We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
A randomized double-blinded controlled trial of hCG as luteal phase support in natural cycle frozen embryo transfer.
- Authors
Lee, Vivian Chi Yan; Li, Raymond Hang Wun; Yeung, William Shu Biu; HO Pak Chung; Ng, Ernest Hung Yu; Pak Chung, H O
- Abstract
<bold>Study Question: </bold>Does the use of hCG as luteal phase support in natural cycle frozen embryo transfer (FET) increase the ongoing pregnancy rate?<bold>Study Answer: </bold>The use of hCG in natural cycle FET did not improve the ongoing pregnancy rate.<bold>What Is Known Already: </bold>The use of luteal phase support in stimulated cycles has been associated with higher live-birth rates and the results are similar when using hCG or progesterone.<bold>Study Design Size, Duration: </bold>This is a randomized double-blinded controlled trial of 450 women recruited between August 2013 and October 2015.<bold>Participants/materials Setting Methods: </bold>Women with regular cycles undergoing natural cycle FET were recruited. Serial serum hormonal concentrations were used to time natural ovulation and at least Day 2 cleavage embryos were replaced. Patients were randomized into either: (i) the treatment group, receiving 1500 IU hCG on the day of FET and 6 days after FET, or (ii) the control group, receiving normal saline on these 2 days.<bold>Main Results and the Role Of Chance: </bold>The ongoing pregnancy rate [60/225 (26.7%) in the treatment group vs 70/225 (31.3%) in the control group, odds ratio 1.242 (95% CI 0.825-1.869)], implantation rate and miscarriage rate were comparable between the two groups. In the treatment group, there were significantly more cycles with top quality embryos transferred and a significantly higher serum oestradiol level, but a comparable serum progesterone level, 6 days after FET. However, no significant differences were observed in serum oestradiol and progesterone levels 6 days after FET between the pregnant and non-pregnant women. In the multivariate logistic regression, the number of embryos transferred was the only significant factor predictive of the ongoing pregnancy rate after natural cycle FET.<bold>Limitations Reason For Caution: </bold>This study only included FET with cleavage stage embryos and only hCG, not vaginal progesterone, was used as luteal phase support.<bold>Wider Implantations Of the Findings: </bold>The findings in this study do not support the use of hCG for luteal phase support in natural cycle FET.<bold>Study Funding/competing Interests: </bold>No external funding was used and there were no competing interests.<bold>Trial Registration Number: </bold>clinicaltrial.gov identifier: NCT01931384.<bold>Trial Registration Date: </bold>23/8/2013.<bold>Date Of First Patient's Enrolment: </bold>30/8/2013.
- Subjects
EMBRYO transfer; CHORIONIC gonadotropins; LUTEAL phase; FROZEN human embryos; BIRTH rate; OVULATION; LOGISTIC regression analysis; RANDOMIZED controlled trials; COMPARATIVE studies; RESEARCH methodology; EVALUATION of medical care; MEDICAL cooperation; PREGNANCY; RESEARCH; STATISTICAL sampling; EVALUATION research; TREATMENT effectiveness; BLIND experiment; THERAPEUTICS
- Publication
Human Reproduction, 2017, Vol 32, Issue 5, p1130
- ISSN
0268-1161
- Publication type
journal article
- DOI
10.1093/humrep/dex049