Open Access

A clinical and basic study of optimal endometrial preparation protocols for patients with infertility undergoing frozen‑thawed embryo transfer

  • Authors:
    • Junxia An
    • Lifei Li
    • Xiang Zhang
    • Lin Liu
    • Liyan Wang
    • Xuehong Zhang
  • View Affiliations

  • Published online on: June 19, 2020     https://doi.org/10.3892/etm.2020.8914
  • Pages: 2191-2199
  • Copyright: © An et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

The optimal protocol for endometrial preparation in patients with infertility remains unclear. Due to this, the current study retrospectively analyzed 1,589 patients with infertility and regular menstrual cycles to assess reproductive outcomes per embryo transferred and per embryo transfer (ET) cycle following the transfer of frozen‑thawed embryos (FET) in a modified natural cycle (mNC) or hormone therapy cycle (HT) with or without gonadotropin‑releasing hormone agonist (GnRHa)‑induced pituitary suppression. The molecular mechanisms involved were also studied using tissues from endometrial biopsies. Patients who underwent FET were assigned to 5 groups as follows: Group A underwent a mNC (n=276); group B (n=338) received estradiol (E2) and progesterone (P4); group C received 1 cycle of GnRHa, E2 and P4 (n=323); group D received 2 cycles of GnRHa, E2 and P4 (n=329); and group E received 3 cycles of GnRHa, E2 and P4 (n=323). Tissues from endometrial biopsies of 91 patients performed on the day of ET were tested for endometrial receptivity marker mRNA expression and microRNA (miR)‑223‑3p mRNA. Furthermore, endometrial stromal cells (ESCs) were used for an in‑depth study of the molecular mechanisms involved. Among the 5 groups of patients, implantation rates, clinical pregnancy rates and live birth rates were not significantly different. However, endometrial receptivity was enhanced in group E when compared with groups A‑D, which was associated with endometrial leukemia inhibitory factor (LIF), osteopontin, vascular endothelial growth factor, integrin β3 and homeobox gene 10 and 11 mRNA upregulation, and miR‑223‑3p miRNA downregulation. Transfection of ESCs with an miR‑223‑3p mimic significantly reduced levels of LIF mRNA and protein. In addition, pre‑treating ESCs with GnRHa upregulated mRNA and protein expression of the decidualization markers prolactin and insulin‑like growth factor binding protein‑1 in a time‑dependent manner. In conclusion, these results indicated that HT with GnRHa may be a potential endometrial preparation protocol for FET.

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September-2020
Volume 20 Issue 3

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Copy and paste a formatted citation
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Spandidos Publications style
An J, Li L, Zhang X, Liu L, Wang L and Zhang X: A clinical and basic study of optimal endometrial preparation protocols for patients with infertility undergoing frozen‑thawed embryo transfer. Exp Ther Med 20: 2191-2199, 2020
APA
An, J., Li, L., Zhang, X., Liu, L., Wang, L., & Zhang, X. (2020). A clinical and basic study of optimal endometrial preparation protocols for patients with infertility undergoing frozen‑thawed embryo transfer. Experimental and Therapeutic Medicine, 20, 2191-2199. https://doi.org/10.3892/etm.2020.8914
MLA
An, J., Li, L., Zhang, X., Liu, L., Wang, L., Zhang, X."A clinical and basic study of optimal endometrial preparation protocols for patients with infertility undergoing frozen‑thawed embryo transfer". Experimental and Therapeutic Medicine 20.3 (2020): 2191-2199.
Chicago
An, J., Li, L., Zhang, X., Liu, L., Wang, L., Zhang, X."A clinical and basic study of optimal endometrial preparation protocols for patients with infertility undergoing frozen‑thawed embryo transfer". Experimental and Therapeutic Medicine 20, no. 3 (2020): 2191-2199. https://doi.org/10.3892/etm.2020.8914