Do serum progesterone levels on day of embryo transfer influence pregnancy outcomes in artificial frozen-thaw cycles?

Volovsky, Michelle; Pakes, Cassandra; Rozen, Genia; Polyakov, Alex

doi:10.1007/s10815-020-01713-w

Cited by 30 publications

(22 citation statements)

References 26 publications

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“…As such, even though serum P has been inadequate on the FET day, this was potentially remedied by additional P administration, reinforcing intervention might still be possible beyond the day of transfer. The results were in coincide with the recent report of Volovsky et al, P replacement enhanced the pregnancy outcome if the P on the FET day was lower than 8.0 ng/ml [8]. In a recent study of Polats et al, the intramuscular P supplementation every third day did not increase the ongoing pregnancy rate compared with vaginal P only in vitri ed blastocyst transfer cycles (48.3% vs 51.8%).…”

Section: Discussionsupporting

confidence: 89%

“…Unfortunately, no data on serum progesterone levels in the three groups were available from that study. The low serum P levels on the FET day in arti cial cycles using vaginal route were previously reported to be associated with poorer reproductive outcomes, the cutoff value was varied in previous reports (5.0-12.0 ng/ml) [5][6][7][8]. In this study, the cutoff value was set as 10.0 ng/ml.…”

Section: Discussionmentioning

confidence: 95%

“…However, body mass index (BMI) and vaginal environment affect serum levels after vaginal route, the serum P concentrations show a marked inter-individual difference despite the similar dose of P administration by vaginal route [4]. Low serum P levels on the FET day in arti cial cycles using vaginal P have been reported to be associated with poorer reproductive outcomes [5][6][7], however, it is no consensus whether the strengthened LPS is bene cial for the patients with low P levels in arti cial cycles [8,9]. The debate of using one-size-t-all regimen or individualized protocols in arti cial endometrial preparation cycles has still continued.…”

Section: Introductionmentioning

confidence: 99%

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Strengthen Luteal Phase Support for the Patients With Low Serum Progesterone on the Day of Embryo Transfer in Artificial Endometrial Preparation Cycles: a Large-sample Retrospective Trial

Gao

et al. 2020

Preprint

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Background: The low serum progesterone (P) on the day of frozen embryo transfer (FET) is associated with diminished pregnancy rates in artificial endometrium preparation cycles using vaginal micronized P, but it is no consensus whether the strengthened luteal phase support (LPS) for the patients with low P on the FET day in artificial cycles is beneficial. A single centric, large-sample retrospective trial was aimed to investigate the contribution of strengthened LPS to the pregnancy outcomes for the groups of low P levels on the FET day in artificial endometrium preparation cycles.Methods: Women who had undergone first artificial cycle for endometrium preparation after freeze-all in our clinic during 2016 and 2018 were classified into two groups depending on the serum P levels on the FET day, routine LPS was administered for group B (P ≥10.0ng/ml on the FET day, n=1261) and strengthened LPS (routine LPS+ im P 40mg daily) for group A (P <10.0 ng/ml on the FET day, n=1295), the primary endpoint was the live birth rate and secondary endpoints were clinical pregnancy, miscarriage and neonatal outcomes.Results: The results showed the clinical pregnancy rate in group A was lower than group B (48.4% vs 53.2%, aRR 0.81, 95% CI 0.68, 0.96), the miscarriage rate was similar between the two groups (16.0% vs 14.7%, aRR 1.09, 95%CI 0.77, 1.54). The live birth rate was slightly lower than group B (39.5% vs 43.3%, aRR 0.84, 95%CI 0.70, 1.0). The birthweights and other neonatal outcomes were found no difference between the two groups (P>0.05).Conclusions: The strengthened LPS for the section of patients of low P levels on the FET day might help to have a reasonable pregnancy outcome, although the live birth rate was slightly lower than the groups with normal serum P levels on the FET day and usage of routine LPS. Trial registration: no available.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

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Strengthen Luteal Phase Support for the Patients With Low Serum Progesterone on the Day of Embryo Transfer in Artificial Endometrial Preparation Cycles: a Large-sample Retrospective Trial

Gao

et al. 2020

Preprint

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“…Our indings might be dif-ferent from some studies (Ko inas et al, 2015;Labarta et al, 2017) where they could determine the cut-off level of P that's diminished pregnancy outcomes despite their differences in serum threshold, doses & routes of progesterone medications, While (Boynukalin et al, 2019) could determine serum P threshold for improving pregnancy outcomes in FET cycles. Nerveless our results might be closer to (Volovsky et al, 2020) study who performed a large retrospective study of 2010 blastocyst-FET cycles utilized vaginal P stated that neither serum P ≥10 ng/mL nor ≥ 20 ng/ml on embryo transfer day signi icantly improved pregnancy outcomes while level ≥5 ng/ml might improve LBR considering it as the lowest threshold to salvage FET cycles.…”

Section: Resultssupporting

confidence: 70%

Endometrial compaction and serum progesterone measurements at the day of embryo transfer cannot predict pregnancy outcomes in frozen-thaw embryo transfer cycles

