Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Konkret geht es um den Diabetes-Patienten mit kardiovaskulären Erkrankungen oder Risiken, die Herzinsuffizienz sowie die kardiovaskuläre Primär- und Sekundärprävention. Sind Sie hier schon auf dem neuesten Stand? Unsere Experten beleuchten, wo und warum das bisherige Procedere geändert werden soll und was in der Praxis sinnvoll ist. Holen Sie sich Ihr Update und 2 CME-Punkte beim MMW-Webinar am 24. April von 17.30 bis 19 Uhr. 
Erweiterte Suche
Anmelden
nach oben
Journal of Assisted Reproduction and Genetics
Erschienen in: Journal of Assisted Reproduction and Genetics 7/2016

24.05.2016 | Assisted Reproduction Technologies

The endometrial preparation for frozen-thawed euploid blastocyst transfer: a prospective randomized trial comparing clinical results from natural modified cycle and exogenous hormone stimulation with GnRH agonist

verfasst von: Ermanno Greco, Katarzyna Litwicka, Cristiana Arrivi, Maria Teresa Varricchio, Alina Caragia, Alessia Greco, Maria Giulia Minasi, Francesco Fiorentino

Erschienen in: Journal of Assisted Reproduction and Genetics | Ausgabe 7/2016

Einloggen, um Zugang zu erhalten

Abstract

Purpose

The aim of the study was to evaluate two methods of endometrial preparation for frozen-thawed single euploid blastocyst transfer: modified natural and artificial cycle with GnRH-agonist pituitary suppression.

Methods

In this prospective, controlled randomized trial, a total of 236 patients undergoing infertility treatment were randomized in 1:1 ratio; 118 received a frozen-thawed single euploid blastocyst transfer in a modified natural cycle and 118 in an artificial cycle with GnRH-agonist pituitary suppression. In the artificial protocol, GnRH-agonist combined with estradiol valerate was administered. In the natural protocol, only final oocyte maturation was induced using human chorionic gonadotropin administration. The primary end-points were the clinical pregnancy and implantation rates; the secondary end-points were the cost-benefit in terms of drug cost and the number of visits and the woman psychological distress caused by the treatment.

Results

No significant differences were found in clinical pregnancy, implantation, and miscarriage rates between protocols. The number of clinical and ultrasound controls and the number of laboratory dosages and venous samplings were similar in both study groups. No significant differences were found between the groups in the anxiety and depression values before the start of treatment, on the days of progesterone administration, the blastocyst transfer, and pregnancy test.

Conclusions

The findings of this study evidence that in case of frozen-thawed single euploid blastocyst transfer, both protocols are equally effective in terms of clinical outcomes, cost-benefit, and patient compliance. The choice of endometrial preparation protocol should be based on women menstrual and ovulatory characteristics or otherwise on patient need for cycle planning.

