Trial reportPLoS medicine2025
Natural cycle versus hormone replacement therapy as endometrial preparation in ovulatory women undergoing frozen-thawed embryo transfer: The COMPETE open-label randomized controlled trial.
Trial report in PLoS medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 10 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
10 citing papers in PubMed.
- Natural ovulation versus programmed regimens before frozen embryo transfer in ovulatory women: multicentre, randomised clinical trial.BMJ (Clinical research ed.) · 2026Trial
- Programmed cycle-induced endometrial perturbations do not independently influence angiogenic imbalance or hypertensive disorders in pregnancy.JCI insight · 2026Observational
- Comparing endometrial preparation protocols and clinical outcomes: lessons learned from 3507 vitrified-warmed euploid transfers.Journal of assisted reproduction and genetics · 2026Article
- Review
- Duration of progesterone exposure before frozen embryo transfer impacts live birth rates following single vitrified-thawed day 6 blastocyst transfer: a multicenter cohort study.Contraception and reproductive medicine · 2026Article
- Effect of progesterone timing on live birth rates in day-6 blastocyst frozen-thawed embryo transfer cycles: a randomized controlled trial.Human reproduction open · 2026Article
- Article
- Pregnancy and obstetric-neonatal outcomes of patients with thin endometrium using three different endometrial preparation protocols in frozen embryo transfer cycles: a historical cohort of 2671 patients.Reproductive health · 2025Article
- A Systematic Review and Meta-Analysis of Single-Dose GnRH Agonist on the Day of Frozen Embryo Transfer in Artificial Cycles: Preliminary Evidence from Randomized Trials.Journal of clinical medicine · 2025Review
- Association of GnRH Agonist Pretreatment with Reproductive Outcomes in Women ≥35 years with Diminished Ovarian Reserve Undergoing Frozen Embryo Transfer: A Large Retrospective Cohort Study.International journal of women's health · 2025Article
Corrections and comments
- Erratum issued
Authors and funding
28 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDifferent endometrial preparation protocols are used prior to frozen-thawed embryo transfer (FET). Optimization of endometrial preparation protocols is mandatory to improve live birth rate and obstetric and perinatal outcomes. In the Comparison of Endometrial Preparation Protocols for Frozen Embryo Transfer (COMPETE) trial, our primary objective is to evaluate whether natural cycles (NCs) lead to a higher live birth rate after the first FET cycle compared to hormone replacement therapy (HRT) cycles in women with a regular ovulatory cycle. METHODS AND
findingsWe performed a single-center, parallel, open-label randomized controlled trial between December 2020 and December 2022 in a single assisted reproduction center in Xi'an, China. Women with a regular menstrual cycle undergoing in vitro fertilization (IVF) scheduled for FET were randomly assigned (1:1) to endometrial preparation in the NC or with HRT, using a web-based electronic data capture system. The primary outcome was live birth rate after the initial FET. The analysis was conducted based on the intention-to-treat principle. Obstetric and perinatal outcomes in all randomly assigned women were reported in this study. We randomly assigned 902 women to receive either NC (n = 448) or HRT (n = 454). In the NC group, 101 women received HRT because of no ovulation, while in the HRT group, 29 women received NC because of spontaneous ovulation. The number of live births was 242 (54.0%) in the NC group versus 195 (43.0%) in the HRT group (absolute difference, 11.1 percentage points, 95% CI 4.6 to 17.5; risk ratio (RR) 1.26, 95% CI 1.10 to 1.44). Miscarriage rates (RR 0.61, 95% CI 0.41 to 0.89) and the antepartum hemorrhage rates (RR 0.63, 95%CI 0.42 to 0.93) were lower in the NC group, with other obstetric and perinatal outcomes not significantly different.
conclusionsIn women with a regular menstrual cycle undergoing FET, a strategy starting with NC endometrial preparation results in higher live birth rates than endometrial preparation with HRT. However, the permitted cross-over between arms limits certainty in directly assessing NC versus HRT efficacy.
trial registrationChinese Clinical Trial Registry: ChiCTR2000040640.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.