Arch Gynecol Obstet. 2025 Dec 30;313(1):1. doi: 10.1007/s00404-025-08277-z.
ABSTRACT
OBJECTIVE: The purpose of this study was to compare oral estradiol valerate and estradiol transdermal gel for clinical pregnancy outcomes in patients undergoing frozen-thaw embryo transfer (FET).
METHODS: This was a prospective study performed between March 1, 2017 and October 30, 2019. Totally 244 HR FET cycles were included, with 123 cycles using oral estrogen tablets (oral group) and 121 applying estradiol transdermal gel (gel group). The primary aim of this study was to compare implantation (IR), clinical pregnancy (CPR), miscarriage (MR) and live birth (LBR) rates between the two groups. The secondary aim was to assess liver function, specifically measuring alanine transaminase (ALT) and aspartate transaminase (AST) levels at 12 weeks of gestation.
RESULTS: There were no significant differences in EPR, IR, and CPR between the two groups. Meanwhile, the gel group had a higher live birth rate (55.37% versus 51.20%, p = 0.302) and a lower miscarriage rate (5.79% versus 10.57%, p = 0.173) compared with the oral group, but statistical significance was not reached. The oral group had higher ALT (16.58 ± 6.13 versus 23.78 ± 7.17, p < 0.001) and AST (19.70 ± 3.58 versus 23.78 ± 7.17, p = 0.001) levels at 12 weeks of gestation.
CONCLUSION: Estradiol transdermal gel is a safe and feasible alternative for endometrial preparation in frozen embryo transfer cycles, yielding comparable ongoing pregnancy rates to the standard oral regimen.
PMID:41469840 | DOI:10.1007/s00404-025-08277-z