Trial registration

www.​clinicaltrials.​gov with number NCT02378584
Literatur
1.
Hill MJ, Miller A, Frattarelli JL. A GnRH agonist and exogenous hormone stimulation protocol has a higher live-birth rate than a natural endogenous hormone protocol for frozen-thawed blastocyst-stage embryo transfer cycles: an analysis of 1391 cycles. Fertil Steril. 2010;93:416–22.CrossRefPubMed
2.
Shapiro BS, Daneshmand ST, Garner FC, Aguirre M, Hudson C, Thomas S. Evidence of impaired endometrial receptivity after ovarian stimulation for in vitro fertilization: a prospective randomized trial comparing fresh and frozen-thawed embryo transfer in normal responders. Fertil Steril. 2011;96:344–8.CrossRefPubMed
3.
4.
Abeyta M, Behr B. Morphological assessment of embryo viability. Semin Reprod Med. 2014;32(2):114–26.CrossRefPubMed
5.
Munné S, Lee A, Rosenwaks Z, Grifo J, Cohen J. Diagnosis of major chromosome aneuploidies in human preimplantation embryos. Hum Reprod. 1993;8(12):2185–91.PubMed
6.
Desai N, Ploskonka S, Goodman LR, Austin C, Goldberg J, Falcone T. Analysis of embryo morphokinetics, multinucleation and cleavage anomalies using continuous time-lapse monitoring in blastocyst transfer cycles. Reprod Biol Endocrinol. 2014;20:12–54.
7.
Katz Jaffe MG, McReynolds S. Embryology in the era of proteomics. Fertil Steril. 2013;15(4):1073–7. 99.CrossRef
8.
9.
Dahdouh EM, Balayla J, García-Velasco JA. Impact of blastocyst biopsy and comprehensive chromosome screening technology on preimplantation genetic screening: a systematic review of randomized controlled trials. Reprod Biomed Online. 2015;30(3):281–9.CrossRefPubMed
10.
Sahin L, Bozkurt M, Sahin H, Gürel A, Yumru AE. Is preimplantation genetic diagnosis the ideal embryo selection method in aneuploidy screening? Kaohsiung J Med Sci. 2014;30(10):491–8.CrossRefPubMed
11.
Lee E, Illingworth P, Wilton L, Chambers GM. The clinical effectiveness of preimplantation genetic diagnosis for aneuploidy in all 24 chromosomes (PGD-A): systematic review. Hum Reprod. 2015;30(2):473–83.CrossRefPubMed
12.
Hellani A, Abu-Amero K, Azouri J, El-Akoum S. Successful pregnancies after application of array-comparative genomic hybridization in PGS-aneuploidy screening. Reprod Biomed Online. 2008;17(6):841–7.CrossRefPubMed
13.
Murata Y, Oku H, Morimoto Y, Tokuda M, Murata T, Sugihara K, et al. Freeze-thaw programmes rescue the implantation of day 6 blastocyts. Reprod Biomed Online. 2005;1:428–33.CrossRef
14.
Shapiro BS, Daneshmand ST, Garner FC, Aguirre M, Thomas S. Large blastocyst diameter, early blastulation, and low preovulatory serum progesterone are dominant predictors of clinical pregnancy in fresh autologous cycles. Fertil Steril. 2008;90:302–9.CrossRefPubMed
15.
Shapiro BS, Daneshmand ST, Restrepo H, Garner FC, Aguirre M, Hudson C. Matched-cohort comparison of single-embryo transfers in fresh and frozen-thawed embryo transfer cycles. Fertil Steril. 2013;99:389–92.CrossRefPubMed
16.
Kuwayama M. Highly efficient vitrification for cryopreservation of human oocytes and embryos: the Cryotop method. Theriogenology. 2007;67(1):73–80.CrossRefPubMed
17.
Lopes AS, Frederickx V, Van Kerkhoven G, Campo R, Puttemans P, Gordts S. Survival, re-expansion and cell survival of human blastocysts following vitrification and warming using two vitrification systems. J Assist Reprod Genet. 2015;32(1):83–90.CrossRefPubMed
18.
Check JH, Choe JK, Katsoff D, Summers-Chase D, Wilson C. Controlled ovarian hyperstimulation adversely affects implantation after in vitro fertilization-embryo transfer. J Assist Reprod Genet. 1999;16:416–20.CrossRefPubMedPubMedCentral
19.
Haouzi D, Assou S, Mahmoud K, Tondeur S, Reme T, Hedon B, et al. Gene expression profile of human endometrial receptivity: comparison between natural and stimulated cycles for the same patients. Hum Reprod. 2009;24:1436–45.CrossRefPubMedPubMedCentral
20.
Horcajadas JA, Dıaz-Gimeno P, Pellicer A, Simon C. Uterine receptivity and the ramifications of ovarian stimulation on endometrial function. Semin Reprod Med. 2007;25:454–60.CrossRefPubMed
21.
