Which endometrial preparation protocol provides better pregnancy and perinatal outcomes for endometriosis patients in frozen-thawed embryo transfer cycles? A retrospective study on 1413 patients

Yaxin Guo, Zishui Fang, Lin Yu, Xin Sun, Fei Li, Lei Jin
Journal of ovarian research · 2023 · vol. 16(1) , pp. 7 · doi:10.1186/s13048-023-01095-4 · PMID:36624470 · PMC9830850 · W4313887940
article OA: gold CC0 ⤵ 6 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

Endometrial preparation using natural cycle, hormone replacement, or GnRHa pretreatment yielded no significant differences in pregnancy or perinatal outcomes for endometriosis patients undergoing frozen-thawed embryo transfer.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-09 ⓘ

This retrospective cohort study analyzed 1413 women with endometriosis who underwent oocyte aspiration (2015–2020) and frozen-thawed embryo transfer (2016–2020), comparing three endometrial preparation protocols: natural cycle, hormone replacement therapy, and hormone replacement therapy with GnRH agonist (GnRHa) pretreatment. Pregnancy outcomes and perinatal outcomes (including singleton analyses of live births, plus miscarriage, ectopic pregnancy, miscarriage-related measures, and obstetric complications) were assessed using clinical definitions and telephone follow-up, with multivariate logistic regression adjusted for selected covariates. The study found no differences in clinical pregnancy or prenatal outcomes among the three protocols, and these results persisted after adjustment. The paper explicitly notes that all FET cycles were from a single tertiary academic center and were retrospective in design, which limits causal inference, and it excluded other preparation protocols. This paper is centrally about endometriosis — it compares endometrial preparation protocols (natural cycle, HRT, and GnRHa+HRT) for FET pregnancy and perinatal outcomes in women with endometriosis.

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Abstract

OBJECTIVE: To determine the optimal endometrial preparation protocol for a frozen embryo transfer in patients with endometriosis. DESIGN: Retrospective cohort study. SETTING: Tertiary care academic medical center. PATIENT(S): One thousand four hundred thirteen patients with endometriosis who underwent oocyte aspiration from 2015 to 2020 and frozen embryo transfer from 2016 to 2020 and received natural cycle, hormone replacement treatment with or without GnRHa pretreatment endometrial preparation. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Clinical pregnancy rate, live birth rate, miscarriage rate, multiple pregnancy rate, biochemical pregnancy rate and ectopic pregnancy rate. Singleton live births were assessed for perinatal outcomes and obstetric complications. RESULT(S): There were no differences in clinical pregnancy outcomes or prenatal outcomes among the three commonly used endometrial preparation protocols for frozen embryo transfer cycles in patients with endometriosis. Results remained after screening variables using univariate logistic regression into multivariate logistic regression. No advantages or disadvantages were found among the three endometrial preparation protocols in patients with endometriosis. CONCLUSION(S): Natural cycle, hormone replacement cycle, or hormone replacement treatment with GnRHa pretreatment showed no superiority or inferiority in pregnancy and perinatal outcomes in patients with endometriosis.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Cryopreservation Cryopreservation Cryopreservation Cryopreservation Cryopreservation Cryopreservation Cryopreservation Cryopreservation Cryopreservation Embryo Transfer

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