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In Vitro Fertilization01:24

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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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Morphometric Protocol for the Objective Assessment of Blastocyst Behavior During Vitrification and Warming Steps
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Natural Cycle Frozen Embryo Transfer: Evaluating Optimal Protocols for Preparation and Timing.

Kai N Holder1, Jessica S Mormol2, Jennifer B Bakkensen3

  • 1Northwestern University Feinberg School of Medicine, Chicago, IL, USA.

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|February 7, 2024
PubMed
Summary

Natural cycle frozen embryo transfer (NC-FET) protocols show varied approaches. Different ovulation induction, trigger, and timing methods did not significantly impact implantation, pregnancy, or live birth rates in this study.

Keywords:
Endometrial preparationfrozen embryo transfernatural cycle

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Area of Science:

  • Reproductive endocrinology
  • Infertility treatments
  • Assisted reproductive technologies

Background:

  • Natural cycle frozen embryo transfer (NC-FET) is increasingly utilized.
  • Significant practice variations exist in NC-FET protocols, including ovulation induction, trigger administration, and embryo transfer timing.
  • There is no established consensus on the optimal NC-FET protocol.

Purpose of the Study:

  • To evaluate the association between key NC-FET protocol aspects and cycle outcomes.
  • To assess the impact of letrozole use, ovulation trigger method, and transfer timing on implantation, pregnancy, and live birth rates.

Main Methods:

  • Retrospective cohort study of blastocyst stage NC-FET cycles (October 2019 - July 2021).
  • Evaluated three primary predictors: letrozole use, exogenous trigger vs. spontaneous LH surge, and trigger-based vs. progesterone-based timing.
  • Primary outcomes included implantation, clinical pregnancy, and ongoing pregnancy rates.

Main Results:

  • 183 cycles from 170 patients were analyzed.
  • Average implantation rate was 0.58; clinical pregnancy rate was 59.0%; ongoing pregnancy rate was 51.4%.
  • No significant associations were found between any of the evaluated protocol variations and implantation, clinical pregnancy, ongoing pregnancy, or live birth rates after adjustment.

Conclusions:

  • Various NC-FET preparation and timing protocols may yield comparable outcomes.
  • Flexibility in protocol selection based on patient and physician preference may be possible.
  • Findings require validation through larger, randomized trials.