Jarrah¹,

Al-Obaidi²,

Asadi³

2021

ijrps

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Endometrial receptivity plays a basic role in successful embryo implantation and pregnancy outcomes and can be assessed by many of non-invasive markers. Our study evaluated the impact of two of these markers specifically serum progesterone and endometrial thickness at embryo transfer day in prediction pregnancy outcomes on (60) patients attempting medicated frozen embryo transfer (FET) cycles. All patients were received sequential estrogen & progesterone medications for endometrial preparation then submitted to measurements of endometrial thickness (EMT) by transvaginal-ultrasound (TV-US) & serums progesterone (P) analysis at the embryo transfer day, thereafter day 3 verified-thawed embryos grades (A±B) were transferred. Compacted (decreased) EMT was seen in 48.3% of patients with higher pregnancy rate (PR) of 58.6%t than non-compacted EMT (no change or increased) which was seen in 51.7% of patients with (PR) of 29.0%, (P value=0.021). However ongoing pregnancy rate (Ong PR) not differed significantly between both groups (44.8% in compacted vs 25.8% in non-compacted, P value=0.053), also the means of serum P not differed between pregnant and non-pregnant patients (P value=0.374). ROC curves for Ong PR prediction in relations to endometrial compaction & serum progesterone at embryo transfer day were poor (AUC= 0.630, & AUC=0.576, respectively). This study suggested that endometrial compaction or serum P levels measurements at embryo transfer day were poor predictors for ongoing pregnancy where any kind of EMT changes (decreased or not) seen after P administration not significantly affect pregnancy outcomes in frozen-thaw cycles of cleavage stage embryos transfer.

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“…However, body mass index (BMI) and the vaginal environment affect serum levels after vaginal administration, and serum progesterone concentrations show a marked inter-individual difference even when similar doses of progesterone are administered by the vaginal route [ 4 ]. Low serum progesterone levels on the FET day in artificial cycles using vaginal progesterone have been reported to be associated with compromised reproductive outcomes [ 5 – 7 ]; however, there is no consensus on whether strengthened LPS is beneficial for patients with low progesterone levels in artificial cycles [ 8 , 9 ]. The debate over whether to use a one-size-fits-all regimen or individualized protocols in artificial endometrial preparation cycles is still active.…”

Section: Introductionmentioning

confidence: 99%

Strengthened luteal phase support for patients with low serum progesterone on the day of frozen embryo transfer in artificial endometrial preparation cycles: a large-sample retrospective trial

Gao

et al. 2021

Reprod Biol Endocrinol

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Background Low serum progesterone on the day of frozen embryo transfer (FET) is associated with diminished pregnancy rates in artificial endometrium preparation cycles, but there is no consensus on whether strengthened luteal phase support (LPS) benefits patients with low progesterone on the FET day in artificial cycles. This single-centre, large-sample retrospective trial was designed to investigate the contribution of strengthened LPS to pregnancy outcomes for groups with low progesterone levels on the FET day in artificial endometrium preparation cycles. Methods Women who had undergone the first artificial endometrium preparation cycle after a freeze-all protocol in our clinic from 2016 to 2018 were classified into two groups depending on their serum progesterone levels on the FET day. Routine LPS was administered to group B (P ≥ 10.0 ng/ml on the FET day, n = 1261), and strengthened LPS (routine LPS+ im P 40 mg daily) was administered to group A (P < 10.0 ng/ml on the FET day, n = 1295). The primary endpoint was the live birth rate, and the secondary endpoints were clinical pregnancy, miscarriage and neonatal outcomes. Results The results showed that the clinical pregnancy rate was significantly lower in group A than in group B (48.4% vs 53.2%, adjusted risk ratio (aRR) 0.81, 95% confidence interval (CI) 0.68, 0.96), whereas miscarriage rates were similar between the two groups (16.0% vs 14.7%, aRR 1.09, 95% CI 0.77, 1.54). The live birth rate was slightly lower in group A than in group B (39.5% vs 43.3%, aRR 0.84, 95% CI 0.70, 1.0). Birthweights and other neonatal outcomes were similar between the two groups (P > 0.05). Conclusions The results indicated that the serum progesterone level on the FET day was one of the risk factors predicting the chances of pregnancy in artificial endometrium preparation cycles, and strengthened LPS in patients with low progesterone on the FET day might help to provide a reasonable pregnancy outcome in artificial cycles, although further prospective evidence is needed to confirm this possibility.

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Do serum progesterone levels on day of embryo transfer influence pregnancy outcomes in artificial frozen-thaw cycles?

Cited by 30 publications

References 26 publications

Strengthen Luteal Phase Support for the Patients With Low Serum Progesterone on the Day of Embryo Transfer in Artificial Endometrial Preparation Cycles: a Large-sample Retrospective Trial

Strengthen Luteal Phase Support for the Patients With Low Serum Progesterone on the Day of Embryo Transfer in Artificial Endometrial Preparation Cycles: a Large-sample Retrospective Trial

Endometrial compaction and serum progesterone measurements at the day of embryo transfer cannot predict pregnancy outcomes in frozen-thaw embryo transfer cycles

Strengthened luteal phase support for patients with low serum progesterone on the day of frozen embryo transfer in artificial endometrial preparation cycles: a large-sample retrospective trial

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