Kolibianakis E, Bourgain C, Albano C, Osmanagaoglu K, Smitz J, Van Steirteghem A, et al. Effect of ovarian stimulation with recombinant follicle-stimulating hormone, gonadotropin releasing hormone antagonists, and human chorionic gonadotropin on endometrial maturation on the day of oocyte pick-up. Fertil Steril. 2002;78:1025–9.CrossRefPubMed
22.
Nikas G, Develioglu OH, Toner JP, Jones Jr HW. Endometrial pinopodes indicate a shift in the window of receptivity in IVF cycles. Hum Reprod. 1999;14:787–92.CrossRefPubMed
23.
Papanikolaou EG, Bourgain C, Kolibianakis E, Tournaye H, Devroey P. Steroid receptor expression in late follicular phase endometrium in GnRH antagonist IVF cycles is already altered, indicating initiation of early luteal phase transformation in the absence of secretory changes. Hum Reprod. 2005;20:1541–7.CrossRefPubMed
24.
Roque M, Lattes K, Serra S, Sola I, Geber S, Carreras R, et al. Fresh embryo transfer versus frozen embryo transfer in in vitro fertilization cycles: a systematic review and meta-analysis. Fertil Steril. 2013;99:156–62.CrossRefPubMed
25.
Ghobara T, Vandekerckhove P. Cycle regimens for frozen-thawed embryo transfer. Cochrane Database Syst Rev. 2008;1:CD003414.PubMed
26.
Groenewoud ER, Cantineau AE, Kollen BJ, Macklon NS, Cohlen BJ. What is the optimal means of preparing the endometrium in frozen-thawed embryo transfer cycles? A systematic review and meta-analysis. Hum Reprod Update. 2013;19(5):458–70.CrossRefPubMed
27.
Candido T, Alsbjerg B, Martikainen H, Humaidan P. Pregnancy lost after frozen-embryo transfer-a comparison of three protocols. Fertil Steril. 2012;98:1165–9.CrossRef
28.
Gelbaya TA, Nardo LG, Hunter HR, Fitgerald CT, Horne G, Pease EEH, et al. Cryopreserved-thawed embryo transfer in natural or down-regulated hormonally controlled cycles: a retrospective study. Fertil Steril. 2006;85:603–9.CrossRefPubMed
29.
Prato LD, Borini A, Cattoli M, Bonu MA, Sciajno R, Flamigni C. Endometrial preparation for frozen-thawed embryo transfer with or without pretreatment with gonadotropin-releasing hormone agonist. Fertil Steril. 2002;77:956–60.CrossRef
30.
Spandorfer SD, Fasouliotis SJ, Cimmino C, Shpizner M, Veeck L, Rosenwaks Z. Blastocyst frozen embryo transfer (FET): comparison of outcome with replacement in natural or programmed/medicated cycle. Fertil Steril. 2004;82:s154.CrossRef
31.
Mounce G, McVeigh E, Turner K, Child TJ. Randomized, controlled pilot trial of natural versus hormone replacement therapy cycles in frozen embryo replacement in vitro fertilization. Fertil Steril. 2015;104:915–20.CrossRefPubMed
32.
An Y, Sun Z, Li L, Zhang Y, Ji H. Relationship between psychological stress and reproductive outcome in women undergoing in vitro fertilization treatment: psychological and neurohormonal assessment. J Assis Reprod Genet. 2013;30(1):35–41.CrossRef
33.
Pasch LA, Gregorich SE, Katz PK, Millstein SG, Nachtigall RD, Bleil ME, et al. Psychological distress and in vitro fertilization outcome. Fertil Steril. 2012;98(2):459–64.CrossRefPubMedPubMedCentral
34.
Eyal S, Weizman A, Toren P, Dor Y, Mester R, Rehavi M. Chronic GnRH agonist administration down-regulates platelet serotonin transporter in women undergoing assisted reproductive treatment. Psychopharmacol (Berl). 1996;125(2):141–5.CrossRef
35.
Amir BY, Yaacov B, Guy B, Gad P, Itzhak W, Gal I. Headaches in women undergoing in vitro fertilization and embryo-transfer treatment. Headache. 2005;45(3):215–9.CrossRefPubMed
36.
Greco E, Litwicka K, Ferrero S, Baroni E, Sapienza F, Rienzi L. GnRH antagonists in ovarian stimulation for ICSI with oocyte restriction: a matched, controlled study. Reprod Biomed Online. 2008;14(5):572–8.CrossRef
37.
Gardner DK, Schoolcraft WB. In vitro culture of human blastocysts. In: Jansen R, Mortimer D, editors. Toward reproductive certainty: fertility and genetics beyond. London: Parthenon Publishing; 1999. p. 378–88.
38.
Testart J, Frydman R, Feinstein MC, Thebault A, Roger M, Scholler R. Interpretation of plasma luteinizing hormone assay for the collection of mature oocytes from women: definition of a luteinizing hormone-surge-initiating rise. Fertil Steril. 1981;36:50–4.CrossRefPubMed
39.
Iani L, Lauriola M, Costantini M. A confirmatory bifactor analysis of the Hospital Anxiety and Depression Scale in an Italian community sample. Health Qual Life Outcomes. 2014;5:12–84.
