Effect of Estrogen Starting Time on the Outcome of Frozen-Thawed Embryo Transfer in Hormone Replacement Treatment after GnRHa Down Regulation

doi:10.12280/gjszjk.20200355

Abstract

Abstract:

Objective: To study the effect of estrogen starting time on the outcome of frozen-thawed embryo transfer (FET) in hormone replacement treatment (HRT) after GnRHa down regulation. Methods: The 436 cycles of FET with GnRHa down regulation + HRT protocol were studied retrospectively. According to the rising or falling trend of serum estrogen level (E₂) before the start of estrogen, these cycles were divided into two groups. Group A: E₂ showed an upward trend before estrogen starting, 262 cycles; Group B, E₂ showed a downward trend before estrogen starting, 174 cycles. The baseline characteristics, clinical indicators after down regulation and pregnancy outcome between the two groups were compared. Results: There were no statistically significant differences in baseline characteristics such as age, body mass index (BMI), years of infertility, and baseline of serum hormone between the two groups (P>0.05). The average days of estrogen use and the amount of estrogen in the group A were significantly lower than those in the group B (both P<0.05). The early miscarriage rate in the group A was lower than that in the group B (P<0.05). Conclusions: During the GnRHa down regulation + HRT cycles, estrogen starting when the level of serum estrogen shows an upward trend can shorten the using days of exogenous estrogen, save the amount of exogenous estrogen, decrease early miscarriage, and improve the pregnancy outcome in the end.

Key words: Down regulation, Gonadotropin-releasing hormone, Hormone replacement therapy, Frozen-thawed embryo transfer, Embryo transfer, Endometrial preparation protocol, Estrogen starting time, Early miscarriage

XING Ya-chun, SU Yan, ZHAO Chun, LI Xin, LING Xiu-feng. Effect of Estrogen Starting Time on the Outcome of Frozen-Thawed Embryo Transfer in Hormone Replacement Treatment after GnRHa Down Regulation[J]. Journal of International Reproductive Health/Family Planning, 2021, 40(2): 89-92.

Figures/Tables 3

References 17

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组别	周期数	年龄（岁）	BMI（kg/m²）	不孕时间（年）	基础LH（IU/mL）	基础FSH（IU/mL）	基础E₂（pg/mL）
A组	262	29.80±3.82	22.83±3.38	3.000（2.000,4.000）	8.36±4.62	7.31±2.11	47.48±23.47
B组	174	29.66±3.84	22.54±2.86	3.000（2.000,4.000）	9.06±4.66	7.40±2.79	47.50±21.56
t或Z		-0.381	-0.947	-0.549	1.546	0.362	0.007
P		0.704	0.344	0.583	0.123	0.717	0.995

组别	周期数	年龄（岁）	BMI（kg/m²）	不孕时间（年）	基础LH（IU/mL）	基础FSH（IU/mL）	基础E₂（pg/mL）
A组	262	29.80±3.82	22.83±3.38	3.000（2.000,4.000）	8.36±4.62	7.31±2.11	47.48±23.47
B组	174	29.66±3.84	22.54±2.86	3.000（2.000,4.000）	9.06±4.66	7.40±2.79	47.50±21.56
t或Z		-0.381	-0.947	-0.549	1.546	0.362	0.007
P		0.704	0.344	0.583	0.123	0.717	0.995

组别	周期数	雌激素启动日LH（IU/mL）	雌激素启动日FSH（IU/mL）	降调节时间（d）	雌激素使用时间（d）	雌激素用量（mg）	移植前子宫内膜厚度（cm）	移植胚胎数（个）	优质胚胎数（个）
A组	262	2.69±1.07	3.39±1.37	20.10±3.50	13.19±2.03	85.48±23.82	1.00（0.90,1.10）	1.92±0.35	1.67±0.50
B组	174	2.74±0.92	3.16±1.47	20.43±2.67	13.86±2.53	93.60±32.01	0.98（0.90,1.10）	1.88±0.38	1.60±0.50
t或Z		0.567	-1.634	1.043	2.945	2.862	-1.515	-1.156	-1.440
P		0.571	0.103	0.297	0.003	0.005	0.130	0.248	0.151

组别	周期数	雌激素启动日LH（IU/mL）	雌激素启动日FSH（IU/mL）	降调节时间（d）	雌激素使用时间（d）	雌激素用量（mg）	移植前子宫内膜厚度（cm）	移植胚胎数（个）	优质胚胎数（个）
A组	262	2.69±1.07	3.39±1.37	20.10±3.50	13.19±2.03	85.48±23.82	1.00（0.90,1.10）	1.92±0.35	1.67±0.50
B组	174	2.74±0.92	3.16±1.47	20.43±2.67	13.86±2.53	93.60±32.01	0.98（0.90,1.10）	1.88±0.38	1.60±0.50
t或Z		0.567	-1.634	1.043	2.945	2.862	-1.515	-1.156	-1.440
P		0.571	0.103	0.297	0.003	0.005	0.130	0.248	0.151

组别	周期数	胚胎种植率	临床妊娠率	早期流产率	活产率
A组	262	40.36（203/503）	60.69（159/262）	9.43（15/159）	51.91（136/262）
B组	174	35.28（115/326）	56.32（98/174）	19.39（19/98）	44.25（77/174）
χ²		2.160	0.823	5.233	2.452
P		0.142	0.364	0.022	0.117