ORİJİNAL ARAŞTIRMALAR
Dondurulmuş-Çözdürülmüş Embriyo Transferlerinde Farklı Naturel (Naturel, Modifiye Naturel, Stimule Edilmiş Modifiye Naturel) Siklus Sonuçlarının Karşılaştırılması
Comparison of Different Naturel (Natural, Modified Natural, Stimulated Modified Natural) Cycle Results in Frozen-Thawed Embryo Transfers
Received Date : 06 Oct 2022
Accepted Date : 15 Dec 2022
Available Online : 27 Dec 2022
Sevinç ÖZMENa, Esra Nur TOLAb
aİstanbul Medipol Üniversitesi Medipol Mega Hastanesi, Tüp Bebek Ünitesi, İstanbul, Türkiye
bİstanbul Medipol Üniversitesi Tıp Fakültesi Doğum ve Kadın Hastalıkları ABD, İstanbul, Türkiye
Doi: 10.24074/tjrms.2022-93740 - Makale Dili: TR
TJRMS. 2022;6(3):185-9
ÖZET
Amaç: Çalışmamızın amacı naturel siklus ile dondurulmuş-çözdürülmüş embriyo transferi (DÇET) uygulanan hastalarda kullanılan 3 farklı naturel siklus yönteminin
klinik sonuçlarını karşılaştırmaktır. Gereç ve Yöntemler: Bu retrospektif çalışma Medipol Mega Hastanesi İn vitro Fertilizasyon (IVF) Ünitesinde yapıldı. Naturel
siklus ile DÇET yapılan 35 yaş ve altı 271 kadın retrospektif olarak çalışmaya alındı. Vakalar DÇET siklusu hazırlama protokolüne göre 3 gruba ayrıldı: Spontan
ovulasyona kadar sadece izlem yapılan grup naturel DÇET (n-DÇET, n=155), spontan folikül gelişimi takip edilip ovulasyon için human koryonik gonadotropin
(hCG) yapılan grup modifiye naturel DÇET (mn-DÇET, n=81), aromataz inhibitörü ile ovulasyon indüksiyonu yapılıp ovulasyonu tetiklemek için hCG yapılan grup
stimule edilmiş modifiye naturel DÇET (s-DÇET, n=35) grubu. Çalışmaya alınan vakaların hepsi dondurulmuş iyi kalite blastokiste sahipti. Gruplar arası implantasyon
(pozitif gebelik testi), klinik gebelik (ultrasonda fetal kalp atımı), abort (20. gestasyonel haftadan önce gebelik terminasyonu) ve canlı doğum oranları karşılaştırıldı.
Bulgular: Naturel DÇET, modifiye naturel DÇET ve stimule edilmiş modifiye naturel DÇET grupları arasında siklus iptali, implantasyon, abortus ve canlı doğum
oranları arasında anlamlı olarak fark izlenmedi. Sonuç: n-DÇET, mn-DÇET ve s-DÇET grupları arasında IVF başarısı benzerdir. Naturel siklusla DÇET yapılacak
vakalarda menstrual siklusu düzenli ise mn-DÇET, siklusu düzenszi grupta ise s-DÇET yapılması daha az maliyetli ve klinisyen ve hasta açısından daha az zaman
alıcı gibi durmaktadır.
Anahtar Kelimeler: İn vitro fertilizasyon; embryo transferi
ABSTRACT
Objective: The aim of our study was to compare the clinical results of 3 different natural cycle methods used in patients who underwent naturel cycle and frozenthawed
embryo transfer (FET). Material and Methods: This retrospective study was conducted at Medipol Mega University Hospital IVF Center. 271 cases aged
35 years and younger who underwent naturel cycle frozen-thawed embryo transfer (FET) were included in the study. Cycles were analyzed in three groups: n-FET
(n=155) in the group that was followed only until spontaneous ovulation, mn-FET (n=81) in the group in which spontaneous follicle development was followed to
trigger ovulation and in which hCG injection was performed, ovulation induction with an aromatase inhibitor and ovulation was performed. was determined as the s-
FET(n=35) group, which was injected with hCG to trigger it. All cases included in the study had frozen good quality blastocyst. Embryological data of the groups
were recorded. The rates of implantation (positive pregnancy test), clinical pregnancy (fetal heartbeat on ultrasound), abortion (pregnancy termination before 20
weeks of gestation) and live birth were compared between the groups. Results: When the subgroup analyzes of the natural FET groups were made, it was seen that
there was no significant difference between the rates of abortion, pregnancy, pregnancy loss and live birth in the three groups. Conclusion: In our study, no difference
was observed between the n-FET, c-FET and mn-FET groups in terms of results. It seems that performing s-FET in the mn-FET higper-responder group in the
normoresponder group in cases where FET will be performed with the naturel cycle is less costly and less time-consuming for the clinician and the patient.