40.
Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67(6):361–70.CrossRefPubMed
41.
Taylor TH, Patrick JL, Gitlin SA, Crain JL, Wilson JM, Griffin DK. Blastocyst euploidy and implantation rates in a young (<35 years) and old (≥35 years) presumed fertile and infertile patient population. Fertil Steril. 2014;102(5):1318–23.CrossRefPubMed
42.
Shapiro BS, Daneshmand ST, Garner FC, Aguirre M, Hudson C. Clinical rationale for cryopreservation of entire embryo cohorts in lieu of fresh transfer. Fertil Steril. 2014;102(1):3–9.CrossRefPubMed
43.
Chang EM, Han JE, Kim YS, Lyu SW, Lee WS, Yoon TK. Use of the natural cycle and vitrification thawed blastocyst transfer results in better in-vitro fertilization outcomes: cycle regimens of vitrification thawed blastocyst transfer. J Assist Reprod Genet. 2011;28(4):369–74.CrossRefPubMedPubMedCentral
44.
Creus M, Ordi J, Fábregues F, Casamitjana R, Carmona F, Cardesa A, et al. The effect of different hormone therapies on integrin expression and pinopode formation in the human endometrium: a controlled study. Hum Reprod. 2003;18(4):683–93.CrossRefPubMed
45.
Morozov V, Ruman J, Kenigsberg D, Moodie G, Brenner S. Natural cycle cryo-thaw transfer may improve pregnancy outcome. J Assist Reprod Genet. 2007;24(4):119–23.CrossRefPubMedPubMedCentral
46.
Richter KS, Shipley SK, McVearry I, Tucker MJ, Widra EA. Cryopreserved embryo transfers suggest that endometrial receptivity may contribute to reduced success rates of later developing embryos. Fertil Steril. 2006;86(4):862–6.CrossRefPubMed
47.
El-Toukhy T, Taylor A, Khalaf Y, Al-Darazi K, Rowell P, Seed P, et al. Pituitary suppression in ultrasound-monitored frozen embryo replacement cycles. A randomized study. Hum Reprod. 2004;19:874–9.CrossRefPubMed
48.
Karlström PO, Bergh T, Forsberg AS, Sandkvist U, Wikland M. Prognostic factors for the success rate of embryo freezing. Hum Reprod. 1997;12(6):1263–6.CrossRefPubMed
49.
Toner JP, Veeck LL, Acosta AA, Muasher SJ. Predictive value of pregnancy during original in vitro fertilization cycle on implantation and pregnancy in subsequent cryothaw cycles. Fertil Steril. 1991;56(3):505.CrossRefPubMed
50.
Hong SW, Sepilian V, Chung HM, Kim TJ. Cryopreserved human blastocysts after vitrification result in excellent implantation and clinical pregnancy rates. Fertil Steril. 2009;92(6):2062–4.CrossRefPubMed
51.
Youssry M, Ozmen B, Zohni K, Diedrich K, Al-Hasani S. Current aspects of blastocyst cryopreservation. Reprod Biomed Online. 2008;16(2):311–20.CrossRefPubMed
52.
Al-Shawaf T, Yang D, Al-Magid Y, Seaton A, Iketubosin F, Craft I. Infertility: ultrasonic monitoring during replacement of frozen/thawed embryos in natural and hormone replacement cycles. Hum Reprod. 1993;8:2068–74.PubMed
53.
Queenan JT, Ramey JW, Seltman HJ, Eure L, Veeck LL, Muasher SJ. Transfer of cryopreserved-thawed pre-embryos in a cycle using exogenous steroids without prior gonadotropin-releasing hormone agonist suppression yields favourable pregnancy results. Hum Reprod. 1997;12:1176–80.CrossRefPubMed
54.
Simon A, Hurwitz A, Zetner BS, Bdolah Y, Laufer N. Transfer of frozen-thawed embryos in artificially prepared cycles with and without prior gonadotropin-releasing hormone agonist suppression: a prospective randomized study. Hum Reprod. 1998;13:2712–7.CrossRefPubMed
55.
Levron J, Yerushalmi GM, Brengauz M, Gat I, Katorza E. Comparison between two protocols for thawed embryo transfer: natural cycle versus exogenous hormone replacement. Gynecol Endocrinol. 2014;30(7):494–7.CrossRefPubMed
56.
Alama P, Melo MAB, Garcia G, Garrido N, Meseguer M, Remohi J. Higher ongoing pregnancy rates in lastocyst transfer of frozen-thawed embryos in natural cycles. Fertil Steril. 2007;8:s161.CrossRef
57.
Givens CR, Markun LC, Ryan IP, Chenette PE, Herbert CM, Schriock ED. Outcomes of natural cycles versus programmed cycles for 1677 frozen-thawed embryo transfers. Reprod Biomed Online. 2009;19:380–4.CrossRefPubMed
58.
Gingold, J.A., Lee, J.A., Rodriguez-Purata, J., Whitehouse, M.C., Sandler, B., Grunfeld, L., Mukherjee, T., Copperman, A.B. Endometrial pattern, but not endometrial thickness, affects implantation rates in euploid embryo transfers. Fertil Steril. 2015;104(3):620–8.
