Modified natural and optimized programmed frozen embryo transfers have equivalent live birth rates: an analysis of 6,682 cycles

Authors

Elizabeth L. Wolfe, Department of Obstetrics and Gynecology, Maine Medical Center, Portland, ME, USA; Tufts University School of Medicine, Boston, MA.Follow
Denis Vaughan, Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston MA, USA; Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Boston MA, USA; Boston IVF-The Eugin Group, Waltham MA, USA.
Wendy Craig, Center for Clinical and Translational Science, MaineHealth Institute for Research, Scarborough, ME, USA; Tufts University School of Medicine, Boston, MA.Follow
Brianna Amaral, Boston IVF-The Eugin Group, Waltham MA, USA.
Alan Penzias, Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston MA, USA; Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Boston MA, USA; Boston IVF-The Eugin Group, Waltham MA, USA.
Denny Sakkas, Boston IVF-The Eugin Group, Waltham MA, USA.
Thomas L. Toth, Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston MA, USA; Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Boston MA, USA; Boston IVF-The Eugin Group, Waltham MA, USA.

Document Type

Article

Publication Date

2-18-2023

Institution/Department

Obstetrics & Gynecology

Journal Title

Fertility and Sterility

Abstract

OBJECTIVE: To compare live birth rates in modified natural and programmed single blastocyst frozen embryo transfer (FET) cycles. DESIGN: Retrospective cohort study. SETTING: University affiliated fertility practice. PATIENT(S): Patients undergoing single blastocyst FETs between January 2014 and December 2019. A total of 15,034 FET cycles from 9,092 patients were reviewed; 1,186 modified natural and 5,496 programmed FET cycles from 4,532 patients met inclusion criteria for analysis. INTERVENTION(S): No intervention. MAIN OUTCOME MEASURE(S): The primary outcome measure was live birth rate. RESULTS: There was no difference in live birth after programmed cycles using intramuscular (IM) progesterone or combination vaginal and IM progesterone compared to modified natural cycles [aRR 0.94 (0.85-1.04)] and [0.91 (0.82-1.02)], respectively. Relative risk of live birth was decreased, compared to modified natural cycles, in programmed cycles that used exclusively vaginal progesterone [aRR 0.77 (0.69-0.86)] CONCLUSION(S): Live birth rate was decreased in programmed cycles that used only vaginal progesterone. However, no difference in live birth rates existed between modified natural and programmed cycles if programmed cycles used either IM or combination IM and vaginal progesterone protocols. This study demonstrates that modified natural FET cycles and optimized programmed FET cycles have equivalent live birth rates.

Recommended Citation

Wolfe EL, Vaughan D, Craig W, et al. Modified natural and optimized programmed frozen embryo transfers have equivalent live birth rates: an analysis of 6,682 cycles [published online ahead of print, 2023 Feb 18]. Fertil Steril. 2023;S0015-0282(23)00148-6. doi:10.1016/j.fertnstert.2023.02.020