy rate per embryo transfer was 53% (15/28) in group I and 10% (8/80) in group II (P < 0.025). Of 15 pregnancies achieved in group I, 14 were ongoing pregnancies, compared to 4 of 8 ongoing pregnancies in group II (P <0.03). Conclusions Our findings suggest that a very modest increase in serum P₄ levels on the day of hCG administration is associated with lower pregnancy and ongoing pregnancy rates in IVF-ET.     

Effects of early luteal-phase vaginal progesterone supplementation on the outcome of in vitro fertilization and embryo transfer

Objective. To determine whether early luteal-phase vaginal progesterone supplementation improves the outcome of in vitro fertilization–embryo transfer (IVF-ET).

Methods. A randomized, controlled trial was conducted on 197 women undergoing IVF-ET cycles with human chorionic gonadotropin (hCG) as the standard luteal-phase support. The participants were randomly assigned to either the study group or the control group. The study group was given 200 mg micronized progesterone vaginally three times per day starting in the afternoon of oocyte retrieval until the morning of embryo transfer, in addition to the standard hCG luteal-phase support. The control group received only the hCG support. The pregnancy rates and the implantation rates were measured.

Results. There were no significant differences in pregnancy rates or implantation rates between groups. However, subgroup analysis revealed significantly higher pregnancy and implantation rates in the study group among those women with fibroids or difficult oocyte retrieval involving uterine puncture (38.7% vs. 15.4% and 26.8% vs. 9.4% respectively, both p = 0.04).

Conclusion. Additional early luteal-phase vaginal progesterone supplementation may improve the outcome of IVF-ET in women with fibroids or difficult oocyte retrieval.     

Elective single embryo transfer: Comparison of blastocyst and cleavage-stage embryo transfer

Objective:   Blastocysts are reportedly suitable for preventing multiple pregnancies as a result of the high implantation rate per embryo. The present study compared clinical results for elective single embryo transfer (ET) between blastocysts and cleavage-stage embryos in order to ascertain the usefulness of blastocyst culturing in single ET.
Methods:   Between January 2002 and December 2004, conventional in vitro fertilization ET and/or intracytoplasmic sperm injection was carried out for single ET in 86 cycles, to prevent multiple pregnancies (for medical reasons or because of patient wishes).
Results:   Among the 80 cycles in which a fresh embryo was transferred, pregnancy/implantation rates per ET were 35.3% for day 2/3 ET and 50.0% for day 5 ET, and pregnancy/implantation rates per oocyte retrieval were 35.3% for day 2/3 ET and 44.2% for day 5 ET. Ongoing pregnancy/delivery rates per oocyte retrieval were 32.4% for day 2/3 ET and 38.5% for day 5 ET. Monozygotic twinning occurred in one case of day 5 ET.
Conclusions:   Pregnancy rates per single ET tended to be higher for day 5 ET than for day 2/3 ET. However, no marked differences were identified in ongoing pregnancy/delivery rates per oocyte retrieval between groups. (Reprod Med Biol 2005; 4 : 197–201)     

Simultaneous program of natural-cycle in vitro fertilization and cryopreserved-thawed embryo transfer

Purpose: This clinical study was designed to identify and compare the pregnancy rates of simultaneous program of natural-cycle IVF and cryopreserved-thawed ET (NICE) with those of natural-cycle IVF and cryopreserved-thawed ET. Methods: All three groups comprised spontaneously ovulating infertile women under the age of 40 and without any male factor present. The NICE program was performed in 36 patients (47 cycles) who had previously undergone IVF-ET resulting in cryopreserved embryos. As control groups, the natural-cycle IVF was performed in 45 patients (80 cycles), and the cryopreserved-thawed ET alone in 29 patients (40 cycles). Results: The cancellation rate of the initiated cycles prior to ET was 19.1% (9/47) in the NICE group, 23.8% (19/80) in the natural-cycle IVF group, and 2.5% (1/40) in the cryopreserved-thawed ET group. The mean number of embryos transferred was 4.0±1.1 (2–5) in the NICE group, 1.0 in the natural-cycle IVF group, and 4.2±1.8 (1–5) in the cryopreserved-thawed ET group. The clinical pregnancy rates per aspiration cycle (32.5%) and per ET cycle (34.2%) in the NICE group were significantly higher than those (14.9, 16.4%) in the natural-cycle IVF group. The clinical and delivered pregnancy rates per ET (34.2, 26.3%) in the NICE group were higher than those (20.5, 15.4%) in the cryopreserved-thawed ET group, without statistical significance. Conclusions: Since the NICE program results in saving the fresh oocyte for patients participating in cryopreserved-thawed ET, more favorable pregnancy rates may be obtained from NICE cycles in women ovulating normally who had previously undergone IVF-ET with embryo cryopreservation.Presented at the 50th Annual Meeting of the American Fertility Society, November 5–10, 1994, San Antonio, Texas.     

