Stimulated cycle versus artificial cycle for frozen embryo transfer in patients with polycystic ovary syndrome: a Meta-analysis

Abstract

Purpose

Our aim is to conduct a meta-analysis comparing clinical outcomes between the mild ovarian stimulation cycle versus an artificial cycle (AC) for frozen embryo transfer (FET) in patients with polycystic ovary syndrome (PCOS).

Methods

We systematically searched the databases of PubMed, EMBASE and the Cochrane Library from inception to January 2020. The outcomes were live birth rate (LBR), ongoing pregnancy rate (OPR), clinical pregnancy rate (CPR), embryo implantation rate (IR) and miscarriage rate (MR). The mild ovarian stimulation cycle and AC were compared according to risk ratios and 95% confidence intervals using a fixed or random effects model.

Results

Four retrospective studies describing the clinical outcomes were included. We found no significant difference in LBR, OPR, CPR, IR or MR between the mild ovarian stimulation cycle and AC protocols, whereas a lower MR was found for the letrozole-stimulated cycle than the AC.

Conclusions

The letrozole-stimulated cycle for endometrial preparation in PCOS patients undergoing FET may lower the MR more than the AC. PCOS patients using the mild ovarian stimulation cycle for endometrial preparation undergoing FET had similar LBR, OPR, CPR and IR compared with the AC. The letrozole-stimulated protocol may be a reasonable choice for endometrial preparation before FET for women with PCOS.

摘要

目的：本研究目的是进行一项荟萃分析, 比较多囊卵巢综合征(PCOS)患者行卵巢微刺激周期和人工周期(AC)进行冷冻胚胎移植(FET)的临床结局。

方法：应用计算机检索PubMed、EMBASE和Cochrane Library数据库, 检索时间从有数据记录开始至2020年1月。观察指标包括活产率（LBR）, 持续妊娠率（OPR）, 临床妊娠率（CPR）, 胚胎着床率（IR）和流产率（MR）。使用固定或随机效应模型, 根据风险比和95％置信区间比较了轻度卵巢刺激周期和AC。

结果：四项描述临床结果的回顾性研究被纳入。我们发现卵巢微刺激周期和AC方案之间的LBR, OPR, CPR, IR或MR没有显着差异, 而来曲唑刺激周期的MR低于AC。

结论：来曲唑刺激周期用于PCOS患者行FET的子宫内膜准备可能比AC更能降低MR。使用卵巢微刺激周期进行FET子宫内膜准备的PCOS患者, 其LBR、OPR、CPR和IR与AC相似。来曲唑刺激方案可能是多囊卵巢综合征妇女FET前子宫内膜准备的合理选择。

Keywords:

• Stimulated cycleartificial cyclefrozen embryo transfer
• polycystic ovary syndrome
• clinical outcomes

Disclosure statement

No potential conflict of interest was reported by the author(s).