Purpose <p>Frozen embryo transfers (FET) have become an integral element of assisted reproduction. There is a paucity of data on the impact of different gonadotropins (Gn) used during the index fresh cycle on FET outcome. Since the source of LH activity in the index cycle may affect subsequent FET outcomes, we compared FET cumulative live-birth rates (cLBR) based on the type of gonadotropin used.</p> Methods <p>Retrospective analysis was used to evaluate FET outcome based on the type of Gn used in the index fresh cycle: rFSH (<i>n</i> = 775), hpHMG + / − rFSH (<i>n</i> = 306), or rFSH/rLH (2:1 ratio; <i>n</i> = 232). Comparisons were initially performed between rFSH alone vs mixed protocol groups for all cycles and in only those using a mixed protocol (rLH vs hCG). Generalized linear models, linear mixed-effects models, or multinomial regression analysis was used.</p> Results <p>FET cLBR was significantly higher in those using rFSH alone vs mixed protocol (45.8% vs 27.6%, <i>p</i> &lt; 0.001); however, after controlling for confounding variables, the Gn type used in the index fresh IVF cycle was not associated with FET-cLBR. When mixed protocols were compared, FET-cLBR was significantly reduced in those using rLH compared with hCG (22.3% vs 31.3%, <i>p</i> = 0.04). After applying regression analysis, LH use remained associated with lower FET-cLBR (OR, 0.55; 0.34, 0.87; <i>p</i> = 0.01).</p> Conclusion <p>Unlike previous studies, our findings suggest that cycles using FSH alone versus any type of mixed protocol in the index fresh cycle resulted in significantly greater FET-cLBR, but outcomes were not attributed to the type of Gn. However, when comparing the source of LH, FET outcomes may be negatively impacted by rLH, and its association should be further explored.</p>

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Does the type of gonadotropin used in the index IVF cycle affect subsequent frozen embryo transfer outcomes? Results of a retrospective analysis

  • Levente Balla,
  • David Nagy U.,
  • Starlla Dabady,
  • Kalman Kovacs,
  • Fady Sharara I.,
  • Steven Lindheim R.,
  • Peter Kovacs

摘要

Purpose

Frozen embryo transfers (FET) have become an integral element of assisted reproduction. There is a paucity of data on the impact of different gonadotropins (Gn) used during the index fresh cycle on FET outcome. Since the source of LH activity in the index cycle may affect subsequent FET outcomes, we compared FET cumulative live-birth rates (cLBR) based on the type of gonadotropin used.

Methods

Retrospective analysis was used to evaluate FET outcome based on the type of Gn used in the index fresh cycle: rFSH (n = 775), hpHMG + / − rFSH (n = 306), or rFSH/rLH (2:1 ratio; n = 232). Comparisons were initially performed between rFSH alone vs mixed protocol groups for all cycles and in only those using a mixed protocol (rLH vs hCG). Generalized linear models, linear mixed-effects models, or multinomial regression analysis was used.

Results

FET cLBR was significantly higher in those using rFSH alone vs mixed protocol (45.8% vs 27.6%, p < 0.001); however, after controlling for confounding variables, the Gn type used in the index fresh IVF cycle was not associated with FET-cLBR. When mixed protocols were compared, FET-cLBR was significantly reduced in those using rLH compared with hCG (22.3% vs 31.3%, p = 0.04). After applying regression analysis, LH use remained associated with lower FET-cLBR (OR, 0.55; 0.34, 0.87; p = 0.01).

Conclusion

Unlike previous studies, our findings suggest that cycles using FSH alone versus any type of mixed protocol in the index fresh cycle resulted in significantly greater FET-cLBR, but outcomes were not attributed to the type of Gn. However, when comparing the source of LH, FET outcomes may be negatively impacted by rLH, and its association should be further explored.