Comparison of different endometrial preparation protocols in frozen-thawed embryo transfer cycles in women with polycystic ovary syndrome

Abstract

Aim: This study aimed to evaluate the most suitable endometrial preparation protocols such as hormone replacement therapy (HRT) with gonadotropin releasing hormone analogue (GnRH-a) suppression, HRT without GnRH-a suppression and mild ovarian stimulation (OS) for women with  polycystic ovary syndrome (PCOS) undergoing frozen-thawed embryo transfer (FET).Material and Method: We conducted a historical cohort analysis of 161 women with PCOS who underwent the “freeze-all” strategy between December 2018 and August 2020 because of their high risk for ovarian hyperstimulation syndrome. Three endometrial preparation protocols were used: HRT with GnRH-a suppression (n=43); HRT without GnRH-a suppression (n=86); mild-OS (n=32).Results: The biochemical pregnancy results (55.8 % vs 54.65 % vs 53, p=0.900), ongoing pregnancy rates (44.2 % vs 43 % vs 40.62, p=0.572), and abort rates (20.8 % vs 21.3 % vs 23.52, p=0.900) were similar between the HRT with GnRH-a suppression, without GnRH-a suppression and mild-OS, respectively. This study showed no statistically significant difference between the three protocols in laboratory parameters (p>0.05). Conclusion: There was no statistically difference between three groups in terms of pregnancy outcomes. Dependent on clinical experience and facility, one of these protocols could be deployed for FET in women with PCOS.