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A GnRH agonist and exogenous hormone stimulation protocol has a higher live-birth rate than a natural endogenous hormone protocol for frozen-thawed blastocyst-stage embryo transfer cycles: an analysis of 1391 cycles.
Fertil Steril. 2010 Feb; 93(2):416-22.FS

Abstract

OBJECTIVE

To compare embryo and birth data in cryopreserved-thawed blastocyst-stage ET cycles between natural endogenous hormone cycles and exogenous hormone stimulation cycles.

DESIGN

Retrospective cohort analysis.

SETTING

Large academic assisted reproductive technology center.

PATIENT(S)

One thousand three hundred ninety-one patient cycles undergoing frozen-thawed blastocyst-stage ET cycles.

MAIN OUTCOME MEASURE(S)

Live-birth rate.

INTERVENTION(S)

The synthetic protocol used GnRH agonist followed by estrogen and P. The natural protocol used monitoring and post-transfer P.

RESULT(S)

The patients in the two protocols had similar baseline characteristics. Multiple linear regression showed the synthetic protocol to have a higher live-birth rate (odds ratio [OR], 1.46; 95% confidence interval [CI], 1.02-2.09). In patients having two embryos transferred, the synthetic stimulation protocol resulted in a higher live-birth rate per cycle start (32.3% vs. 20.4%; relative risk [RR], 1.58; 95% CI, 1.22-2.06). Similarly, patients with one or two embryos transferred who had additional cryopreserved blastocysts available also had a higher live-birth rate per cycle start (36.1% vs. 12.1; RR, 2.98; 95% CI, 1.16-7.63).

CONCLUSION(S)

The synthetic hormone protocol was associated with a higher live-birth rate when compared with a natural cycle protocol for frozen-thawed blastocyst-stage ET cycles. This improvement persisted when analysis was controlled for cycle cancellation. The synthetic stimulation protocol for frozen-thawed embryo cycles offers improved outcome results for patients.

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Authors+Show Affiliations

Hill MJ
Reproductive Biology and Medicine Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Building 10, CRC, Room E1-3140, 10 Center Drive, Bethesda, Maryland 20892, USA. hillmicah@mail.nih.gov
Miller KA
No affiliation info available
Frattarelli JL
No affiliation info available

MeSH

AdultChorionic GonadotropinCohort StudiesCryopreservationEmbryo ImplantationEmbryo TransferEndometriumEstrogensFemaleGonadotropin-Releasing HormoneHumansInfant, NewbornLive BirthMaleMonitoring, PhysiologicPregnancyProgesteroneRegression AnalysisRetrospective Studies

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19171338

Clinical Trial Links

Down-regulated Hormonally Controlled Cycles for Vitrification-warmed Blastocyst Transfers

Citation

Hill, Micah J., et al. "A GnRH Agonist and Exogenous Hormone Stimulation Protocol Has a Higher Live-birth Rate Than a Natural Endogenous Hormone Protocol for Frozen-thawed Blastocyst-stage Embryo Transfer Cycles: an Analysis of 1391 Cycles." Fertility and Sterility, vol. 93, no. 2, 2010, pp. 416-22.
Hill MJ, Miller KA, Frattarelli JL. A GnRH agonist and exogenous hormone stimulation protocol has a higher live-birth rate than a natural endogenous hormone protocol for frozen-thawed blastocyst-stage embryo transfer cycles: an analysis of 1391 cycles. Fertil Steril. 2010;93(2):416-22.
Hill, M. J., Miller, K. A., & Frattarelli, J. L. (2010). A GnRH agonist and exogenous hormone stimulation protocol has a higher live-birth rate than a natural endogenous hormone protocol for frozen-thawed blastocyst-stage embryo transfer cycles: an analysis of 1391 cycles. Fertility and Sterility, 93(2), 416-22. https://doi.org/10.1016/j.fertnstert.2008.11.027
Hill MJ, Miller KA, Frattarelli JL. A GnRH Agonist and Exogenous Hormone Stimulation Protocol Has a Higher Live-birth Rate Than a Natural Endogenous Hormone Protocol for Frozen-thawed Blastocyst-stage Embryo Transfer Cycles: an Analysis of 1391 Cycles. Fertil Steril. 2010;93(2):416-22. PubMed PMID: 19171338.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A GnRH agonist and exogenous hormone stimulation protocol has a higher live-birth rate than a natural endogenous hormone protocol for frozen-thawed blastocyst-stage embryo transfer cycles: an analysis of 1391 cycles. AU - Hill,Micah J, AU - Miller,Kathleen A, AU - Frattarelli,John L, Y1 - 2009/01/26/ PY - 2008/03/03/received PY - 2008/11/23/revised PY - 2008/11/24/accepted PY - 2009/1/28/entrez PY - 2009/1/28/pubmed PY - 2010/2/25/medline SP - 416 EP - 22 JF - Fertility and sterility JO - Fertil Steril VL - 93 IS - 2 N2 - OBJECTIVE: To compare embryo and birth data in cryopreserved-thawed blastocyst-stage ET cycles between natural endogenous hormone cycles and exogenous hormone stimulation cycles. DESIGN: Retrospective cohort analysis. SETTING: Large academic assisted reproductive technology center. PATIENT(S): One thousand three hundred ninety-one patient cycles undergoing frozen-thawed blastocyst-stage ET cycles. MAIN OUTCOME MEASURE(S): Live-birth rate. INTERVENTION(S): The synthetic protocol used GnRH agonist followed by estrogen and P. The natural protocol used monitoring and post-transfer P. RESULT(S): The patients in the two protocols had similar baseline characteristics. Multiple linear regression showed the synthetic protocol to have a higher live-birth rate (odds ratio [OR], 1.46; 95% confidence interval [CI], 1.02-2.09). In patients having two embryos transferred, the synthetic stimulation protocol resulted in a higher live-birth rate per cycle start (32.3% vs. 20.4%; relative risk [RR], 1.58; 95% CI, 1.22-2.06). Similarly, patients with one or two embryos transferred who had additional cryopreserved blastocysts available also had a higher live-birth rate per cycle start (36.1% vs. 12.1; RR, 2.98; 95% CI, 1.16-7.63). CONCLUSION(S): The synthetic hormone protocol was associated with a higher live-birth rate when compared with a natural cycle protocol for frozen-thawed blastocyst-stage ET cycles. This improvement persisted when analysis was controlled for cycle cancellation. The synthetic stimulation protocol for frozen-thawed embryo cycles offers improved outcome results for patients. SN - 1556-5653 UR - https://www.unboundmedicine.com/medline/citation/19171338/A_GnRH_agonist_and_exogenous_hormone_stimulation_protocol_has_a_higher_live_birth_rate_than_a_natural_endogenous_hormone_protocol_for_frozen_thawed_blastocyst_stage_embryo_transfer_cycles:_an_analysis_of_1391_cycles_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0015-0282(08)04639-6 DB - PRIME DP - Unbound Medicine ER -