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Different Strategies in Frozen IVF/ICSI Cycles

Completed
Conditions
Pregnancy Rates
Interventions
Drug: Hormone Replacement cycle 1
Drug: Hormone Replacement cycle 2
Registration Number
NCT03965949
Lead Sponsor
National and Kapodistrian University of Athens
Brief Summary

In the absence of robust contemporary data, investigators decided to perform a multicenter cohort study of various IVF centers, to compare the different modalities used for pregnancy rates following frozen-thawed embryo transfer (FET) treatment cycles in normoovulatory patients undergoing IVF/ICSI.

Detailed Description

In general, the type of FET protocol for each patient is selected by the attending physicians at their own discretion. In all centers, patients with ovulatory cycles are typically prescribed an NC-FET or mNC-FET, whereas patients with oligomenorrhoea or amenorrhoea are prescribed an artificial cycle to prepare the endometrium for FET.

Ovarian stimulation protocol

1. The antagonist protocol

2. The long 21 /2 agonist protocol Laboratory technique

a. IVF or b. ICSI Embryo freezing using only vitrification will be performed in days 3 or 5/6. Embryo transfer will be conducted at days 3 or 5/6. The maximum number of embryos transferred will be two, as in accordance to the Hellenic legislation.

The following modalities will be analyzed, patients with:

1. Natural cycle, spontaneous ovulation or ovulation triggering by exogenous hCG without luteal support (Group 1)

2. Natural cycle, spontaneous ovulation or ovulation triggering by exogenous hCG with luteal support (progesterone) (Group 2)

3. Hormone Replacement cycle (cyclacur) plus GnRHa suppression with luteal support (progesterone) (Group 3)

4. Hormone Replacement cycle (cyclacur) without GnRHa suppression with luteal support (progesterone) (Group 4)

Of note, the conversion between different supplementation methods may be testimated as follows: 0.75 mg of micronised estradiol (oral administration) = 1.25 g of estradiol gel (transdermal administration) = 1 mg of estradiol valerate (oral or vaginal adminstration).

Recruitment & Eligibility

Status
COMPLETED
Sex
Female
Target Recruitment
311
Inclusion Criteria

age 25-39 years, BMI ≤ 35 and ≥ 19, normo-ovulatory patients and basal FSH ≤11 mIU/mL. Definition of expected normal ovarian response will be based primarily on antral follicle count (AFC) between 6-14.

Exclusion Criteria

history of more than three previous unsuccessful IVF/ICSI cycles, FSH > 12 mIU/mL, BMI >35 or <19, poor ovarian response according to the 2011 Bologna criteria, PCOS patients according to the Rotterdam criteria, history of untreated autoimmune, endocrine or metabolic disorders, history of pathology affecting the endometrial cavity and/or receptivity and clinical and/or laboratory markers of hereditary or acquired thrombophilia that complied to the standard protocols of each Unit and patients without embryo after thawing.

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Group 1Hormone Replacement cycle 1Natural cycle, spontaneous ovulation or ovulation triggering by exogenous hCG without luteal support
Group 2Hormone Replacement cycle 1Natural cycle, spontaneous ovulation or ovulation triggering by exogenous hCG with luteal support (progesterone)
Group 3Hormone Replacement cycle 2Hormone Replacement cycle (cyclacur) plus GnRHa suppression with luteal support (progesterone)
Group 4Hormone Replacement cycle 2Hormone Replacement cycle (cyclacur) without GnRHa suppression with luteal support (progesterone)
Primary Outcome Measures
NameTimeMethod
live birth1 year

birth after 20 weeks of gestation

ongoing pregnancy3 months

positive heart rate after 12 weeks

miscarriage6 months

pregnancy loss up to 20 weeks of gestation

Secondary Outcome Measures
NameTimeMethod
biochemical pregnancy (positive β-hCG), multiple, ectopic and clinical pregnancy rates3 months

positive β-hCG, multiple, ectopic and clinical pregnancy rates

Trial Locations

Locations (1)

Attikon University Hospital

🇬🇷

Athens, Chaidari, Greece

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