Clinical Outcome Of Frozen Thawed Embryo Transfer In Natural Cycles And Artificial Cycles

Objective:To determine the factors about the pregnancy outcome of F-ET. To compare the clinical pregnancy rate of the natural cycle scheme and the artificial cycle scheme. To understand whether the artificial cycle scheme is the best F-ET program for secondary infertility patients.Methods:The patient was choiced in our reproductive center from March 2012 to June 2014,there were 411 cycles. The age of the patients was 20 to 47 years, infertility duration ranged from 1 to 19 years. We use the hyperstimulation cycle, including long and short program. The way of fertilization was in vitro fertilization or intracytoplasmic sperm injection technique. According to the basic situation of patients to decide whether they were conducted the operation of fresh transplantation, then the remaining embryos were cryopreserved. The embryo were divided into 5 grade on the third day.The patients F-ET with natural cycle began the transvaginal ultrasound monitoring in the eighth day period,to observe the size of follicles and endometrial thickness and ovulation. After Ovulation the patients were given intramuscular injection of Progesterone 3 days, which dose was40 mg, 40 mg, 60 mg, when the endometrium become to the secretory phase, we monitor patients’ blood level of E2 and P, then embryo transplantation was conducted. Patients with artificial cycles began to use estradiol valerate tablets on the third day of menstruation, the dose’s range was 2 ~ 4mg, which was according to the patients’ endometrial groth situation. After 7 ~ 8 days the petients were taken vaginal ultrasound examination to observa the endometrial thickness and to assess the growth rate ofendometrium, so as to adjust the dose of estradiol valerate tablets(2 ~ 8 mg). When the endometrial thickness was more than 9 mm, the patients were used progesterone for 3days, the dosage was 40 mg, 40 mg, 60 mg, so that the endometrial become into the secretory phase, at the same time we test the level of patients’ E2 and P. Then we conduct frozen-thawed embryo transplantation. After embryo transfer the patients were still inject progesterone 60 mg/d, for 14 consecutive days. After 14 days of transplantation patients were tested blood HCG to determine whether they were biochemical pregnancy. 28 days later they will take ultrasound examnation to judge whether they were clinical pregnancy.Results:There were no difference on age, duration of infertility, the basic level of E2, P,FSH, LH, the transfer embryos’ number and quality(P>0.05); the difference of the endometrial thickness and E2’s level on the day of plantation were significant(P < 0.05);about secondary infertility there were no difference on embryo implantation rate, clinical pregnancy rate, abortion rate between two group(P > 0.05).Conclusion:The clinical pregnancy outcome is similar between the natural cycle and the artificial cycle in F-ET. The pregnancy rate of the two schemes of secondary infertility is also similar in F-ET.