الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Endometrial receptivity and embryo quality are two major factors influencing FET success in PCOS patients, and their synchronisation is crucial for pregnancy establishment.
Due to the irregular menstrual cycles or oligo-anovulation often experienced by women with PCOS, natural endometrial preparation for frozen embryo transfer (FET) is rarely employed. Instead, artificial cycle and ovarian stimulation methods have gained widespread use. In women with PCOS, hormone replacement therapy (HRT) is used to establish an artificial cycle where the endometrium is prepared using a controlled regimen of estrogen and progesterone, resulting in a predetermined period for embryo transfer.
Ovulation induction protocols employ letrozole to stimulate ovulation and promote endogenous estradiol production, contrasting with hormone replacement therapy (HRT) protocols that utilize exogenous estradiol.
HRT is the most commonly used endometrial preparation method prior to FET for women with PCOS due to its ease of administration by clinicians. Exogenous estrogen and progesterone are administered to mimic the hormonal fluctuations of a natural menstrual cycle. However, in the absence of a corpus luteum, exogenous hormones cannot be discontinued once pregnancy is established.
This prospective randomized study was conducted on PCOS cases who fulfil the inclusion criteria. After approval of the Medical Ethical Committee of the Faculty of Medicine, Alexandria University and having an informed written consent from every patient included in this study, the present study was carried out on 130 participants who have frozen embryos and undergoing endometrial preparation for FET. They were allocated into two groups randomly by pick up closed envelope.
group I: 65 participants were stimulated with letrozole and group II: 65 participants, where endometrium was prepared by HRT.
The sample size was approved to be sufficient by the Department of Statistics, Medical Research Institute, University of Alexandria.
This study aimed to compare reproductive outcomes between letrozole and HRT for endometrial preparation in frozen thawed embryo transfer in polycystic ovary syndrome patients.
Reproductive outcomes:
1. Clinical pregnancy which was defined as the presence of gestational sac with fetal heart beat on ultrasound conducted 4 weeks after ET.
2. Endometrial thickness and pattern at the day of embryo transfer.
3. Implantation rate.
During endometrial preparation in letrozole group and HRT group, endometrium thickness and endometrial pattern were recorded at the day of embryo transfer, also number of embryos and day of embryos verification were recorded.
Clinical pregnancy and implantation rate were recorded 4 weeks after embryo transfer.