HRT Versus MOS for Endometrial Preparation Prior to FET in PCOS Patients
Condition: Infertility; Polycystic Ovarian Syndrome
MeSH terms: Polycystic Ovary Syndrome; Infertility; Syndrome
Study type: Observational

Summary: 
      Evaluation of endometrial preparation using either hormonal therapy or ovarian stimulation
      prior to frozen-thawed embryo transfer (FET) in patients with polycystic ovarian syndrome
      (PCOS)
    

Detailed description: 
      Women will be randomly divided into two groups; one will be subjected to endometrial
      preparation by hormone replacement therapy (HRT) and the other will be subjected to minimal
      ovarian stimulation (MOS). Women in the HRT group will be given estradiol valerate 4 mg daily
      from day 2 to day 12 of the cycle then the endometrial thickness will be assessed on day 13
      by transvaginal sonography (TVS). If the endometrium is ≥ 8 mm and of moderate echogenicity,
      luteal phase support (using progesterone supplements) will be started but if the endometrium
      is < 8 mm, estradiol valerate will be continued until reaching appropriate endometrial
      thickness and echogenicity then the luteal phase support will be started. Women in the MOS
      group will be given clomiphene citrate in dose of 100-150 mg daily for 5 days (from day 2 to
      day 6 of the cycle) then switched to low dose gonadotropin (75-150 IU daily) followed by
      monitoring of the follicular growth (folliculometry) ); starting from day 10 of the
      stimulation cycle and repeated every 2 days. Final oocyte maturation will be induced by
      administration of human chorionic gonadotropin (HCG) when there will be at least one leading
      follicle > 18 mm in diameter followed by luteal phase support (using progesterone
      supplements) after 48 hours. In both groups, FET will be planned in the appropriate day
      according to the stage that the embryos have been cryopreserved in it.
    

Intervention name(s): Estradiol valerate; Sequential Clomiphene citrate and Gonadotropin
Intervention type(s): Drug; Drug
Intervention description(s): Women will be given estradiol valerate 4 mg daily from day 2 to day 12 of the cycle then the endometrial thickness will be assessed on day 13 by transvaginal sonography (TVS). If the endometrium is ≥ 8 mm and of moderate echogenicity, luteal phase support (using progesterone supplements) will be started but if the endometrium is < 8 mm, estradiol valerate will be continued until reaching appropriate endometrial thickness and echogenicity then the luteal phase support will be started.; Women will be given clomiphene citrate in dose of 100-150 mg daily for 5 days (from day 2 to day 6 of the cycle) then switched to low dose gonadotropin (75-150 IU daily) followed by monitoring of the follicular growth (folliculometry) ); starting from day 10 of the stimulation cycle and repeated every 2 days. Final oocyte maturation will be induced by administration of human chorionic gonadotropin (HCG) when there will be at least one leading follicle > 18 mm in diameter followed by luteal phase support (using progesterone supplements) after 48 hours.
Other intervention name(s): Cycloprogynova (white tablets); Sequential Clomid and Menogon
Intervention MeSH terms: Estradiol 17 beta-cypionate; Estradiol 3-benzoate; Clomiphene; Enclomiphene; Zuclomiphene; Estradiol; Polyestradiol phosphate
Observational model: Cohort
Time perspective: Retrospective
Sampling method: Non-Probability Sample
Study population: 
        FET cycles carried out for PCOS women who had previously undergone ICSI with
        cryopreservation of at least 2 good quality cleavage-stage embryos
      
Keywords: Frozen-thawed embryo transfer; FET protocols