| Endometrial preparation for women undergoing embryo transfer with frozen embryos or embryos derived from donor oocytes. | |
| | |
MedLine Citation:
|
PMID: 20091592 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: If a fresh embryo, assisted reproductive technology procedure cycle is unsuccessful and there are frozen embryos available, a frozen-thawed embryo transfer is performed. In some specific cases women may undergo oocyte donation treatment. In both situations the endometrium is primed by the administration of estrogen and progesterone. To prevent the possibility of spontaneous ovulation, gonadotropin-releasing hormone (GnRH) agonists are frequently used. OBJECTIVES: To evaluate the most effective endometrial preparation for women undergoing transfer with frozen embryos or embryos from donor oocytes with regard to the subsequent live birth rate. SEARCH STRATEGY: We searched the Cochrane Menstrual Disorders and Subfertility Group Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library), MEDLINE, EMBASE, LILACS, and abstracts of reproductive societies' meetings (from inception). No language restrictions were applied. Experts in the field were contacted. SELECTION CRITERIA: Randomised controlled trials evaluating endometrial preparation in women undergoing fresh donor cycles and frozen embryo transfers. DATA COLLECTION AND ANALYSIS: Two review authors independently applied the inclusion criteria, assessed trial risk of bias, and extracted data. MAIN RESULTS: Twenty two randomised controlled trials were included. Five studies analysed the use of a GnRH agonist versus control. No significant benefit was demonstrated when using GnRH agonists. No evidence of statistically significant benefit was found for one GnRH agonist over another, or vaginal over intramuscular progesterone administration. No difference in pregnancy rate was demonstrated when no treatment was compared to aspirin, steroids, ovarian stimulation, or human chorionic gonadotropin (hCG) prior to embryo transfer, although using hCG several times before the oocyte retrieval decreases the pregnancy rate. Finally, when oocyte recipients were studied further, starting progesterone on the day of oocyte pick-up (OPU) or the day after OPU produced a significantly higher pregnancy rate (OR 1.87, 95% CI 1.13 to 3.08) than when recipients started progesterone the day prior to OPU. AUTHORS' CONCLUSIONS: There is insufficient evidence to recommend any one particular protocol for endometrial preparation over another with regard to pregnancy rates after embryo transfers. These were either frozen embryos or embryos derived from donor oocytes. However, there is evidence of a lower pregnancy rate and a higher cycle cancellation rate when the progesterone supplementation is commenced prior to oocyte retrieval in oocyte donation cycles. Adequately powered studies are needed to evaluate each treatment more accurately. |
| | |
Authors:
|
Demi?n Glujovsky; Romina Pesce; Gabriel Fiszbajn; Carlos Sueldo; Roger J Hart; Agust?n Ciapponi |
Publication Detail:
|
Type: Journal Article; Meta-Analysis; Review Date: 2010-01-20 |
Journal Detail:
|
Title: Cochrane database of systematic reviews (Online) Volume: - ISSN: 1469-493X ISO Abbreviation: Cochrane Database Syst Rev Publication Date: 2010 |
Date Detail:
|
Created Date: 2010-01-21 Completed Date: 2010-04-16 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 100909747 Medline TA: Cochrane Database Syst Rev Country: England |
Other Details:
|
Languages: eng Pagination: CD006359 Citation Subset: IM |
Affiliation:
|
Reproductive Medicine, CEGYR (Centro de Estudios en Ginecologia y Reproduccion), Viamonte 1438,, Buenos Aires, Argentina. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Cryopreservation* Drug Administration Schedule Embryo Implantation / physiology Embryo Transfer / methods* Embryo, Mammalian* Endometrium / drug effects*, physiology Female Gonadotropin-Releasing Hormone / agonists* Humans Oocyte Donation* Pregnancy Pregnancy Rate Progesterone / administration & dosage Progestins / administration & dosage Randomized Controlled Trials as Topic |
| Chemical | |
Reg. No./Substance:
|
0/Progestins; 33515-09-2/Gonadotropin-Releasing Hormone; 57-83-0/Progesterone |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Serotonin receptor antagonists for highly emetogenic chemotherapy in adults.
Next Document: Combined use of hyperthermia and radiation therapy for treating locally advanced cervical carcinoma.