Intensive luteal phase support in hormone replacement and modified natural cycle frozen embryo transfers in ovulatory patients: A propensity score-matched study.

Intensive luteal phase support in hormone replacement and modified natural cycle frozen embryo transfers in ovulatory patients: A propensity score-matched study.

<h4>Background</h4>The optimal endometrial preparation protocol for frozen embryo transfer (FET) remains controversial, with different cycle regimens and luteal phase support strategies across studies yielding conflicting results. This study aimed to compare the pregnancy outcomes of mod...

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Main Authors: Huong Thi Lien Nguyen, Thang Duc Le, Long Bao Hoang, Anh Thi Tu Phi, Hieu Phuc Nguyen, Quy Quang Luu, Thuy Thu Tran, Tuyen Thi Thanh Nguyen, Huy Tien Nguyen, Phuong Thi Mai Giap, Thuy Le Nguyen, Anh Tuan Cao, Huy Quoc Hoang, Hong Thi Nguyen, Tien Van Do, Jean Noel Hugues, Hoang Le
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2025-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0327470
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Summary:<h4>Background</h4>The optimal endometrial preparation protocol for frozen embryo transfer (FET) remains controversial, with different cycle regimens and luteal phase support strategies across studies yielding conflicting results. This study aimed to compare the pregnancy outcomes of modified natural cycles (mNC) versus hormone replacement therapy (HRT) cycles, both with intensive luteal support using vaginal micronized progesterone and oral dydrogesterone.<h4>Methods</h4>This retrospective cohort study included 2365 FET cycles (1892 HRT and 473 mNC) in ovulatory women. Both groups received vaginal progesterone (800 mg/day) and oral dydrogesterone (30 mg/day) from the day after ovulation trigger or upon progesterone initiation. Propensity score matching was used to balance baseline characteristics, resulting in 1419 HRT and 473 mNC cycles for analysis. Treatment effect estimates with 95% confidence intervals were estimated using appropriate regression models.<h4>Results</h4>The propensity score-matched population had similar live birth rate (34.7% in the mNC group and 34.8% in the HRT group; aRR 1.02, 95% CI 0.80-1.29), pregnancy rate (54.3% vs 51.3%), clinical pregnancy rate (42.9% vs 42.0%), ongoing pregnancy rate (35.5% vs 35.7%), and miscarriage rate (7.8% vs 7.1%). There were no significant differences in multiple pregnancy rates, gestational age at delivery, birthweight, preterm birth rates between the two protocols.<h4>Conclusions</h4>In ovulatory women undergoing FET with intensive luteal phase support, the use of HRT or mNC for endometrial preparation yields comparable pregnancy and live birth rates.
ISSN:1932-6203

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