Table_4_The relationship between dominant follicle development and clinical outcomes of hormone replacement therapy-frozen embryo transfer: a retrospective clinical study.docx

Research questionHormone replacement therapy (HRT) is one of the most used endometrial preparation protocols for frozen embryo transfer (FET) due to the convenience of its administration and stability of pregnancy outcomes. There are several HRT cycles accompanied by the development of dominant follicles. However, the relationship between dominant follicle development and clinical outcomes in HRT-FET cycles remains unclear.
DesignWe carried out a retrospective cohort study of 13251 cycles at our reproductive medicine center from 2012 to 2019. Total cycles were divided into two groups according to whether there was dominant follicular development. In addition, we conducted a secondary analysis that used propensity-score matching to reduce confounding variables. A univariate and multivariable logistic regression model was further employed to analyze the effect of dominant follicle development in HRT cycles on clinical pregnancy outcomes.
ResultsThere was no significant correlation between dominant follicle development in HRT-FET cycles and the clinical pregnancy rate (adjusted OR = 1.162, 95% CI: 0.737-1.832, P = 0.52). In addition, there was a positive correlation between the basic follicle-stimulating hormone (FSH) level and the development of dominant follicles, while there was a negative correlation between antral follicle count (AFC), menstrual cycle length and the development of dominant follicles in HRT cycles.
ConclusionsThe development of dominant follicles in HRT-FET cycles does not affect the clinical pregnancy rate, early miscarriage rate and live birth rate. Therefore, it is not necessary to immediately cancel the FET cycle immediately when dominant follicle development is monitored in the HRT-FET cycle.

研究问题：激素替代疗法（Hormone replacement therapy, HRT）因给药便捷、妊娠结局稳定，是冻融胚胎移植（frozen embryo transfer, FET）最常用的子宫内膜准备方案之一。部分HRT周期中会伴随优势卵泡发育，但此类HRT-FET周期内，优势卵泡发育与临床结局的关联仍不明确。
研究设计：本研究针对2012年至2019年间本生殖医学中心的13251个周期开展了一项回顾性队列研究。根据是否存在优势卵泡发育，将全部周期分为两组；此外，我们采用倾向得分匹配（propensity-score matching）以减少混杂变量的干扰，并进一步通过单因素及多因素logistic回归模型，分析HRT周期中优势卵泡发育对临床妊娠结局的影响。
研究结果：HRT-FET周期中优势卵泡发育与临床妊娠率无显著相关性（校正后OR=1.162，95%CI：0.737~1.832，P=0.52）。此外，HRT周期内，基础卵泡刺激素（follicle-stimulating hormone, FSH）水平与优势卵泡发育呈正相关，而窦卵泡计数（antral follicle count, AFC）、月经周期长度与优势卵泡发育呈负相关。
研究结论：HRT-FET周期中的优势卵泡发育不会对临床妊娠率、早期流产率及活产率造成影响。因此，在HRT-FET周期中监测到优势卵泡发育时，无需立即取消该FET周期。