59.
Zhao J, Zhang Q, Li Y. The effect of endometrial thickness and pattern measured by ultrasonography on pregnancy outcomes during IVF-ET cycles. Reprod Biol Endocrinol. 2012;10:100.CrossRefPubMedPubMedCentral
60.
Werner MD, Forman EJ, Hong KH, Franasiak JM, Bergh PA, Scott RT. Endometrial disruption does not improve implantation in patients who have failed the transfer of euploid blastocysts. J Assist Reprod Genet. 2015;32(4):557–62.CrossRefPubMedPubMedCentral
61.
62.
Tabibzadeh S. Molecular control of the implantation window. Hum Reprod Update. 1998;4(5):465–71.CrossRefPubMed
63.
Andersen AG, Als-Nielsen B, Hornnes PJ, Franch Andersen L. Time interval from human chorionic gonadotrophin (HCG) injection to follicular rupture. Hum Reprod. 1995;10(12):3202–5.PubMed
64.
Fatemi HM, Kyrou D, Bourgain C, Van den Abeel E, Griesunger G, Devroey P. Cryopreserved-thawed human embryo transfer: spontaneous natural cycle is superior to human chorionic gonadotropin-induced natural cycle. Fertil Steril. 2010;94(6):2054–8.CrossRefPubMed
65.
Griesinger G, Weig M, Schroer A, Diedrich K, Kolibianakis EM. Mid-cycle serum levels of endogenous LH are not associated with the likelihood of pregnancy in artificial frozen-thawed embryo transfer cycles without pituitary suppression. Hum Reprod. 2007;22(10):2589–93.CrossRefPubMed
66.
Alfarawati S, Fragouli E, Colls P, Stevens J, Gutiérrez-Mateo C, Schoolcraft WB, et al. The relationship between blastocyst morphology, chromosomal abnormality, and embryo gender. Fertil Steril. 2011;95(2):520–4.CrossRefPubMed
67.
Kroener L, Ambartsumyan G, Briton-Jones C, Dumesic D, Surrey M, Munné S, et al. The effect of timing of embryonic progression on chromosomal abnormality. Fertil Steril. 2012;98(4):876–80.CrossRefPubMed
68.
Forman EJ, Upham KM, Cheng M, Zhao T, Hong KH, Treff NR, et al. Comprehensive chromosome screening alters traditional morphology-based embryo selection: a prospective study of 100 consecutive cycles of planned fresh euploid blastocyst transfer. Fertil Steril. 2013;100(3):718–24.CrossRefPubMed
69.
Weissman A, Horowitz E, Ravhon A, Steinfeld Z, Mutzafi R, Golan A, et al. Spontaneous ovulation versus HCG triggering for timing natural-cycle frozen-thawed embryo transfer: a randomized study. Reprod Biomed Online. 2011;23(4):484–9.CrossRefPubMed
70.
Mahajan NN, Turnbull DA, Davies MJ, Jindal UN, Briggs NE, Taplin JE. Changes in affect and state anxiety across an in vitro fertilization/intracytoplasmic sperm injection cycle. Fertil Steril. 2010;93(2):517–26.CrossRefPubMed
71.
Verhaak CM, Smeenk JM, Evers AW, Kremer JA, Kraaimaat FW, Braat DD. Women's emotional adjustment to IVF: a systematic review of 25 years of research. Hum Reprod Update. 2007;13(1):27–36.CrossRefPubMed
72.
Cousineau TM, Domar AD. Psychological impact of infertility. Best Pract Res Clin Obstet Gynaecol. 2007;21(2):293–308.CrossRefPubMed
73.
Turner K, Reynolds-May MF, Zitek EM, Tisdale RL, Carlisle AB, Westphal LM. Stress and anxiety scores in first and repeat IVF cycles: a pilot study. PLoS One. 2013;23:8(5).
74.
Stenbæk DS, Toftager M, Hjordt LV, Jensen PS, Holst KK, Bryndorf T, et al. Mental distress and personality in women undergoing GnRH agonist versus GnRH antagonist protocols for assisted reproductive technology. Hum Reprod. 2015;30(1):103–10.CrossRefPubMed
75.
Karatas JC, Strong KA, Barlow-Stewart K, McMahon C, Meiser B, Roberts C. Psychological impact of preimplantation genetic diagnosis: a review of the literature. Reprod Biomed Online. 2010;20(1):83–91.CrossRefPubMed
Metadaten
Titel
The endometrial preparation for frozen-thawed euploid blastocyst transfer: a prospective randomized trial comparing clinical results from natural modified cycle and exogenous hormone stimulation with GnRH agonist
verfasst von
Ermanno Greco
Katarzyna Litwicka
Cristiana Arrivi
Maria Teresa Varricchio
Alina Caragia
Alessia Greco
Maria Giulia Minasi
Francesco Fiorentino
Publikationsdatum
24.05.2016
Verlag
Springer US
Erschienen in
Journal of Assisted Reproduction and Genetics / Ausgabe 7/2016
Print ISSN: 1058-0468
Elektronische ISSN: 1573-7330
DOI
https://doi.org/10.1007/s10815-016-0736-y

