Abstract
Purpose: The aim of this study was to investigate the effect of human chorionic gonadotropin (hCG) in hormone replacement (HT) regime for frozen thawed embryo transfer in women with endometriosis (EM).Methods: We performed a retrospective, database-search, cohort study and included data on EM patients who underwent frozen embryo transfer (FET) between January 1, 2009 and August 31, 2018. According to the protocols for FET cycle, the patients were divided into two groups: control group (n = 296) and hCG group (n = 355). Clinical pregnancy rate, live birth rate, early abortion rate, late abortion rate, and ectopic pregnancy rate were compared between the two groups.Results: There was a significant increase in clinical pregnancy rate in the hCG group (57.7 vs. 49%, p = 0.027) compared with the control group. The live birth rate in the hCG group (45.6 vs. 38.5%, p = 0.080) was also elevated, but this difference was not statistically significant.Conclusion: hCG administration in HT regime for FET increases the pregnancy rate in women with EM.
Highlights
Endometriosis (EM) is a chronic gynecological disease characterized by lesions of endometrial-like tissue outside of the uterine cavity [1, 2]
There were no differences in terms of age, body mass index (BMI), basal endocrine hormone levels, number of oocytes retrieved in the fresh cycle, fertilization rate of oocytes, number of available embryos, and the percentage of patients with coexisting polycystic ovarian syndrome (PCOS) and adenomyosis between the two groups
The concentration of estrogen and luteinizing hormone (LH), the number and stage of transferred embryos, and the proportion of patients with recurrent endometrioma did not differ significantly between the two groups, but the endometrium was thicker in the human chorionic gonadotropin (hCG) group than in the control group
Summary
Endometriosis (EM) is a chronic gynecological disease characterized by lesions of endometrial-like tissue outside of the uterine cavity [1, 2]. Almost 50% of women with EM experience infertility [3]. EM affects the outcomes of assisted reproductive technology (ART). There are different factors involved in poor outcomes, including poor quality of oocyte and/or embryo, impaired receptivity of the endometrium, and implantation failure [4, 5]. There is little doubt that the endometrium of women with EM is less receptive to embryo implantation, and strong evidence suggests that endometrial changes are associated with decreased cycle fecundity [6]. Endometrial biomarkers are differentially expressed in the endometrium of women with EM compared with normal women [7, 8]. Seeking an effective approach to improve endometrial receptivity in EM is a complex clinical issue
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