Natural ovulation versus programmed regimens before frozen embryo transfer in ovulatory women: multicentre, randomised clinical trial

作者：Daimin Wei, Y Qin, Yun Sun, Junhao Yan, Hongyun Zhao, Yichun Guan, Jiaxi Tan, Ting Guo, Ze Wang, Fei Gong, Cuifang Hao, Xiang Ma, Cuilian Zhang, A. Zhang, Ling Geng, Meng Sun, Xiufang Li, Xiufeng Ling, Qun Lu, Hongchu Bao, Lan Chao, Wei Huang, Qinghua Shi, Junli Zhao, Yao Lu, Sheling Wu, Shunji Zhang, Jing Wang, Meiling Guo, Xiaoxi Sun, Yanli Ma, Qiongfang Wu, Yanping Li, XiangHong OU, Zhou Fang, Jiao Chen, Guimin Hao, Heping Zhang, Richard S Legro, Zi‐Jiang Chen · 发表于：BMJ · 年份：2026 · DOI：10.1136/bmj-2025-087045 · 被引用次数：14 · 研究领域：Ovarian function and disorders、Reproductive Biology and Fertility、Reproductive Health and Technologies

Abstract Objective To test the hypothesis that women assigned to a natural ovulation regimen before frozen embryo transfer compared with a programmed regimen would have an increased chance of a healthy live birth and a reduced risk of pre-eclampsia or eclampsia. Design Multicentre, randomised, parallel group, assessor blinded clinical trial. Setting 24 academic fertility centres in China. Participants 4376 ovulatory women (aged 20-40 years) planning to undergo a frozen single blastocyst transfer. Interventions Eligible participants were randomised (1:1) to receive a natural ovulation regimen or a programmed regimen of hormone replacement for endometrial preparation. Endometrial preparation and frozen embryo transfer timing were determined in the natural ovulation regimen group by monitoring natural follicle development and measuring serum levels of luteinising hormone, oestradiol, and progesterone. In the programmed regimen group, endometrial preparation was achieved by sequential administration of oestrogen and progesterone. Main outcomes and measures Primary outcomes were a healthy live birth and pre-eclampsia or eclampsia after a frozen embryo transfer. Secondary outcomes were cycle cancellation, biochemical pregnancy, clinical pregnancy, ongoing pregnancy, pregnancy loss, ectopic pregnancy, live birth, birth weight, and maternal, fetal, and neonatal complications. Results In the intention-to-treat analyses, 910 (41.6%) of 2185 patients in the natural ovulation regimen gro...