Very early pregnancy wastage in in vitro fertilization and embryo transfer (IVF-ET)

The occurrence and incidence of early pregnancy wastage in an in vitro fertilization and embryo transfer (IVF-ET) program have been studied in 750 patients. In 297 (39.6%) a pregnancy was diagnosed; of these, 14.8% were biochemical and 24.8%, clinical pregnancies. In the latter group 23.6% aborted, while 75.8% had clinical ongoing pregnancies. The mean embryo quality score of the biochemical pregnancy group was similar to that of the clinical ongoing pregnancy group but statistically different from that of the clinical abortion group (P<0.005). Furthermore, the clinical ongoing pregnancy rate in women with previous biochemical pregnancy was 24.7%, a significantly higher percentage compared to clinical ongoing pregnancies achieved in IVF-ET cycles (P<0.05). It is possible that biochemical pregnancy does not represent an index for infertility but rather an intact stage of reproduction leading toward implantation. The high clinical pregnancy rate in subsequent cycles may probably serve as an encouraging sign or a marker for future clinical pregnancy.     

Relationship between peak serum estradiol levels and treatment outcome in in vitro fertilization cycles after embryo transfer on day 3 or day 5

OBJECTIVE: To examine the relationships between peak serum estradiol (E(2)) levels and treatment outcome in in vitro fertilization (IVF) cycles after embryo transfer (ET) on day 3 or day 5. DESIGN: Retrospective analysis of 697 IVF-ET cycles between January 1999 and December 2001. SETTING: A university-affiliated assisted reproduction program. PATIENT(S): Infertile patients undergoing IVF-ET cycles. INTERVENTION(S): Peak E(2) concentration in serum was determined on the day of human chorionic gonadotropin (hCG) administration. The IVF-generated embryos were cultured for 2 days until transfer on day 3. If more than four 8-cell embryos were present on day 3, embryo culture was continued until day 5 for blastocyst transfer. MAIN OUTCOME MEASURE(S): Clinical pregnancy rates. RESULT(S): High peak E(2) levels did not adversely affect treatment outcome. After the cycles were divided according to the day of ET, high peak E(2) levels were associated with improved pregnancy rates after ET on day 5 but not on day 3. CONCLUSION(S): Increasing peak E(2) levels in IVF cycles are associated with improved pregnancy rates after ET on day 5.     

Blastocyst-stage versus cleavage-stage embryo transfer in women with high oestradiol concentrations: randomized controlled trial

This prospective, randomized, controlled trial tested the hypothesis that delaying embryo transfer to the blastocyst stage can increase the probability of clinical pregnancy and live birth in women with high oestradiol concentrations on the day of human chorionic gonadotrophin (HCG) undergoing intracytoplasmic sperm injection using the long protocol. A total of 200 women with oestradiol >3000 pg/ml on the HCG day with four or more good-quality, day-3 embryos were randomized in a 1:1 ratio to undergo day-3 or day-5 embryo transfer. Clinical pregnancy rates (CPR; 41% versus 59%; relative risk 0.70, 95% CI 0.52–0.93) and ongoing pregnancy/live-birth rates (35% versus 52%; relative risk 0.67, 95% CI 0.46–0.93) were lower in women undergoing cleavage-stage than blastocyst-stage embryo transfer. Using receiver operating characteristic curves, among women undergoing cleavage-stage embryo transfer, a detrimental cut-off value for not achieving pregnancy for oestradiol was 4200 pg/ml, with lower CPR and ongoing pregnancy/live-birth rates (P = 0.006 and 0.02, respectively). No detrimental cut-off value for oestradiol was identified among women undergoing blastocyst-stage embryo transfer. Delaying embryo transfer to the blastocyst stage can increase the probability of pregnancy in women with high oestradiol on the HCG day     

