The FET cycle
In the group of TAM, 20 mg per day was giving from day 5 of the
menstrual cycle for 5 days. Vaginal ultrasound examinations were
performed on day 10 of the cycle to monitor the number and size of
developing follicles and endometrial thickness. Ovulation was induced
with 10,000 I.U. hCG (human chorionic gonadotropin, Lizhu Pharmaceutical
Trading Co.) when the leading follicle reached 18–22 mm and the
endometrium thickness reached 7 mm. Day-3 ET was performed four days
later while blastocyst transfer was performed six days later. Exogenous
progesterone (20 mg/d; Duphaston; Abbott Biologicals B.V.,
Netherlands) was given vaginally starting 2 days after hCG
administration.If no dominant follicle developed, a daily dosage of 75
IU hMG (human menopausal gonadotropin, Lizhu Pharmaceutical Trading Co.)
was given from day 10 up to hCG injection, with incremental doses of
37.5 IU if needed. If there was no dominant follicle after 15 days of
ovarian stimulation or if the follicle reached a diameter of maturity
and endometrial thickness did not attain 7 mm, the cycle would be
cancelled. If the endometrial thickness did not attain 7 mm when
follicle reached a diameter of maturity, the cycle would be cancelled
either.
In the group of
hormone
replacement treatment cycle, oral estradiol valerate (progynova,
Schering, German) was taken 6 mg/d from menstrual cycle day 2-3. An
ultrasound assessment was done 12 to 14 days later to assess endometrium
thickness. Progesterone 40 mg/d,which would be changed to 60 mg/d 2
days later, was given to transform the endometrium, provided the
endometrial thickness exceeded 7 mm. Embryo transfer was performed 3
days after progesterone administration for day-3 embryos or 5 days later
for blastocysts. If the endometrium thickness is not adequate,
endometrial preparation continued with step-up dose of E2 or adding
vaginal estradiol (Femoston, Solvay pharmaceuticals B.V.) 1-2 mg/d till
the endometrium thickness reaching 7 mm. Cycles were canceled in
patients whose endometrial thickness remained <7 mm after 21
days of continuous estradiol administration.
In both TAM-FET and HRT-FET groups, luteal support was continued to 10
weeks of gestation if a pregnancy achieved.