{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T16:06:12Z","timestamp":1791389172507,"version":"4.3.3"},"reference-count":37,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,3,27]],"date-time":"2025-03-27T00:00:00Z","timestamp":1743033600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82260315"],"award-info":[{"award-number":["82260315"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004479","name":"Natural Science Foundation of Jiangxi Province","doi-asserted-by":"publisher","award":["20224BAB216025"],"award-info":[{"award-number":["20224BAB216025"]}],"id":[{"id":"10.13039\/501100004479","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004479","name":"Natural Science Foundation of Jiangxi Province","doi-asserted-by":"publisher","award":["20242BAB25446"],"award-info":[{"award-number":["20242BAB25446"]}],"id":[{"id":"10.13039\/501100004479","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp; Gyne"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To evaluate the impact of different endometrial preparation protocols on pregnancy outcomes in patients with unexplained recurrent implantation failure (uRIF) undergoing frozen embryo transfer (FET).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective cohort study reviewed 110\u2009372 FET cycles from three fertility centers in China between January 2014 and July 2021. Among them, 4346 cycles were performed in patients with uRIF, including 557 who had the natural cycle (NC) protocol, 1310 who had the stimulated cycle (SC) protocol and 2479 who had the artificial cycle (AC) protocol. The primary outcome measure was live birth rate. For singleton live births, the main obstetric outcomes (hypertensive disorders of pregnancy, gestational diabetes mellitus, abnormal placentation and prelabor rupture of membranes) and neonatal outcomes (Cesarean delivery, preterm birth, post\u2010term birth, low birth weight, macrosomia, small\u2010for\u2010gestational age, large\u2010for\u2010gestational age and major birth defect) were collected through standardized questionnaire interviews. Potential confounders were controlled by 1:1:1 propensity score matching and multivariable logistic regression analysis using prematched data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 397 cycles in each group after matching and all baseline characteristics were balanced with no significant differences between the groups. The\u00a0live birth rate was comparable among the NC, SC and AC groups (29.5% <jats:italic>vs<\/jats:italic> 35.3% <jats:italic>vs<\/jats:italic> 33.0%, respectively; <jats:italic>P<\/jats:italic>\u2009=\u20090.21), as were the rates of clinical pregnancy, embryo implantation and miscarriage. The three groups differed significantly in Cesarean delivery rate (65.6% <jats:italic>vs<\/jats:italic> 71.1% <jats:italic>vs<\/jats:italic> 81.1%, respectively; <jats:italic>P<\/jats:italic>\u2009=\u20090.04), with <jats:italic>post\u2010hoc<\/jats:italic> statistical significance identified between the NC and AC groups (<jats:italic>P<\/jats:italic>\u2009=\u20090.01). No significant associations were observed between endometrial preparation protocols and other pregnancy, obstetric and neonatal outcomes. The results after matching were in good agreement with the multivariable\u2010adjusted outcomes before matching.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our findings do not prioritize one specific endometrial preparation protocol over another for improving pregnancy rates among patients with uRIF; however, the increased risk of Cesarean delivery in the AC group necessitates careful consideration to optimize  delivery outcomes. Nonetheless, given the overall high rate of Cesarean delivery in all three groups, further clarification is required on whether medical indication or personal preference influenced the decision on the mode of delivery. \u00a9 2025 International Society of Ultrasound in Obstetrics and Gynecology.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.29209","type":"journal-article","created":{"date-parts":[[2025,3,30]],"date-time":"2025-03-30T12:41:21Z","timestamp":1743338481000},"page":"633-640","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Impact of endometrial preparation protocols on pregnancy outcomes in patients with unexplained recurrent implantation failure undergoing frozen embryo transfer"],"prefix":"10.1002","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2629-3986","authenticated-orcid":false,"given":"J.","family":"Huang","sequence":"first","affiliation":[{"name":"Center for Reproductive Medicine, Jiangxi Key Laboratory of Reproductive Health, Jiangxi Maternal and Child Health Hospital, Jiangxi Branch of National Clinical Research Center for Obstetrics and Gynecology Nanchang Medical College  Nanchang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y.","family":"Liao","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine, School of Queen Mary Nanchang University  Nanchang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Xia","sequence":"additional","affiliation":[{"name":"Center for Reproductive Medicine, Jiangxi Key Laboratory of Reproductive Health, Jiangxi Maternal and Child Health Hospital, Jiangxi Branch of National Clinical Research Center for Obstetrics and Gynecology Nanchang Medical College  Nanchang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"Wu","sequence":"additional","affiliation":[{"name":"School of Public Health, Li Ka Shing Faculty of 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Medicine, Jiangxi Key Laboratory of Reproductive Health, Jiangxi Maternal and Child Health Hospital, Jiangxi Branch of National Clinical Research Center for Obstetrics and Gynecology Nanchang Medical College  Nanchang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Q.","family":"Wu","sequence":"additional","affiliation":[{"name":"Center for Reproductive Medicine, Jiangxi Key Laboratory of Reproductive Health, Jiangxi Maternal and Child Health Hospital, Jiangxi Branch of National Clinical Research Center for Obstetrics and Gynecology Nanchang Medical College  Nanchang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"Chen","sequence":"additional","affiliation":[{"name":"Center for Reproductive Medicine, Jiangxi Key Laboratory of Reproductive Health, Jiangxi Maternal and Child Health Hospital, Jiangxi Branch of National Clinical Research Center for Obstetrics and Gynecology Nanchang Medical College  Nanchang 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