Frozen embryo transfer: Endometrial preparation by letrozole versus hormone replacement cycle: A randomized clinical trial|
Samsami, Alamtaj; Ghasmpour, Leila; Davoodi, Sara; Alamdarloo, Shaghayegh Moradi; Rahmati, Jamshid; Karimian, Ali & Homayoon, Hamide
Background: The endometrial preparation with stimulating natural cycles for frozen
embryo transfer (FET) have benefits like lower cost and ease of use.
Objective: Comparing the clinical outcome of letrozole versus hormone replacement
(HR) for endometrial preparation in women with normal menstrual cycles for FET in
artificial reproduction techniques.
Materials and Methods: A total of 167 participants who had frozen embryos and regular
ovulatory cycles were randomly divided into two groups for endometrial preparation.
One group (82 women) was stimulated with letrozole 5mg/day and the other group
(85 women) was hormonally stimulated by oral estradiol valerate (2 mg three times a
day). All participants were followed serially by ultrasonography. Any patient who did
not reach optimal endometrial thickness was excluded from the study. Implantation,
biochemical and clinical pregnancy and abortion rate were reported.
Results: There was no significant difference in the mean age, duration, and primary or
secondary infertility, cause of the infertility, number, and quality of transferred embryos
between the groups. The mean estradiol level on the day of transfer was 643 ± 217 in
the HR group and 547 ± 212 in the letrozole group (P = 0.01), which was significantly
different. The clinical pregnancy rate was 38.7 in the letrozole group, higher than the
HR group (25.3) but not significantly different (P = 0.06).
Conclusion: For endometrial preparation in women with a normal cycle, letrozole yields
higher pregnancy rate although it is not significant; due to its cost, ease in use, and
lower side effects, letrozole is a good choice.
Letrozole; Hormone replacement; Endometrial; Preparation; Frozen; Embryo.