• Mariana Oliva Cassará Carvalho, Sônia Maria Rolim Rosa Lima, Claudia Godman Glina, Leopoldo de Oliveira Tso, Rodrigo Sabato Romano, Sidney Glina, Newton Eduardo Busso, and Cristiano Eduardo Busso.
• Santa Casa de Sao Paulo School of Medical Sciences, Department of Obstetrics and Gynecology - São Paulo (SP), Brazil.
• Rev Assoc Med Bras (1992). 2024 Jan 1; 70 (5): e20231548e20231548.

ObjectiveThe aim of this study was to compare endometrial thickness with the use of transdermal estrogen (gel) versus oral estrogen (pills) for endometrial preparation in the frozen embryo transfer cycle and serum estrogen concentrations during the preparation cycle, side effects, and chemical and clinical pregnancy rates.MethodsThis was a prospective, randomized controlled trial of women undergoing endometrial preparation for cryopreserved blastocyst transfer. A total of 88 women were randomized, of which 82 completed the study protocol. Of this group, 44 received 6 mg/day of estradiol valerate orally (pills group) and 38 received 4.5 mg/day of estradiol hemihydrate transdermally (gel group). Endometrial thickness was measured using transvaginal ultrasound between the 7 and 10th day of the cycle. Serum estradiol concentrations were measured on the day of initiating the cycle, on control transvaginal ultrasounds, and on the day of embryo transfer. Side effects were documented at each study visit. p<0.05 were adopted as statistically significant. The groups were compared using Student's t-test for continuous variables and chi-square or Fisher's exact test for categorical variables.ResultsThere were no significant group differences (p>0.05) in endometrial thickness, biochemical and clinical pregnancy rates, miscarriage rate, blood estradiol concentrations, duration of estradiol administration, or cycle cancellation rates.ConclusionEndometrial preparation with transdermal estrogen yielded similar reproductive outcomes to oral estrogen with fewer side effects.

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