Objective: To explore the application of Femoston in hormone replacement treatment-frozen embryo transfer (HRT-FET) versus endometrial preparation with Progynova and examine the effects of different endometrial thickness and estradiol levels on clinical outcomes.
Methods: Retrospective analysis was conducted for a total of 1072 HRT-FET cycles at our center during January-June 2012. According to the type of medication, the patients were divided into 2 groups: Group A: Progynova only (798 cycles). Group B: non-satisfactory endometrial thickness or E2 level only by Progynova or repeated implantation failure, Progynova plus Femoston for preparing endometrium (274 cycles). Then the inter-group differences of basic profiles and clinical outcomes were compared. Comparison of clinical outcomes was performed based on different estradiol (E2) levels and endometrial thickness on the day of using progesterone. And then, the patients whose endometrial double thickness was thinner than 7 mm in Progynova + Femoston group were compared with the group of similar endometrial thickness in 2011. The data were analyzed with SPSS 16.0.
Results: In Group A, the percentage of first transfer, average endometrial thickness on the day of using progesterone in FET cycles were all significantly higher than Group B. And the ratio of < 7 mm was significantly higher in Group B (8.8% vs 2.4%). However, no significant differences existed in clinical pregnancy rate (54.8% vs 52.9%) or embryo implantation rate (38.1% vs 35.8%). With endometrial thickening, both clinical pregnancy and embryo implantation rates increased. There was no significant difference in maximum E2 level. Clinical pregnancy rate, embryo implantation rate and live birth rate of the patients whose endometrial double thickness was thinner than 7 mm in Group B were all higher than those of similar endometrial thickness (all Progynova only) in 2011.
Conclusion: For patients with thin endometrium, vaginal Femoston may be added if ideal endometrial thickness or E2 level is not achieved by Progynova alone. It improves endometrial receptivity and clinical outcomes are more satisfactory.