Comparison of the duration of estradiol administration and the effect on pregnancy outcome of day 3 vitrified–warmed embryo transfer cycle: a randomized controlled trial

Summary Based on the fact that the follicular phase in the menstrual cycle has length variation, it has been assumed that the duration of oestrogen (E2) administration could also be variable; therefore, for the first time, this randomized clinical trial study was conducted to investigate and compare the duration of estradiol administration and the effect on pregnancy outcomes in the cleavage-stage frozen embryo transfer (FET) cycle. We included women aged 20–40 with a normal uterus on hysteroscopy between September and December 2022 and who were divided randomly into three groups: group A [ n = 79; 8–11 days of oestrogen before progesterone (P4) supplementation], group B ( n = 78; 12–14 days of oestrogen before P4 supplementation), and group C ( n = 76; 15–18 days of estrogen before P4 supplementation). Serum levels for E2 on the initial progesterone day and P4 on the transfer day were measured. The effect of the duration of E2 administration on clinical pregnancy and pregnancy loss was investigated. We found no significant differences between the three groups in the clinical pregnancy rate ( P = 0.696) and clinical abortion rate ( P = 0.925) according to the duration of the E2. There was no significant difference in the E2, P4 levels, and endometrial thickness in pregnant vs. non-pregnant women. The mean of the E2 and P4 levels was 300.03 ± 22.21 and 25.36 ± 5.78, respectively. Our findings suggest that variation in the length of E2 administration (8–18 days) before progesterone initiation in day 3 FET cycles does not affect pregnancy outcome and transfer time can be flexibly arranged.