The future of frozen-thawed embryo transfer in hormone replacement therapy cycles
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The future of frozen-thawed embryo transfer in hormone replacement therapy cycles. / Løssl, Kristine; Spangmose, Anne Lærke; Asserhøj, Louise Laub; Dam, Tine Vrist; Pinborg, Anja.
In: Current Opinion in Obstetrics and Gynecology, Vol. 35, No. 3, 2023, p. 200-209.Research output: Contribution to journal › Review › Research › peer-review
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TY - JOUR
T1 - The future of frozen-thawed embryo transfer in hormone replacement therapy cycles
AU - Løssl, Kristine
AU - Spangmose, Anne Lærke
AU - Asserhøj, Louise Laub
AU - Dam, Tine Vrist
AU - Pinborg, Anja
N1 - Publisher Copyright: © 2023 Lippincott Williams and Wilkins. All rights reserved.
PY - 2023
Y1 - 2023
N2 - Purpose of reviewThis 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.Recent findingsThe 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.SummaryNatural 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.
AB - Purpose of reviewThis 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.Recent findingsThe 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.SummaryNatural 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.
KW - frozen embryo transfer
KW - hormone replacement therapy
KW - letrozole
KW - live birth rate
KW - preeclampsia
U2 - 10.1097/GCO.0000000000000867
DO - 10.1097/GCO.0000000000000867
M3 - Review
C2 - 37185352
AN - SCOPUS:85158021931
VL - 35
SP - 200
EP - 209
JO - Current Opinion in Obstetrics and Gynecology
JF - Current Opinion in Obstetrics and Gynecology
SN - 1040-872X
IS - 3
ER -
ID: 365544053