Transdermal versus oral estrogen: clinical outcomes in patients undergoing frozen-thawed single blastocyst transfer cycles without GnRHa suppression, a prospective randomized clinical trial

Semra Kahraman,Yucel Sahin,Gokalp Oner,Caroline Pirkevi Çetinkaya

doi:10.1007/s10815-018-1380-5

Semra Kahraman, Yucel Sahin + Show 2 more

Open Access

https://doi.org/10.1007/s10815-018-1380-5

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Abstract

PurposeTo conduct a non-inferiority study to compare the clinical outcomes of transdermal estrogen patch and oral estrogen in patients undergoing frozen-thawed single blastocyst transfer non-donor cycles without GnRHagonist (GnRHa) suppression.MethodsA total of 317 women with irregular menses or anovulatory cycle undergoing frozen-thawed embryo transfer (FET) non-donor cycles without GnRHa suppression were involved in a prospective randomized clinical trial between May 2017 and October 2017. The trial was conducted in an ART and Reproductive Genetics Centre within a private hospital. The unit is designated as a teaching center by the Turkish Ministry of Health. Oral or transdermal estrogen was administered in patients undergoing frozen-thawed single blastocyst transfer. The outcomes of the study were the following: endometrial thickness on the day of progesterone administration, implantation rate, and clinical and viable ongoing pregnancy rates.ResultsEndometrial thickness and clinical outcomes of oral and transdermal estrogen administration were equally successful (p > 0.05).ConclusionNo significant difference was found in endometrial thickness on the day of progesterone administration nor in clinical outcomes between transdermal estrogen and oral estrogen in patients undergoing frozen-thawed single blastocyst stage transfer cycles without GnRHa suppression.

Highlights

Advances in cryopreservation techniques have resulted in a dramatic increase in freeze-all cycles as the preferred method of ART. One reason for this preference is the higher rate of viable embryos available after thawing, which almost eliminates the risk of ovarian hyperstimulation syndrome (OHSS)
This was conducted retrospectively and in oocyte donation cycles with fresh embryo transfer, and the authors could not exclude the possibility that the response to endometrial state of a high-quality female gamete might be different to that of a patient’s own oocytes
Our rationale for conducting this study was that, unlike any other study, we were able to find in the literature; it combined all the following factors; no gonadotrophin-releasing hormone agonists (GnRHas) pre-treatment was given before estrogen usage; only non-donor cycles were included; embryos were vitrified at blastocyst stage only; in all cases, a single embryo was transferred

Summary

Results

Endometrial thickness and clinical outcomes of oral and transdermal estrogen administration were successful (p > 0.05). Conclusion No significant difference was found in endometrial thickness on the day of progesterone administration nor in clinical outcomes between transdermal estrogen and oral estrogen in patients undergoing frozen-thawed single blastocyst stage transfer cycles without GnRHa suppression.

Introduction

Materials and methods

Design

Compliance with ethical standards