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Comparison of natural versus artificial cycles for endometrial preparation prior to frozen embryo transfer Tyagitha, Galuh Anindya; Nuryanto, Kartiwa Hadi; Pratama, Gita; Maidarti, Mila; Harzif, Achmad Kemal; Sumapraja, Kanadi; Lestari, Silvia Werdhy; Ampri, Irfan Arieqal Hatta; Talya, Natasha; Yanfaunas, Atika Mahira
Universa Medicina Vol. 43 No. 3 (2024)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2024.v43.304-312

Abstract

BackgroundThe endometrial preparation phase preceding embryo transfer assumes pivotal significance in achieving optimal endometrial receptivity and ensuring the success of pregnancy. The natural cycle (NC) and artificial cycle (AC) are the preferred methods for many in vitro fertilization (IVF) specialists. The objective of this study was to compare the difference between NC and AC in women undergoing frozen-thawed embryo transfer (FET) after IVF. MethodsA cross-sectional study was conducted involving 150 adult women who underwent FET with a single autologous blastocyst stage embryo in a 5-year period (2014-2019). Bivariate analysis was conducted to discern implantation and pregnancy rates associated with NC and AC for endometrial preparation. Multiple logistic regression was used to assess the association between endometrial preparation and clinical outcomes while adjusting for potential confounders. ResultsOf the 150 subjects meeting study criteria, 19 underwent NC, while 131 underwent AC for endometrial preparation. Natural cycle exhibited a higher biochemical pregnancy rates compared to AC (89.5% vs. 53.4%; p=0.003). Artificial cycle is a significant determinant for biochemical pregnancy rates compared to NC (aOR: 0.132;95% CI: 0.028 – 0.623; p=0.010) ConclusionIn women undergoing FET, NC resulted in higher biochemical pregnancy rates compared to AC. However, clinical pregnancy rates and ongoing pregnancies rates did not exhibit significant disparities between NC and AC. Future studies will hopefully further illuminate which protocol is most suitable for the individual patient. Further multi-center randomized clinical trials are needed to confirm the relationship between biochemical pregnancy rates and NC.
Detection of Uterine Cavity Pathology in Subfertile Women Prior to In Vitro Fertilization Using Transvaginal Sonography and Office Hysteroscopy Lusiana, Nadya; Werdhani, Retno Asti; Maidarti, Mila; Harzif, Achmad Kemal; Sumapraja, Kanadi; Yanfaunnas, Atika Mahira; Ampri, Irfan Arieqal Hatta; Talya, Natasha; Pratama, Gita
Indonesian Journal of Obstetrics and Gynecology Volume 14. No. 1 January 2026
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v14i1.2795

Abstract

Objective: To compare transvaginal sonography (TVS) and office hysteroscopy in detecting uterine cavity pathology in subfertile women prior to in vitro fertilization (IVF).Methods: This retrospective cross-sectional study included 104 subfertile women who underwent both TVS and office hysteroscopy at the Yasmin IVF Clinic, Dr. Cipto Mangunkusumo Kencana Hospital, Jakarta. Findings from TVS and hysteroscopy were compared with histopathological results for chronic endometritis, endometrial polyps, submucosal fibroids, and endometrial hyperplasia. Findings of uterine septum and intrauterine synechiae on TVS were compared with hysteroscopy as the reference standard. Results: Office hysteroscopy detected chronic endometritis in 16.3% of subjects, with a sensitivity of 33% and specificity of 68%, whereas TVS did not identify any cases. Submucosal fibroids were detected by both modalities with identical specificity (100%) and sensitivity (75%). Endometrial polyps were identified in 47.1% of cases by hysteroscopy and 15.4% by TVS. TVS demonstrated higher specificity (88% vs. 35%), although both modalities showed low sensitivity (15% for TVS vs. 50% for hysteroscopy). Both methods accurately detected endometrial hyperplasia, showing high specificity (97%). Uterine septum and intrauterine synechiae were detected exclusively by hysteroscopy. Conclusion: Both TVS and office hysteroscopy are effective in detecting submucosal fibroids and endometrial hyperplasia. However, only hysteroscopy can identify chronic endometritis, uterine septum, and intrauterine synechiae, while TVS demonstrates higher specificity for detecting endometrial polyps. Histopathology remains the gold standard, and office hysteroscopy provides important complementary diagnostic value prior to IVF. Keywords: in vitro fertilization, office hysteroscopy, sub-fertility, transvaginal sonography