Reproductive and Obstetric Outcomes Following a Natural Cycle vs. Artificial Endometrial Preparation for Frozen–Thawed Embryo Transfer: A Retrospective Cohort Study
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Published:2023-06-13
Issue:12
Volume:12
Page:4032
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ISSN:2077-0383
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Container-title:Journal of Clinical Medicine
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language:en
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Short-container-title:JCM
Author:
Carosso Andrea Roberto1, Brunod Nicole1, Filippini Claudia2, Revelli Alberto3ORCID, Evangelisti Bernadette1, Cosma Stefano1ORCID, Borella Fulvio1ORCID, Canosa Stefano1ORCID, Benedetto Chiara1, Gennarelli Gianluca1ORCID
Affiliation:
1. Obstetrics and Gynecology 1U, Physiopathology of Reproduction and IVF Unit, Department of Surgical Sciences, Sant’Anna Hospital, University of Torino, 10124 Turin, Italy 2. Department of Surgical Sciences, Clinical Statistics, University of Torino, 10124 Turin, Italy 3. Obstetrics and Gynecology 2U, Department of Surgical Sciences, Sant’Anna Hospital, University of Torino, 10124 Turin, Italy
Abstract
Background: The proportion of frozen embryo transfer cycles has consistently grown in recent decades. Some adverse obstetric outcomes after frozen embryo transfer could possibly be explained by different approaches in endometrial preparation. The aim of the present study was to investigate reproductive and obstetric outcomes after frozen embryo transfer, comparing different endometrial preparation strategies. Methods: This retrospective study included 317 frozen embryo transfer cycles, of which 239 had a natural or modified natural cycle and 78 underwent artificial endometrial preparation. After excluding late abortion and twin pregnancies, the outcomes of 103 pregnancies were analyzed, 75 of which were achieved after a natural cycle/modified natural cycle, and 28 were achieved after an artificial cycle. Results: The overall clinical pregnancy rate/embryo transfer was 39.7%, the miscarriage rate was 10.1%, and the live birth rate/embryo transfer was 32.8%, without significant differences in reproductive outcomes between natural/modified cycle and artificial cycle groups. The risks of pregnancy-induced hypertension and abnormal placental insertion were significantly increased in pregnancies achieved after the artificial preparation of the endometrium (p = 0.0327 and =0.0191, respectively). Conclusions: Our study encourages the use of a natural cycle or modified natural cycle for endometrial preparation for frozen embryo transfer in order to ensure the presence of a corpus luteum able to orchestrate maternal adaptation to pregnancy.
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