Keywords: İn vitro fertilization, embryo transfer
REFERANSLAR
- Ghobara T, Vandekerckhove P. Cycle regimens for frozen-thawed embryo transfer (Review). The Cochrane Library. 2008;2 23;(1):CD003414. [Crossref] [PubMed]
- von Versen-Höynck F, Schaub AM, Chi YY et al. Increased preeclampsia risk and reduced aortic compliance with ın vitro fertilization cycles in the absence of a corpus luteum.Hypertension. 2019 ;73(3):640-9. [Crossref] [PubMed] [PMC]
- Wong KM, Mastenbroek S, Repping S. Cryopreservation of human embryos and its contribution to in vitro fertilization success rates. Fertil Steril. 2014;102(1):19-26. [Crossref] [PubMed]
- Zhu Q, Chen Q, Wang L et al. Live birth rates in the first complete IVF cycle among 20 687 women using a freeze-all strategy. Hum Reprod. 2018;33(5):924-9. [Crossref] [PubMed]
- Mackens S, Santos-Ribeiro S, van de Vijver A,.Hum Reprod. 2017;32(11):2234-42. [Crossref] [PubMed]
- Agha-Hosseini M, Hashemi L, Aleyasin A, et al.Naturel cycle versus artificial cycle in frozenthawed embryo transfer: A randomized prospective trial.Turk J Obstet Gynecol. 2018;15(1):12-7. [Crossref] [PubMed] [PMC]
- Gardner DK, Lane M, Stevens J, Schlenker T, Schoolcraft WB. Blastocyst score affects implantation and pregnancy outcome: towards single blastocysts transfer. Fertil Steril. 2000;73(6):1155-8. [Crossref] [PubMed]
- Bartels CB, Ditrio L, Grow DR, et al The window is wide: flexible timing for vitrified-warmed embryo transfer in naturel cycles. Reprod BioMed Online. 2019;39(2):241-8. [Crossref] [PubMed]
- Al-Shawaf T, Yang D, Al-Magid Y, Seaton A, Iketubosin F, Craft I. Infertility: Ultrasonic monitoring during replacement of frozen/thawed embryos in naturel and hormone replacement cycles. Hum Reprod. 1993;8:2068-74. [Crossref] [PubMed]
- Le QV, Abhari S, Abuzeid OM, et al. Modified naturel cycle for embryo transfer using frozen-thawed blastocysts: A satisfactory option. Eur J Obstet Gynecol Reprod Biol. 2017;213:58-63. [Crossref] [PubMed]
- Weissman A, HorowitzE, Ravhon A, Steinfeld Z, Mutzafi R, Golan A, Levran,D. Spontaneous ovulation versus HCG triggering for timing naturel-cycle frozen-thawed embryo transfer: a randomized study. Reprod Biomed Online. 2011;23(4):484-9. [Crossref] [PubMed]
- Fatemi HM, Kyrou D, Bourgain C, Van den Abbeel E, Griesinger G, Devroey P. Cryopreserved-thawed human embryo transfer: spontaneous naturel cycle is superior to human chorionic gonadotropin-induced naturel cycle Fertil Steril. 2010;94:2054-8B. [Crossref] [PubMed]
- Li SJ, Zhang YJ, Chai XS, Nie MF, Zhou YY, Chen JL, Tao GS Letrozole ovulation induction: an effective option in endometrial preparation for frozen-thawed embryo transfer.Arch Gynecol Obstet. 2014;289(3):687-93. [Crossref] [PubMed]
- Peeraer K, Couck I, Debrock S, et al. Frozen-thawed embryo transfer in a naturel or mildly hormonally stimulated cycle in women with regular ovulatory cycles: a RCT. Hum Reprod. 2015;30(11):2552-62. [Crossref] [PubMed]