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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.

Authors+Show Affiliations

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.govNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19171338

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 -