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Live birth rates after natural cycle versus hormone replacement therapy for single euploid blastocyst transfers: a retrospective cohort study

  • Ziqi Jin
    Affiliations
    Reproductive Medical Center, Henan Province Key Laboratory for Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou Henan Province, China
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  • Hao Shi
    Affiliations
    Reproductive Medical Center, Henan Province Key Laboratory for Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou Henan Province, China
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  • Zhiqin Bu
    Affiliations
    Reproductive Medical Center, Henan Province Key Laboratory for Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou Henan Province, China
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  • Yihong Guo
    Affiliations
    Reproductive Medical Center, Henan Province Key Laboratory for Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou Henan Province, China
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  • Yingchun Su
    Affiliations
    Reproductive Medical Center, Henan Province Key Laboratory for Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou Henan Province, China
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  • Hui Song
    Affiliations
    Reproductive Medical Center, Henan Province Key Laboratory for Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou Henan Province, China
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  • Mingzhu Huo
    Affiliations
    Reproductive Medical Center, Henan Province Key Laboratory for Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou Henan Province, China
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  • Entong Yang
    Affiliations
    Reproductive Medical Center, Henan Province Key Laboratory for Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou Henan Province, China
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  • Jingdi Li
    Affiliations
    Reproductive Medical Center, Henan Province Key Laboratory for Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou Henan Province, China
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  • Yile Zhang
    Correspondence
    Corresponding author.
    Affiliations
    Reproductive Medical Center, Henan Province Key Laboratory for Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou Henan Province, China
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Published:September 14, 2021DOI:https://doi.org/10.1016/j.rbmo.2021.09.003

      Abstract

      Research question

      Is there any difference in live birth rate between the natural cycle and hormone replacement therapy (HRT) endometrial preparation protocols for women with regular menstrual cycles undergoing their first single vitrified–warmed euploid blastocyst transfer?

      Design

      This was a retrospective cohort study that enrolled 722 women who underwent vitrified–warmed euploid blastocyst transfer at assisted reproductive technology (ART) centre of The First Affiliated Hospital of Zhengzhou University, from January 2013 to December 2019. Univariate and multivariate logistic regression models were used to analyse the relationship between the endometrial preparation protocols and live birth rates. Stratified analyses and sensitivity analyses were performed to ensure the reliability and stability of the results.

      Results

      A total of 722 single vitrified–warmed euploid blastocyst transfer cycles were included. Overall, the live birth rates were 50.00% (110/220) in the natural cycle group and 47.61% (239/502) in the HRT group. Multiple logistic regression analyses showed that there was no significant association (adjusted odds ratio 0.82; 95% confidence interval 0.56–1.20; P = 0.313) between natural cycle and HRT protocols and the live birth rate. Interaction analysis showed that there was no significant difference in live birth rates between the two groups for any subgroup after adjusting for confounding factors.

      Conclusions

      For single vitrified–warmed euploid blastocyst transfer, natural cycle and HRT endometrial preparation protocols result in similar live birth rates among women with regular menstrual cycles. Further studies are needed into the effects of endometrial preparation protocols on pregnancy outcomes.

      Keywords

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      Biography

      Dr Ziqi Jin completed her medical degree at Zhengzhou University in China. Currently she is a graduate student at the Center for Reproductive Medicine at The First Affiliated Hospital of Zhengzhou University. Her research has focused on female reproductive physiology and diseases.
      Key message
      Both natural cycle and hormone replacement therapy for endometrial preparation produce similar live birth rates among women with regular menstrual cycles in the context of a first single vitrified–warmed euploid blastocyst transfer. Endometrial preparation for cryopreserved embryo transfer should be selected according to the patient's menstruation and cycle plan.