Natural cycle for frozen-thawed embryo transfer: Spontaneous ovulation or triggering by HCG

S. Huberlant (1, 2) , M. Vaast , T. Anahory (3, 2) , M. L. Tailland (1) , N. Rougier (1) , N. Ranisavljevic (2) , S. Hamamah (3, 4)

1 CHU Nîmes - Centre Hospitalier Universitaire de Nîmes
2 Service de gynécologie-obstétrique et médecine de la reproduction
3 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
4 UMR 1203 - Développement embryonnaire précoce humain et pluripotence EmbryoPluripotency

OBJECTIVE: To compare frozen-thawed embryo transfer (FET) outcomes in natural cycles according to ovulation induction: spontaneous versus recombinant human chorionic gonadotrophin (r-hCG) triggering. METHODS: This retrospective study included all patients monitored for natural cycle FET during one year. When serial monitoring were performed until spontaneous LH rise, patients were included in group A (n=38) whereas those receiving r-hCG for ovulation triggering formed group B (n=43). All embryos had been cryopreserved by a vitrification method following a previous IVF cycle. No luteal phase support had been given. We compared outcomes between the 2 groups. RESULTS: After checking groups comparability, we didn't find significant difference for the implantation rate, clinical pregnancy rate and live birth (31% vs 45%, 32% vs 51% et 21% vs 32%, respectively for group A and B). The number of monitoring was significantly lower in group B (1,9\textpm0,8 versus 2,5\textpm1, P=0,006). DISCUSSION: Although no consensus has been yet established, natural cycle seems indicated for normo-ovulating patients but the question of ovulation induction is still debated. In our study, triggering ovulation by r-hCG, respecting strict criteria, seems provide good results while reducing both protocol's constraints and cost.

Mots clés: Human chorionic gonodotrophin; Hormone chorionique gonadotrope; Frozen-thawed embryo transfer; Natural cycle; Live Birth; Humans; Female; Pregnancy; Retrospective Studies; Adult; Recombinant Proteins; Chorionic Gonadotropin; Cryopreservation; Cycle naturel; Cycle regimen; Déclenchement de l\textquoterightovulation; Embryo Implantation; Embryo Transfer; Ovulation; Ovulation Induction; Pregnancy Outcome; Pregnancy Rate; Préparation endométriale; Transfert d\textquoterightembryons congelés

Domaines: Sciences du Vivant [q-bio]

S. Huberlant, M. Vaast, T. Anahory, M. L. Tailland, N. Rougier, et al.. Natural cycle for frozen-thawed embryo transfer: Spontaneous ovulation or triggering by HCG. Gynécologie Obstétrique Fertilité & Sénologie, 2018, 46 (5), pp.466--473. ⟨10.1016/j.gofs.2018.03.006⟩. ⟨hal-02340912⟩