Journal of Shandong University (Health Sciences) ›› 2023, Vol. 61 ›› Issue (4): 56-63.doi: 10.6040/j.issn.1671-7554.0.2023.0032

• 临床医学 • Previous Articles    

Pregnancy outcomes of frozen embryo transfer in 112 patients of endometrial hyperplasia and early-stage endometrial cancer after fertility preserving treatment

QI Dan1, ZHANG Xi1, YU Qian1,2, CUI Linlin1,2, YAN Lei1,2   

  1. 1. Center for Reproductive Medicine, Shandong University &
    Department of Gynecology, Reproductive Hospital Affiliated to Shandong University, Jinan 250021, Shandong, China;
    2. Department of Reproductive Medicine, The Second Hospital of Shandong University, Jinan 250033, Shandong, China
  • Published:2023-04-11

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Abstract: Objective To investigate the effects of endometrial preparation protocol in frozen embryo transfer(FET)on pregnancy outcomes after fertility preserving treatment of complex hyperplasia/atypical hyperplasia/early-stage endometrial cancer(CH/AEH/EEC). Methods Clinical data of 179 FET cycles of 112 patients with CH/AEH/EEC, who underwent in vitro fertilization or intracytoplasmic single sperm injection(IVF/ICSI)during Jan. 2015 and Dec. 2020 were retrospectively analyzed. The patients were divided into four groups according to endometrial preparation protocols: natural cycle(group 1, n=29), stimulated cycle(group 2, n=38), hormone replacement treatment(group 3, n=89), and down-regulation in combination with hormone replacement therapy(group 4, n=23). Clinical characteristics and IVF/ICSI outcomes were assessed. The influencing factors of live birth rate were determined with binary Logistic regression analysis. Results Compared with groups 2, 3 and 4, group 1 had higher live birth rate per transfer cycle(34.2% vs. 31.0% vs. 31.5% vs. 30.4%), higher live birth rate(46.7% vs. 31.8% vs. 34.8% vs. 22.2%), higher clinical pregnancy rate per transfer cycle(52.6% vs. 37.9% vs. 49.4% vs. 43.5%), higher biochemical pregnancy rate per transfer cycle(65.8% vs. 44.8% vs. 64.0% vs. 47.8%), and lower miscarriage rate per transfer cycle(18.2% vs. 35.0% vs. 36.4% vs. 30.0%), but the differences were not statistically significant(P>0.05). Multivariate regression analysis showed that higher TSH level led to lower live birth rate per transfer cycle(OR=1.461, 95%CI=0.002-2.130), and increased number of retrieved oocytes led to higher live birth rate per transfer cycle(OR=0.903, 95%CI=0.833-0.980). The other potential confounders such as endometrium preparation protocol for FET had no significant correlation with the live birth rate per transfer cycle(P>0.05). Conclusion The endometrial preparation with FET shows no difference in terms of live birth rate, clinical pregnancy rate, biochemical pregnancy rate, and abortion rate of patients after fertility preserving treatment of CH/AEH/EEC. The endometrial preparation with FET should be selected individually so that patients have better endometrial transformation and achieve clinical pregnancy faster.

Key words: Complex hyperplasia, Atypical endometrial hyperplasia, Endometrial cancer, Assisted reproduction technology, Frozen-thawed embryo transfer, Live birth rate

CLC Number: 

  • R714
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