两种不同胚胎装载技术对体外受精-胚胎移植及冻融胚胎移植临床结局的影响

目的探讨两种不同胚胎装载技术对体外受精-胚胎移植(IVF-ET)和冻融胚胎移植(FET)临床妊娠率及胚胎种植率的影响。方法回顾性分析了543个新鲜胚胎移植周期及658个FET周期。根据移植时胚胎装载方法分为A组(含胚培养液体积周围空气体积)和B组(含胚培养液体积周围空气体积)。比较两种胚胎装载方法对妊娠结局的影响。结果新鲜周期中,B组的临床妊娠率(64.52%)显著高于A组(54.62%)(P0.05),种植率组间虽无统计学差异(P0.05),但B组明显高于A组。FET周期中卵裂胚移植B组的临床妊娠率(49.43%)明显高于A组(38.24%),但没有统计学差异(P0.05),B组(34.62%)的种植率显著高于A组(23.61%)(P0.05)。囊胚移植两组的妊娠率和种植率均没有统计学差异(P0.05),但B组比A组有增高的趋势。结论胚胎移植时含胚培养液体积周围空气体积会显著提高IVF-ET和FET的临床妊娠率和种植率。     

卵巢高反应患者全胚冷冻临床应用研究

目的 探讨卵巢高反应患者新鲜移植周期与冻融胚胎移植(frozen-thawed embryo transfer, FET)周期妊娠结局的差异,了解促排卵药物对新鲜周期子宫内膜容受性的影响。方法 回顾性分析2011年1月至2013年12月在中国医科大学附属盛京医院生殖中心促排卵周期行新鲜胚胎移植(582例)和全部胚胎冷冻再行FET(167例)周期的临床妊娠率、生化妊娠率、种植率、胚胎停育率、异位妊娠率、流产率、持续妊娠率和多胎妊娠率。结果 582例促排卵周期新鲜胚胎移植与167例FET周期比较临床妊娠率（42.44% vs. 69.46%）,生化妊娠率（7.22% vs. 2.99%）,种植率（28.27% vs. 48.99%）,胚胎停育率（8.10% vs. 7.76%）,异位妊娠率（5.26% vs. 4.31%）,流产率（8.10% vs. 6.90%）,持续妊娠率（34.19% vs. 59.88%）,多胎率（35.22% vs. 37.93%）。组间比较临床妊娠率、生化妊娠率、种植率、持续妊娠率差异均有统计学意义(P<0.05)。结论 全胚冷冻再行冻融周期移植可显著提高卵巢高反应患者临床妊娠率、种植率及持续妊娠率,不增加多胎率的发生,可获得更为理想的妊娠结局。新鲜周期高雌激素可能对子宫内膜容受性有损害作用。     

Anti-Müllerian hormone in association with euploid embryo transfer outcomes

Research questionTo investigate the association between anti-Müllerian hormone (AMH) concentration and maternal age with single euploid cryopreserved embryo transfer.DesignRetrospective cohort study from 2014 to 2018 at an academic medical centre, including 389 cycles of IVF with 24-chromosome Day 5/6 preimplantation genetic testing for aneuploidies (PGT-A). Multivariate logistic regression was used to study AMH and age in relation to IVF outcomes (positive beta human chorionic gonadotrophin [bHCG], ongoing pregnancy and pregnancy loss rates) for patients with at least one euploid embryo for transfer, controlling for patient and cycle confounders.ResultsIn this cohort the overall unadjusted positive bHCG rate was 69.2% and ongoing pregnancy rate was 52.7% per transfer, while the pregnancy loss rate was 23.4% per cycle with positive bHCG. Multivariate analysis found that compared with the reference group of AMH 1 to <5 ng/ml, AMH <1 and 5+ did not have any significant difference in positive bHCG (odds ratio, OR 0.65 [0.30–1.44] and 1.27 [0.61–2.65] for AMH <1 and AMH 5+, respectively) or ongoing pregnancy (OR 0.80 [0.43–1.50] and 1.41 [0.68–2.90]). However, AMH <1 had statistically significant lower euploid miscarriage rates compared with the reference group with OR 0.32 (0.12–0.85, P = 0.022); AMH 5+ did not have any statistical difference in miscarriage rate. Neither age at retrieval nor age at transfer were significantly associated with transfer outcomes.ConclusionsAMH concentration was not associated with positive bHCG or ongoing pregnancy for euploid embryo transfers after adjustment for potential confounders. Maternal age was not associated with euploid transfer outcomes. Further study is warranted in larger cohorts.     

