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Cycle regimens for frozen-thawed embryo transfer.

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This review found insufficient evidence to recommend one frozen-thawed embryo transfer (FET) cycle regimen over another for subfertile women. More research is needed to determine the most effective FET preparation methods for improved pregnancy outcomes.

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Area of Science:

  • Reproductive Medicine
  • Gynecology
  • Infertility Treatment

Background:

  • Frozen-thawed embryo transfer (FET) is a key component of assisted reproductive technology (ART).
  • Historically, FET cycles have shown lower pregnancy rates than fresh embryo transfers.
  • FET offers benefits including increased cumulative pregnancy rates, reduced costs, and shorter treatment times.

Purpose of the Study:

  • To compare the effectiveness and safety of different FET cycle regimens.
  • To evaluate natural cycle FET, hormone therapy (HT) FET, and ovulation induction FET.
  • To compare subtypes within these regimens.

Main Methods:

  • Systematic review and meta-analysis of randomized controlled trials (RCTs).
  • Searched multiple databases for relevant studies up to December 2016.
  • Included 18 RCTs involving 3815 women, focusing on live birth rates and miscarriage.

Main Results:

  • Low to very low quality of evidence across comparisons.
  • No significant differences found between natural cycle FET and HT FET (with or without GnRHa suppression) for live birth or multiple pregnancy rates.
  • HT FET alone was associated with lower live birth rates compared to HT FET with GnRHa suppression.
  • Human menopausal gonadotrophin (HMG) alone showed higher live birth rates than clomiphene plus HMG in ovulation induction FET.

Conclusions:

  • Insufficient evidence to recommend one FET cycle regimen over another for women with regular ovulatory cycles.
  • The most common FET modalities are natural cycles and HT cycles, with limited direct comparative data.
  • Further high-quality research is needed to guide optimal FET preparation strategies.