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Related Concept Videos

In Vitro Fertilization01:24

In Vitro Fertilization

In vitro fertilization (IVF) is a form of assisted reproductive technology where an egg is fertilized with sperm in a controlled laboratory environment before transferring the resulting embryo into the uterus. This process is designed to help individuals and couples experiencing difficulties conceiving.
The IVF process begins with ovarian stimulation, during which reproductive endocrinologists prescribe hormonal medications to stimulate the ovaries to produce multiple eggs instead of the single...

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Cycle regimens for frozen-thawed embryo transfer.

T Ghobara1, P Vandekerckhove

  • 1University Hospitals Coventry & Warwickshire NHS Trust, Centre for Reproductive Medicine, Walsgrave, Coventry, UK CV2 2LB. tghobara@hotmail.com

The Cochrane Database of Systematic Reviews
|February 7, 2008
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Frozen-thawed embryo transfer (FET) pregnancy rates are lower than fresh transfers but improve cumulative rates. While GnRH agonist plus estrogen/progesterone FET showed higher live birth rates, overall evidence is insufficient to prefer one FET regimen over another.

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Area of Science:

  • Reproductive Medicine
  • In Vitro Fertilization
  • Embryo Transfer Technologies

Background:

  • Frozen-thawed embryo transfer (FET) offers advantages over fresh embryo transfer, including increased cumulative pregnancy rates, reduced costs, and simpler procedures.
  • FET can be performed using various cycle regimens: natural ovulatory cycles, ovulation induction cycles, or hormonally prepared cycles using estrogen (O) and progesterone (P), with or without gonadotropin-releasing hormone agonist (GnRHa).

Purpose of the Study:

  • To compare the effectiveness of different frozen-thawed embryo transfer (FET) cycle regimens: natural cycle FET, artificial cycle FET (hormone replacement), and ovulation induction cycle FET.
  • To determine if specific endometrial preparation protocols influence pregnancy outcomes in FET treatments.

Main Methods:

  • A systematic review and meta-analysis of randomized controlled trials (RCTs) comparing various FET cycle regimens.
  • Searched multiple databases (CENTRAL, DARE, MEDLINE, EMBASE, CINAHL) from inception to 2007.
  • Extracted data on dichotomous outcomes (e.g., clinical pregnancy rate) and continuous outcomes (endometrial thickness), calculating odds ratios (OR) and weighted mean differences (WMD).

Main Results:

  • Seven RCTs involving 1120 women were included.
  • GnRH agonist + estrogen/progesterone FET showed a significantly higher live birth rate compared to estrogen/progesterone FET alone (OR 0.38, 95% CI 0.17-0.84).
  • Human menopausal gonadotropin (HMG) FET resulted in a significantly higher pregnancy rate than clomiphene + HMG FET (OR 0.46, 95% CI 0.23-0.92). No significant differences were found between other compared regimens, though confidence intervals were often wide.

Conclusions:

  • Current evidence is insufficient to definitively recommend one frozen-thawed embryo transfer (FET) regimen over another.
  • While some specific combinations showed statistically significant advantages in certain outcomes, further research with wider confidence intervals is needed to establish superiority.