Predictive value of hCG level 14 days after embryo transfer

Objective It has been reported that the quantitative serum hCG level 14 days after embryo transfer (ET) correlated with pregnancy outcome as well as a likelihood of a multiple gestation pregnancy. This prospective study was designed to assess the predictive value of a 14-day post-ET hCG level with pregnancy outcome and multiple gestation pregnancies.Methods Patients undergoing in vitrofertilization (IVF) and ET were monitored by serum quantitative hCG levels 14 days after ET. If positive, serial values of hCG were obtained and transvaginal ultrasound was performed 3 weeks after ET and weekly until fetal cardiac activity was seen. Ongoing pregnancies were defined as greater than 20 weeks.Results One hundred eleven patients had positive serum quantitative hCG levels 14 days post-ET; 89/111, or 80.2%, had ongoing pregnancies. The spontaneous miscarriage rate was, therefore, 19.8% (22/111). If the level was less than 300, the ongoing multiple pregnancy rate was 9% (5/57). If the level was between 300 and 600, the ongoing pregnancy rate was 40% (10/25). If the hCG level was greater than 600, the multiple pregnancy rate was 100% (7/7).Conclusions These data support the hypothesis that hCG levels greater than 200 mIU/ml on 14 days post-ET are more likely to have ongoing pregnancies; hCG levels greater than 600 have a high likelihood of a multiple gestation pregnancy.Presented at the 50th Annual Meeting of the American Fertility Society, San Antonio, Texas, November 5–10, 1994.     

Multiple attempts at embryo transfer: Effect on pregnancy outcome in an in vitro fertilization and embryo transfer program

Purpose This study derives from the observation that a correlation exists between failed first attempts (FFA) at embryo transfer caused by one or more embryos remaining in the catheter and reduced pregnancy rates (20.3 vs 3.0%). The aim of this study was to examine the relationship between failed first attempts at transfer and contamination of the transfer set; the related aspects of cervix dilatation and late embryo transfer were also investigated.Results The following observations were made. Retention of embryos in the transfer sets significantly reduced the pregnancy rate (P =0.015); catheters contaminated with blood and cervical mucus indirectly contributed to this effect by increasing the incidence of failed first transfer attempts. Even though cervical dilatations, if indicated by uterus sounding, were done 2 days before embryo transfer, no pregnancies were effected in these 18 cases (P =0.0001). Late transfers of embryos, due to delayed fertilization or slow cleavage rates, yielded a pregnancy rate of 10.5%. Conclusion The approach of immediately retransferring retained embryos does not solve the problem of reduced pregnancy rates in FFA cases. It is suggested that ET should be repeated 1 day later in FFA cases in an attempt to improve pregnancy rates.     

Ultrasound guided embryo transfer significantly improves pregnancy rates in women undergoing oocyte donation.

OBJECTIVES: Recent reports suggest ultrasound (US) guided embryo transfer (ET) improves pregnancy rates. Using the ovum donation model to eliminate confounding variables, we assessed the impact of US guided ET on pregnancy rates, implantation rates, and multiple gestation rates. METHODS: All women who underwent IVF-ET cycles using donated oocytes from November 1997 to September 1998 (n = 137) were evaluated retrospectively. ET from November 1997 to April 1998 were performed without US, while all ET from May 1998 to September 1998 were performed using transvaginal or transabdominal US. ET was further categorized as easy or difficult. Difficult ET was defined as requiring at least two attempts and/or the presence of blood on the catheter and/or > 5 min. RESULTS: Pregnant patients (n = 73) were similar with respect to the number and morphology of the embryos transferred compared to non-pregnant patients (n = 65). US guidance significantly improved implantation and pregnancy rates in cycles with easy transfers [28.8 vs. 18.4% and 63.1 vs. 36.1%, respectively (P < 0.05)] without impacting multiple pregnancy rates. CONCLUSION: US guided ET is simple and reassuring and appears to significantly improve pregnancy outcomes in ovum donation cycles by optimizing the placement of embryos.     

A study of intrauterine infusion of human chorionic gonadotropin (hCG) before frozen-thawed embryo transfer after two or more implantation failures

Objective: To investigate the effect of intrauterine infusion of human chorionic gonadotropin (hCG) before frozen-thawed embryo transfer (FET) after two or more implantation failures (TIFs).

Methods: The study was a prospective randomized single-blind study of 161 cycles in patients undergoing FET who had TIFs. The intervention group received an intrauterine injection of 1000?IU of hCG before embryo transfer (ET) (n?=?62). A placebo group (n?=?49) received an intrauterine injection of physiological saline before ET. A control group (n?=?50) did not receive an intrauterine injection. Clinical pregnancy rates, abortion rates, and ongoing pregnancy rates were compared between the three groups.

