Frozen Embryo Transfer Clinical Trial
Official title:
The Association Between Serum Estradiol and Progesterone on the Same Day of FET and the Pregnancy Outcome
The outcomes of frozen embryo transfer (FET) have substantially improved over the last decade, due to the improvements in the cryopreservation process, Artificial endometrial preparation is typically accomplished by the administration of estradiol (E2) supplementation and exogenous progesterone (P) in order to transform the endometrium into a secretory one, mimicking a natural cycle , The current study aims to determine the association, if any, between serum E2 and P levels, measured same day of FET, and pregnancy outcome
Study design a retrospective cohort study for 402 FET cycles which will be conducted in Al-
Baraka Fertility Hospital, Manama, Bahrain, between April 2018 and May 2019. The trial
registration number for the study is (NCT04114500), and it was approved by our ethical
committee Study population
- Inclusion criteria were women who underwent FET, were age below 40 yrs., body mass index
(BMI) below 30 kg/m2, patients who underwent FET treatment using the endometrial
preparation was initiated with oral estradiol valerate, the endometrial thickness was no
less than 8 mm on the day when P was administrated; with normal endometrial ultrasound
imaging and euploid pre-genetically tested embryos;
- Exclusion criteria were chromosomal and genetic disorders, age> 40 years, BMI > 35 ,
abnormal ultrasonogram of uterine cavity (acquired or congenital) and abnormal embryos
not suitable for transfer.
Study protocol Endometrial preparation in frozen embryo transfer (FET) briefly, patients
received treatment with 2 mg/8h E2 (Estrofem, Novo Nordisk) for 12-14 days, Endometrial
thickness was evaluated with transvaginal sonography. When endometrial thickness reached 8 mm
or greater and was trilaminar in appearance, patients were initiated on both vaginal
micronized P (Crinone gel, Merck) and oral P (Duphastone, Abott) treatment at 200 mg/8h. P4
was given as supplementation because normal ovarian steroid production and the ovarian
follicular-to-luteal transition were suppressed with estradiol. A depot GnRH agonist was
administered in the midluteal phase of the preceding cycle at clinician's discretion. On the
early morning of day 5 of P treatment, the same day of FET, a blood sample was obtained and
immediately analyzed. Hormone determinations of E2 and P were performed. Then, embryo
transfer of the pre-genetically tested euploid embryos was performed under ultrasound
guidance. 12 days later pregnancy test was assessed, 4 weeks after FET date ultrasound will
be scheduled to check the viability and clinical pregnancy.
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