Endometrial preparation before the transfer of single, vitrified-warmed, euploid blastocysts: does the duration of estradiol treatment influence clinical outcome?
Open accessAbstract
Objective To investigate whether the duration of estrogen administration before euploid embryo transfer affects clinical outcome.Design Retrospective cohort study.Setting Private, academic fertility center.Patient(s) Patients (n = 1,439) undergoing autologous freeze-only in vitro fertilization with preimplantation genetic testing (PGT) followed by endometrial preparation with estrogen and progesterone in a frozen, euploid blastocyst transfer cycle.Intervention(s) None.Main outcome measure(s) Primary outcome was live birth, and secondary outcomes included implantation, clinical pregnancy, early pregnancy loss, live birth, infant birthweight, low birth weight, infant gestational age at delivery, and preterm birth.Result(s) The duration of estrogen administration (mean: 17.5 ± 2.9 days; range: 10-36 days) before frozen embryo transfer did not impact implantation (odds ratio [OR] 0.99; 95% confidence interval [CI], 0.95-1.03), clinical pregnancy (OR 0.98; 95% CI, 0.94-1.01), early pregnancy loss (OR 1.03; 95% CI, 0.95-1.12), or live birth (OR 0.99; 95% CI, 0.95-1.03). The duration of estrogen exposure did not affect infant birthweight (in grams) (β= -10.65 ± 8.91) or the odds of low birth weight (OR 0.87; 95% CI, 0.68-1.13). For every additional day of estrogen administration, we observed a reduction in gestational age at delivery (in weeks) (β= -0.07 ± 0.03), but the odds of preterm delivery were not affected (OR 1.05; 95% CI, 0.95-1.17).Conclusion(s) Variation in the duration of estradiol supplementation before progesterone initiation does not impact frozen, euploid blastocyst transfer outcome. The duration of estrogen administration was inversely correlated with gestational age at delivery, but this did not translate into an increase in preterm delivery. Further studies are required on the downstream effects of endometrial preparation on the placental-endometrium interface.
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Within reasonable limits, the length of estradiol priming does not change embryo implantation rates.
“the necessity for sufficient estrogen priming is very permissive, with no difference in embryo implantation rates related to the duration (2, 3) and/or dosing of E 2 priming (4), within reasonable limits of course”
From Endometrial receptivity in adenomyosis and/or endometriosis (2023) · cites this paper as [2]
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Endometrial receptivity in adenomyosis and/or endometriosis
Pirtea, P., de Ziegler, D., & Ayoubi, J. M. (2023) · Fertility and Sterility · doi:10.1016/j.fertnstert.2023.03.004 · Cited by 65 · see citing works
Pirtea, P., de Ziegler, D., & Ayoubi, J. M. (2019) · Fertility and Sterility · doi:10.1016/j.fertnstert.2019.04.007 · Cited by 6 · see citing works
- Authors
- Sekhon, L., Feuerstein, J., Pan, S., Overbey, J., Lee, J. A., Briton-Jones, C., Flisser, E., Stein, D. E., Mukherjee, T., Grunfeld, L., Sandler, B., & Copperman, A. B.
- Affiliations
- Reproductive Medicine Associates of New York (US)
- Icahn School of Medicine at Mount Sinai (US)
- Corresponding author
- Sekhon, Lucky
- Venue
- Fertility and Sterility
- Publisher
- Elsevier BV
- Published
- 2019-06
- Volume
- 111
- Issue
- 6
- Pages
- 1177-1185.e3
- ISSN
- 0015-0282 (ISSN-L)
- OpenAlex
- W2940979044
- Cited by
- 48
- References
- 29
- Citations by year
- 2026: 3 · 2025: 9 · 2024: 2 · 2023: 16 · 2022: 8 · 2021: 5 · 2020: 3 · 2019: 2
- FWCI
- 4.14
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Fertility and Sterility (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Biology and Fertility
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Assisted Reproductive Technology and Twin Pregnancy
- Health Sciences › Medicine › Reproductive Medicine › Reproductive Health and Technologies
- Keywords
- endometrial preparation, frozen embryo transfer, euploid blastocysts, preimplantation genetic testing, live birth rate, implantation rate, early pregnancy loss, birth weight, preterm birth, gestational age at delivery, progesterone
- MeSH terms
- Adult, Blastocyst, Drug Administration Schedule, Endometrium, Estradiol, Female, Fertility Agents, Female, Fertilization in Vitro, Humans, Infertility, Embryo Implantation, Pregnancy, Pregnancy Complications, Retrospective Studies, Risk Factors, Time Factors, Cryopreservation, Treatment Outcome, Pregnancy Rate, Live Birth, Single Embryo Transfer, Vitrification
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