Results: The clinical pregnancy rates were 59.68%, 53.06%, and 32.00% in the hCG group, placebo group, and control group, respectively. The clinical pregnancy rates were significantly higher in the hCG and placebo groups than in the control group. There were no significant differences in the abortion rates among the three groups.

Conclusion: An intrauterine administration of hCG before FET significantly improved the pregnancy rates after TIFs. But local injury caused by the operation of intrauterine perfusion may play an important role in improving clinical pregnancy rates.     

The graduated embryo score predicts the outcome of assisted reproductive technologies better than a single day 3 evaluation and achieves results associated with blastocyst transfer from day 3 embryo transfer

OBJECTIVE: To evaluate the graduated embryo score (GES) for predicting assisted reproductive technology (ART) outcome compared to a single morphologic evaluation on day 3 of culture (grade A: > or =7 cells; <20% fragmentation). DESIGN: Prospective cohort analysis. SETTING: Private practice. PATIENT(S): Women aged <40 years with a normal uterine cavity treated with ART (n = 106). INTERVENTION(S): Embryos were graded by GES and by day 3 morphologic characteristics alone before ET. Cycle outcomes were compared with embryo grade. MAIN OUTCOME MEASURE(S): Ongoing gestation and implantation rates. RESULT(S): Overall ongoing gestation and implantation rates were 48% and 26%, respectively. With 1+ embryo GES > or =70 (n = 77), the rates were 62% and 36%, respectively, which were significantly higher than for those with 0 embryos GES > or =70 (n = 29). With 1+ grade A embryo (n = 102), the rates were 50% and 27%, respectively. Transfer of more than one embryo GES > or =70 did not improve the pregnancy rate, but did increase the risk of multiple gestations. A single day 3 evaluation had an extremely low specificity (7%) compared to GES (47%). Graduated embryo scoring (GES) was an excellent predictor of pregnancy and implantation rates from blastocyst transfer. Day of transfer did not affect pregnancy rates, although implantation was higher from day 5 embryo transfer (ET) than from day 3 ET, as fewer embryos were transferred. CONCLUSION(S): Transfer of one or more embryo GES > or =70 predicts pregnancy and implantation rates better than a single morphologic evaluation on day 3 and achieves ART outcomes associated with blastocyst transfer from day 3 ET, making extended culture unnecessary for most patients.     

Natural cycle as first approach in aged patients with elevated follicle-stimulating hormone undergoing intracytoplasmic sperm injection: A pilot study

Background.?Poor ovarian response to standard in vitro fertilization–embryo transfer (IVF-ET) protocols or different regimens of treatment, as consequence of a diminished ovarian reserve, correlates strictly with patient age, elevated follicle-stimulating hormone (FSH) and reduced antral follicle count. The aim of the present pilot study was to evaluate the outcome of patients with poor prognostic features undergoing IVF-ET with natural cycles as a first approach and not as a consequence of a previous failure treatment.

Materials and methods.?Eighteen aged patients (mean ± standard deviation 40.2 ± 0.7 years, range 37–43 years) with elevated serum FSH and reduced antral follicle count underwent intracytoplasmic sperm injection (ICSI) after spontaneous ovulation.

Results.?A total of 26 natural cycles with ICSI were analyzed. Pregnancy was observed in three patients, of which two were ongoing as assessed by fetal heart beat at ultrasound scan performed 4–5 weeks after ET.

Conclusion.?The overall pregnancy rates achieved (11.5% per cycle, 20.0% per ET) are comparable with those of conventional IVF-ET in aged patients, and not impaired by a single embryo transferred. Better embryo quality, as a consequence of natural selection of oocytes, better endometrium receptivity and monthly repeatability of the procedure, can balance the relatively low chance to perform ET.     

