Hormone replacement therapy alone or in combination with tamoxifen in women with thin endometrium undergoing frozen-thawed embryo transfer: A retrospective study

Qingqing Shi; Chenyang Huang; Jingyu Liu; Yifan Li; Na Kong; Jie Mei; Xiaoyue Shen; Yanxin Sun; Feifei Lu; Haixiang Sun; Guijun Yan

doi:10.3389/fendo.2023.1102706

Hormone replacement therapy alone or in combination with tamoxifen in women with thin endometrium undergoing frozen-thawed embryo transfer: A retrospective study

Front Endocrinol (Lausanne). 2023 Mar 1:14:1102706. doi: 10.3389/fendo.2023.1102706. eCollection 2023.

Authors

Qingqing Shi^{1

2

3}, Chenyang Huang^{1

2

3}, Jingyu Liu^{1

2

3}, Yifan Li^{1

2

3}, Na Kong^{1

2

3}, Jie Mei^{1

2

3}, Xiaoyue Shen^{1

2

3}, Yanxin Sun^{1

2

3}, Feifei Lu^{1

2

3}, Haixiang Sun^{1

2

3}, Guijun Yan^{1

2

3}

Affiliations

¹ Center for Reproductive Medicine and Obstetrics and Gynecology, Drum Tower Clinic Medical College of Nanjing Medical University, Nanjing, China.
² Center for Reproductive Medicine and Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, China.
³ Center for Molecular Reproductive Medicine, Nanjing University, Nanjing, China.

Abstract

Research question: To investigate the effects of two protocols (hormone replacement therapy (HRT) alone or in combination with tamoxifen) on the endometrium and pregnancy outcome of patients with thin endometrium in frozen-thawed embryo transfer (FET) cycles.

Design: A total of 465 infertile patients with thin endometrium who underwent FET between January 2020 to June 2021 at the Drum Tower Hospital affiliated with Nanjing University Medical School were retrospectively analyzed. A total of 187 patients were given tamoxifen in addition to HRT (TMXF-HRT group), whereas 278 patients were given only HRT (HRT group). Clinical data were compared between the two groups, including general characteristics, endometrial thickness, and clinical pregnancy outcomes.

Results: There were no significant differences in baseline characteristics of all enrolled patients between two groups. Serum progesterone (P) was higher in HRT group than in the TMXF-HRT group (0.28 ± 0.53 ng/mL vs. 0.15 ± 0.25 ng/mL, P = 0.002). There was a significant increase in endometrial thickness in the TMXF-HRT group compared with the HRT group (OR: 1.54, 95% CI: 1.32-1.75, P < 0.001). There were no significant differences in the clinical pregnancy rate, embryo implantation rate, early miscarriage rate, or live birth rate between these two groups.

Conclusion: Although tamoxifen when used in combination with hormone replacement therapy can significantly increase endometrial thickness, it may not have a role in improving the pregnancy outcomes of patients with thin endometrium undergoing FET cycles.

Keywords: frozen-thawed embryo transfer; hormone replacement; pregnancy outcomes; tamoxifen; thin endometrium.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Embryo Transfer / methods
Endometrium*
Female
Hormone Replacement Therapy
Humans
Pregnancy
Retrospective Studies
Tamoxifen* / pharmacology
Tamoxifen* / therapeutic use

Substances

Tamoxifen

Grants and funding

This work was supported by the National Natural Science Foundation of China (81801530) and Reproductions Research Program of Young and Middle-aged Physicians and China Health Promotion Foundation (BJHPA-2022-SHZHYXZHQNYJ-LCH-002).