The future of frozen-thawed embryo transfer in hormone replacement therapy cycles.
Journal
Current opinion in obstetrics & gynecology
ISSN: 1473-656X
Titre abrégé: Curr Opin Obstet Gynecol
Pays: England
ID NLM: 9007264
Informations de publication
Date de publication:
01 06 2023
01 06 2023
Historique:
medline:
17
5
2023
pubmed:
15
5
2023
entrez:
15
5
2023
Statut:
ppublish
Résumé
This review focuses on the efficacy of letrozole stimulated frozen-thawed embryo transfer (FET) compared to hormone replacement therapy (HRT) FET in women with polycystic ovarian syndrome (PCOS) and/or oligo-anovulation. Further, obstetric and perinatal risks in HRT FET are summarized. The presence of a corpus luteum seems to reduce the risk of pregnancy-related hypertension and preeclampsia after FET. As a natural cycle (NC) FET is not an option for women with oligo-/amenorrhea these women may benefit from FET with mild stimulation compared to HRT FET. The intention of mild stimulation in anovulatory women is to induce (mono) ovulation to mimic the endocrine profiles of the natural cycle and the early pregnancy after natural conception. Mild stimulation by letrozole is patient friendly and cheap compared to gonadotropin stimulated FET and has been increasingly used in recent years. Although the quality of evidence is low, the pregnancy outcomes after letrozole FET seems similar or even better compared to HRT FET in women with PCOS and/or oligo-anovulation. Natural and modified NC FET should be used whenever possible to mitigate adverse obstetric and perinatal outcomes after HRT FET. For anovulatory women, whenever ovulation can be induced, we advocate the use of mild stimulation FET to create a corpus luteum awaiting results from RCTs limited to oligo-anovulatory women.
Identifiants
pubmed: 37185352
doi: 10.1097/GCO.0000000000000867
pii: 00001703-202306000-00005
doi:
Substances chimiques
Letrozole
7LKK855W8I
Types de publication
Review
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
200-209Informations de copyright
Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
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