Does a frozen embryo transfer ameliorate the effect of elevated progesterone seen in fresh transfer cycles?

Healy, M.W.; Patounakis, George; Connell, Matthew T.; Devine, Kate; DeCherney, Alan H.; Levy, Michael J.; Hill, Micah J.

doi:10.1016/j.fertnstert.2015.09.015

Cited by 87 publications

(66 citation statements)

References 28 publications

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“…This is based on evidence that elevated P alters gene expression within the endometrium to change endometrial receptivity (14). The effect of elevated P on live birth is ameliorated in the subsequent frozen embryo transfer cycle (4) or in a donor–recipient transfer cycle (15). Additionally, elevated P is not associated with oocyte quality in autologous and donor cycles (1, 4, 5, 15).…”

Section: Discussionmentioning

confidence: 99%

“…This negative association has been confirmed in a meta-analysis of more than 60,000 ART cycles from Venetis et al (3). Further research has demonstrated that this negative association of P with pregnancy persists across various parameters of ART cycles to include GnRH antagonist cycles, GnRH and hCG trigger cycles, and in patients with young age, good-quality embryos, and blastocysts for transfer (4–7). …”

mentioning

confidence: 99%

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Revisiting the progesterone to oocyte ratio

Hill

Healy

Richter

et al. 2017

Fertility and Sterility

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Objective To critically evaluate the P to oocyte (O) ratio (P/O) in the prediction of live birth in assisted reproductive technology (ART) cycles. Design Retrospective cohort study. Setting Not applicable. Patient(s) A total of 7,608 fresh autologous ART ET cycles. Intervention(s) None. Main Outcome Measure(s) Live birth. Result(s) Generalized estimating equation (GEE) models and receiver operating characteristic curves assessed the ability of P, O, and the P/O ratio to predict live birth. In univariate GEE models, P, O, and P/O were each associated with live birth. However, in multivariate GEE models, the P/O ratio was not associated with live birth, but P alone was. This suggested that converting P and O into a ratio of P/O was not more helpful than the two independent variables themselves. Measures of overall model fit further suggested that P/O did not increase the predictive ability of the model over P and O alone. Receiver operating characteristic curves using incremental predictors further demonstrated that the P/O provided no incremental improvement in predicting live birth over P and O separately. Conclusion(s) These data suggest that P and O have utility in prediction modeling but demonstrate that additional oocytes were not protective from the negative association of P with live birth. There was no incremental improvement related to the P/O ratio specifically for predicting live birth over each variable independently.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Revisiting the progesterone to oocyte ratio

Hill

Healy

Richter

et al. 2017

Fertility and Sterility

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show abstract

“…The progesterone cut-off thresholds used were 0.8, 0.9, 1.2, 1.5, 1.75, 2.0 or over, and 2.25 ng/ml, as these levels have been published as having a detrimental effect on assisted reproduction technique outcomes (Bosch, 2010; Venetis, 2013; Hill, 2015; Healy 2016). The prevalence of progesterone above these thresholds was calculated for each racial group.…”

Section: Methodsmentioning

confidence: 99%

“…Gene expression studies demonstrate differential expression of global and implantation genes when premature elevated progesterone levels are present (Rong, 2011; Lahoud, 2012). The implementation of cryopreserved embryo transfer cycles may represent a method of ameliorating the effect of elevated progesterone on live birth (Healy, 2016). …”

Section: Introductionmentioning

confidence: 99%

Does elevated progesterone on day of oocyte maturation play a role in the racial disparities in IVF outcomes?

Hill

Royster

Taneja

et al. 2017

Reproductive BioMedicine Online

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The aim of this study was to evaluate if premature progesterone elevation on the last day of assisted reproduction technique stimulation contributes to racial disparities. A total of 3289 assisted reproduction technique cycles were evaluated in Latino, Asian, African American, and white women. Live birth was more likely in white women (42.6%) compared with Asian (34.8%) and African American women (36.3%), but was similar to Latino women (40.7%). In all racial groups, progesterone was negatively associated with live birth and the negative effect of progesterone persisted when adjusting for confounders. Although the effect of elevated progesterone was similar in all racial groups, the prevalence of elevated progesterone differed. P > 1.5 ng/ml occurred in only 10.6% of cycles in white women compared with 18.0% in Latino and 20.2% in Asian women. P > 2 ng/ml occurred in only 2.3% of cycles in white women compared with 6.3% in Latino, 5.9% in Asian and 4.4% in African American women. The increased prevalence of premature elevated progesterone persisted when controlling for IVF stimulation parameters. In conclusion, premature progesterone elevation had a negative effect on live birth in all racial groups studied. The prevalence of elevated progesterone was higher in racial minorities.

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“…9 Prematür P yüksekliği saptanan olgularda, taze transfer yapmadan embriyoları dondurmak ve transferi ileri bir tarihe ertelemek, gebelik ve canlı doğum oranlarını artırmaktadır. 10 Pre-implantasyon genetik test, özellikle de tarama (PGT) amacıyla kullanımı son yılların oldukça popüler konusudur. İleri kadın yaşı, tekrarlayan implantasyon başarısızlığı, tekrarlayan gebelik kayıpları ve şiddetli erkek infertilitesi amacıyla yaygın kullanımı olan PGT, teknolojinin gelişmesi ile türlü modifikasyonlara uğramıştır.…”

Section: Dondurulmuş Embri̇yo Transferi̇ni̇n Başlica Kullanildiği Durumlarunclassified

Fresh vs Frozen Embryo Transfer

Pabuçcu¹,

Pabuçcu²

2017

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Does a frozen embryo transfer ameliorate the effect of elevated progesterone seen in fresh transfer cycles?

Cited by 87 publications

References 28 publications

Revisiting the progesterone to oocyte ratio

Revisiting the progesterone to oocyte ratio

Does elevated progesterone on day of oocyte maturation play a role in the racial disparities in IVF outcomes?

Fresh vs Frozen Embryo Transfer

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