Against
from Section III - The Best Policy
Published online by Cambridge University Press: 25 November 2021
Frozen – thawed embryo transfer (FET) is becoming increasingly important in the armamentarium of assisted reproductive medicine. In the Netherlands, in 2018, 46% of all ongoing pregnancies was the result of a FET cycle. More and more fertility centres offer freeze-all cycles to prevent OHSS. Nevertheless, there remains controversy regarding the optimal method of preparing the endometrium of normal ovulatory women before FET. The most applied protocols are the artificial FET cycle, the true natural FET cycle and the modified natural FET cycle. In an artificial FET cycle, the endometrium is prepared by applying estrogens and progesterone to mimic a natural cycle. Estrogen is applied until the endometrium reaches a thickness of least 7 mm and then progesterone is added. In a true natural FET cycle the spontaneous LH surge is detected by LH testing in urine or blood to plan thawing and transfer. In a modified natural cycle, hCG is given once the follicle has reached a mean diameter of 16–18 mm with an adequate endometrium thickness. This paper will show that the artificial cycle FET should be offered to all ovulatory women instead of the (modified) natural cycle FET.
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