Success Rate Natural Cycles Versus Modified Natural Cycles in Frozen Embryos

Study Overview
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Brief Summary
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There has been a recent significant increase in the frozen embryo replacement (FER) cycles due to freeze-all cycles to decrease the risk of ovarian hyperstimulation syndrome. Now a days making frozen embryo transfers (FETs) a viable alternative to fresh embryo transfer

Detailed Description
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There has been a recent significant increase in the frozen embryo replacement (FER) cycles due to freeze-all cycles to decrease the risk of ovarian hyperstimulation syndrome. Now a days making frozen embryo transfers (FETs) a viable alternative to fresh embryo transfer, with reports from observational studies and randomized controlled trials suggesting that: The endometrium in stimulated cycles is not optimal for implantation Pregnancy rates are increased following FET Perinatal outcomes are less affected after FET Preimplantation genetic screening We will follow only natural and modified natural cycles patients. Spontaneous ovulation will documented with hormonal and sonographic monitoring. Hormonal monitoring are including estradiol and luteinizing hormone (LH). Sonographic monitoring is including follicule diameter (16-20 mm). At modified natural cycles we will use hCG triggering for ovulation approximately 16-20 mm diameter. We will compare success rate between natural and modified natural cycles

Official Title
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Comparison of Clinical Results of Frozen Embryo Transfer in Natural and Modified Natural Cycles

Conditions
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Infertility, Female

Intervention / Treatment
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* Other: natural cycle
* Other: modified natural cycle
* Other: embryo transfer


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patient who are admitted to the IVF center and who will be transferred to frozen embryos. Infertile women under 40 years of age who accepted this study. Unexplained infertilite couple. All ovulatory patient. Male factor. Tubal factor. Exclusion Criteria: Patients who made intrauterin surgery. Over 40 years of age women. Patients with preimplantation genetic diagnosis. Anovulatory patient.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 40 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Natural frozen embryo transfer group<br>In this group all embryos will be frozen when transfer planned sonographic follicle diameter measured. After spontaneous ovulation, embryo transfer will be planned. Luteal phase support will not be used. | Other: natural cycle<br>* When follicle is ready for ovulation, we will use this injection by intra-dermal route<br>* Other names: natural LH surge;Other: modified natural cycle<br>* we will use that drug in the natural modified transfer group after embryo transfer<br>* Other names: recombinant hcg;Other: embryo transfer<br>* we will do transfer when the endometrium is ready<br>* Other names: frozen embryo transfer;|
| modified natural embryo transfer group<br>In this group all embryos will be frozen when transfer planned sonographic follicle diameter measured. When follicle diameter is 16-17 mm we will apply hCG (recombinant hCG). After ovulation, embryo transfer will be done. Luteal phase support will not be used. | Other: natural cycle<br>* When follicle is ready for ovulation, we will use this injection by intra-dermal route<br>* Other names: natural LH surge;Other: modified natural cycle<br>* we will use that drug in the natural modified transfer group after embryo transfer<br>* Other names: recombinant hcg;Other: embryo transfer<br>* we will do transfer when the endometrium is ready<br>* Other names: frozen embryo transfer;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| birth | live birth | bigger than 24 weeks pregnancy | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| pregnancy rate | hcg blood test | 10th day after embryo transfer | 
| clinical pregnancy rate | positive fetal cardiac activity | 8 weeks | 
| abortion rate | abortion after visualization of fetal cardiac activity | 8 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Frozen embryo replacement, IVF success, ovarian stimulation