Initial IVF-ET experience with assisted hatching performed 3 days after retrieval followed by day 5 embryo transfer

OBJECTIVE: To report our initial IVF-ET experience combining assisted hatching performed 3 days after oocyte retrieval with day 5 embryo transfer (ET). DESIGN: Retrospective review of 110 consecutive IVF cycles not involving donor oocytes, including 16 cycles that involved assisted hatching performed 3 days after oocyte retrieval in combination with day 5 ET. SETTING: Academic teaching hospital IVF center. PATIENT(S): Eighty-six consecutive IVF patients undergoing ET. INTERVENTION(S): Assisted hatching using acid Tyrode's solution performed 3 days after oocyte retrieval in selected cases in combination with day 3 or 5 ETs. MAIN OUTCOME MEASURE(S): Clinical pregnancy rate per ET. RESULT(S): Of the 16 women undergoing day 5 ET following day 3 assisted hatching, 14 had a clinical pregnancy. These included 11 ongoing/delivered singletons and 2 ongoing/delivered twin pregnancies, neither of which was monochorionic. These clinical and ongoing/delivered pregnancy rates compared very favorably with those of 54% and 46%, respectively, for the 35 patients undergoing day 5 ETs without assisted hatching, even though the latter group appeared to be better IVF candidates based on the prognostic factors commonly used to predict success. CONCLUSION(S): Our experience suggests that day 3 assisted hatching followed by day 5 ET may be a useful combination in selected patients. Although not seen in our small series, an increased risk of monochorionic pregnancies remains a theoretical concern when such a combination is used, since both assisted hatching and blastocyst transfers have been independently linked to an increased risk in some reports.     

胚胎移植技术对IVF临床妊娠率的影响

目的 :研究胚胎移植技术对IVF临床妊娠率的影响。方法 :分析IVF ET 373例移植管是否沾血 ,移植管放置的难易度及移植持续时间。结果 :移植管沾血组的临床妊娠率、胚胎种植率明显低于未沾血组 ,胚胎残留率高于未沾血组 ;插管顺利组的临床妊娠率明显高于插管有阻力组、困难组及极困难组 ;移植持续 5～ 15min组的临床妊娠率与 <5min组无明显差异。结论 :胚胎移植时出血、插管困难降低了IVF的临床妊娠率。     

Endometrial receptivity is preserved in Diethylstilbestrol-associated and other Müllerian anomalies: Evidence from tubal embryo transfer

Purpose  To report implantation and pregnancy rates following TET in women with anomalous uteri, and to compare these with previously reported rates following trans-cervical ET. Materials and Methods  Between 1995 and 2003, 12 TET procedures were performed in seven women with Müllerian anomalies. Tubal ET was performed via laparoscopy 48 h after standard IVF in 3 cycles in two patients, whereas in 9 cycles in five patients, TET was performed 24 h or 48 h following oocyte donation. Results  Of the seven patients, 5 (71%) had a history of 15 failed cycles with trans-cervical ET. The 12 TET procedures resulted in eleven clinical pregnancies (92%; 95% CI: 63, 99%). There were seven deliveries/ongoing pregnancies (58%; 95% CI: 27%, 85%). Conclusions  We observed high implantation and ongoing pregnancy rates in women with Müllerian anomalies, suggesting that 1) endometrial receptivity in anomalous uteri is preserved, and 2) transfer efficiency is reduced but may be restored with the use of TET. Capsule Tubal embryo transfer results in high implantation and live birth rates in women with diethylstilbestrol-exposed and other anomalous uteri, suggesting that endometrial receptivity is preserved.     

The addition of single dose GnRH agonist to luteal phase support in artificial cycle frozen embryo transfer: a randomized clinical trial

This prospective randomized clinical trial (RCT) was to evaluate the effect of single-dose gonadotrophin-releasing hormone agonist (GnRHa) in artificial cycle frozen-embryo transfer (AC-FET). A total of 868 FET cycles were included and randomized into two groups: Group A (n?=?434) received GnRHa 0.1?mg subcutaneous injection on day 3 after embryo transfer (ET); Group B (n?=?434) did not receive GnRHa. The demographic characteristics, primary endpoint (implantation rate) and secondary endpoints (chemical pregnancy rate, clinical pregnancy rate, ongoing pregnancy rate) were compared between two groups and subgroups (aged <35?years and 35-37?years). There were no significant differences in terms of the rates of implantation, clinical pregnancy, ongoing pregnancy, and miscarriage between two groups. While, the subgroups analysis showed the implantation rate was significantly increased in advanced age women (35–37?years) in GnRHa group compared with control group (45.3% vs. 27.8%, p?=?.03). In conclusion, single dose of GnRHa (0.1?mg triptorelin acetate) supplementation 3?days after ET in AC-FET cycles did not show significant benefit on pregnancy outcomes as a whole. However, in ageing women subgroup, the implantation rate was increasing by adding up GnRHa in peri-implantation periods, and this tendency needs to be further demonstrated by RCT with larger sample size.