Weitere Artikel der Ausgabe 7/2016

Journal of Assisted Reproduction and Genetics 7/2016 Zur Ausgabe

Editor’s Commentary

On the dichotomy (im)posed by developmental autonomy during early human embryogenesis

Review

Preimplantation genetic testing for aneuploidy: what technology should you use and what are the differences?

Review

Immunogenetic contributions to recurrent pregnancy loss

Reproductive Physiology and Disease

The presence of heparins during decidualization modulates the response of human endometrial stromal cells to IL-1β in vitro

Genetics

Discrepant diagnosis rate of array comparative genomic hybridization in thawed euploid blastocysts

Assisted Reproduction Technologies

Is oocyte donation a risk factor for preeclampsia? A systematic review and meta-analysis

Neu im Fachgebiet Gynäkologie und Geburtshilfe

23.04.2024 | Medikamente in Schwangerschaft und Stillzeit | Nachrichten

ICI-Therapie in der Schwangerschaft wird gut toleriert

23.04.2024 | Depression antepartal oder postpartal | Nachrichten

Weniger postpartale Depressionen nach Esketamin-Einmalgabe

22.04.2024 | DGIM 2024 | Kongressbericht | Nachrichten

Bei RSV-Impfung vor 60. Lebensjahr über Off-Label-Gebrauch aufklären!

20.04.2024 | EAU 2024 | Kongressbericht | Nachrichten

Harnwegsinfektprophylaxe: Es geht auch ohne Antibiotika
weitere anzeigen

Update Gynäkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.

Newsletter bestellen