Transfer of cryopreserved-thawed pre-embryos in a cycle using exogenous steroids without prior gonadotrophin-releasing hormone agonist suppression yields favourable pregnancy results

Hum Reprod. 1997 Jun;12(6):1176-80. doi: 10.1093/humrep/12.6.1176.

Abstract

We have analysed the use of a programmed cycle of administration of exogenous steroids without prior suppression with a gonadotrophin-releasing hormone agonist (GnRHa) for the transfer of cryopreserved-thawed pre-embryos. From July 1992 to June 1994, 199 cycles (162 patients) were studied. Pre-embryos had been previously cryopreserved at the pronuclear stage using 1.5 M 1,2-propanediol as a cryoprotectant. Preparation of the endometrium was achieved in a step-up regime with transdermal oestradiol patches (0.1 to 0.4 mg). Progesterone in oil (50 mg i.m.) was started on cycle day 13. Pre-embryos were thawed on day 14 and transferred on day 15 after evidence of survival and cleavage. The mean (+/- SD) age of patients undergoing transfer was 35.4 +/- 4.3 years. The mean number of pre-embryos thawed was 4.7 +/- 1.8 with a mean of 3.3 +/- 1.4 pre-embryos being transferred. Eight of the cycles demonstrated follicular development >16 mm prior to thaw and transfer; however, these patients did not demonstrate a luteinizing hormone surge. Mean endometrial thickness on day 13 was 10.8 +/- 2.1 mm. Overall pregnancy rate was 29.2% (57/195). The ongoing or delivery rate was 16.1% (32/195). The rate of preclinical losses per transfer was 6.2% (12/195). Overall, the implantation rate was 6.2% (47/757). Thus, the use of a programmed cycle for cryopreserved embryo transfer yields favourable pregnancy outcome and offers practical advantages to patients. Prior suppression with a GnRHa is not necessary for endometrial preparation.

MeSH terms

  • Adult
  • Cryopreservation
  • Embryo Implantation
  • Embryo Transfer / methods*
  • Endometrium / drug effects
  • Endometrium / physiology
  • Estradiol / administration & dosage*
  • Female
  • Gonadotropin-Releasing Hormone / agonists*
  • Humans
  • Infertility / therapy
  • Menstrual Cycle / drug effects
  • Menstrual Cycle / physiology
  • Pregnancy
  • Progesterone / administration & dosage*
  • Retrospective Studies
  • Time Factors

Substances

  • Gonadotropin-Releasing Hormone
  • Progesterone
  • Estradiol