Different endometrial preparation protocols for frozen-thawed embryo transfer in elderly patientscompari-son of pregnancy outcomes
GENG Wenjun
ZHAO Bei
YAN Huili
KONG Hongjiao
TAN Yu
ZHANG Li
Abstract：Objective To explore the influence of different endometrial preparation regimens for elderly patients on the pregnancy outcomes of frozen-thawed embryo transfer.Methods A retrospective analysis was performed on 504 elderly patients(aged 35～45 years)who underwent frozen-thawed embryo transfer after receiving IVF or ICSI-assisted pregnancy at Henan Provincial Reproductive and Obstetrics Hospital from April 2022 to April 2025.These patients were divided into the natural cycle(NC)group(n=102),hormone replacement cycle(HRT)group(n=268),and down-regulation-hormone replacement(GnRH-a+HRT)group(n=134)according to the transfer strategy.The clinical pregnancy rate,continuous pregnancy rate,miscarriage rate,and biochemical pregnancy rate of the three patient groups were compared,and the risk factors influencing clinical pregnancy were analyzed.Results(1)There were no statistically significant differences among the three groups of patients regard-ing age,anti-Mullerian hormone(AMH),body mass index(BMI),duration of infertility,fertilization method,and type of transplanted embryo(P>0.05).The endometrial thickness on the transplantation day in the GnRH-a+HRT group was greater than that in the NC group and the HRT group,and this difference was statistically significant(P<0.05).(2)Both the clinical pregnancy rate and the sustained clinical pregnancy rate in the GnRH-a+HRT group were higher than those in the NC group and the HRT group,and the differences were statistically significant(P<0.05).There were no statistically significant differences in the miscarriage rate and biochemical pregnancy rate among the three groups(P>0.05).(3)The results of multivariate Logistic regression analyses indicated that increased age was a risk factor for clinical pregnancy(OR=0.896,P<0.05),whereas increased endometrial thickness and high AMH level were protective factors for clinical pregnancy(OR=1.171,1.089,respectively,P<0.05).Transplantation type and transplantation protocol are independent risk factors for clinical pregnancy in elderly patients.Conclusions For elderly patients,the GnRH-a+HRT regimen is capable of enhancing endome-trial receptivity,elevating the clinical pregnancy rate,and improving pregnancy outcomes.Therefore,GnRH-a+HRT can serve as an effective endometrial preparation protocol for frozen-embryo transfer(FET)in elderly patients.
Keywords：advanced agefrozen-thawed embryo transferdown-regulation-hormone replacement regimenpregnancy outcome
Publication Date：2026-03-10
Online Publishing Date：2026-03-20(First online date of this platform, not the publication date of the document)
Pages：6( 878-883 )