Early stop of progesterone supplementation after confirmation of pregnancy in IVF/ICSI fresh embryo transfer cycles of poor responders does not affect pregnancy outcome

Pan, Song-Po; Chao, Kuang Han; Huang, Chien-Hua; Wu, Ming‐Jung; Chen, Mei-Jou; Chang, Chin‐Hao; Yang, Jehn-Hsiahn; Yang, Yu‐Shih; Chen, Shee‐Uan

doi:10.1371/journal.pone.0201824

Cited by 10 publications

(3 citation statements)

References 36 publications

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“…Aboulghar and colleagues conducted a research in which patients were indided to either continue or discontinue receiving progesterone when there was fetal heart with ultrasound, and found comparable outcomes between the groups, indicating that continuing progesterone beyond this time has no benefit [ 78 ]. In addition, several studies have found no difference in pregnancy outcome and suggested that progesterone supplement would be safely discontinued after the first test for positive β-hCG [ 84 , 85 ].…”

Section: Methodsmentioning

confidence: 99%

Individualized luteal phase support after fresh embryo transfer: unanswered questions, a review

Zhao

HAO

2022

Reprod Health

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Background Luteal phase support (LPS) is an important part of assisted reproductive technology (ART), and adequate LPS is crucial for embryo implantation. At present, a great number of studies have put emphasis on an individualized approach to controlled ovarian stimulation (COS) and endometrium preparation of frozen- thawed embryo transfer (FET); However, not much attention has been devoted to the luteal phase and almost all ART cycles used similar LPS protocol bases on experience. Main body This review aims to concisely summarize individualized LPS protocols in fresh embryo transfer cycles with hCG trigger or GnRH-a trigger. The PubMed and Google Scholar databases were searched using the keywords: (luteal phase support or LPS) AND (assisted reproductive technology or ART or in vitro fertilization or IVF). We performed comprehensive literature searches in the English language describing the luteal phase support after ART, since 1978 and ending in May 2019. Recent studies have shown that many modified LPS programs were used in ART cycle. In the cycle using hCG for final oocyte maturation, the progesterone with or without low dose of hCG may be adequate to maintain pregnancy. In the cycle using GnRH-a for trigger, individualized low dose of hCG administration with or without progesterone was suggested. The optimal timing to start the LPS would be between 24 and 72 h after oocyte retrieval and should last at least until the pregnancy test is positive. Addition of E2 and the routes of progesterone administration bring no beneficial effect on the outcomes after ART. Conclusions Individualized LPS should be applied, according to the treatment protocol, the patients’ specific characteristics, and desires.

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Section: Methodsmentioning

confidence: 99%

Individualized luteal phase support after fresh embryo transfer: unanswered questions, a review

Zhao

HAO

2022

Reprod Health

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“…Progesterone production in early pregnancy is therefore normal in fresh transfer ART. Several investigators have documented that progesterone supplementation can be stopped on the day of the positive pregnancy test [5,6] without risking an increase in the rate of pregnancy losses. Most groups, however, continue progesterone treatment for further weeks-often 10 weeks, but without good reason.…”

Section: Fresh Embryo Transfersmentioning

confidence: 99%

Implantation Failures and Miscarriages in Frozen Embryo Transfers Timed in Hormone Replacement Cycles (HRT): A Narrative Review

Ziegler

Pirtea

Ayoubi

2021

Life

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The recent advent of embryo vitrification and its remarkable efficacy has focused interest on the quality of hormone administration for priming frozen embryo transfers (FETs). Products available for progesterone administration have only been tested in fresh assisted reproduction technologies (ARTs) and not in FET. Recently, there have been numerous concordant reports pointing at the inefficacy of vaginal preparations at delivering sufficient progesterone levels in a sizable fraction of FET patients. The options available for coping with these shortcomings of vaginal progesterone include (i) rescue options with the addition of injectable subcutaneous (SC) progesterone at the dose of 25 mg/day administered either solely to women whose circulating progesterone is <10 ng/mL or to all in a combo option and (ii) the exclusive administration of SC progesterone at the dose of 25 mg BID. The wider use of segmented ART accompanied with FET forces hormone replacement regimens used for priming endometrial receptivity to be adjusted in order to optimize ART outcomes.

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“…Miscarriage rate was similar for both study groups. In addition, several retrospective cohort studies have failed to demonstrate any benefit of extended LPS administration (11)(12)(13).…”

Section: Review Of the Literaturementioning

confidence: 99%

When Can We Safely Stop Luteal Phase Support in Fresh IVF Cycles? A Literature Review

Mizrachi

Raziel

Weissman

2020

Front. Reprod. Health

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There is no consensus on the optimal duration of luteal phase support (LPS) in fresh IVF cycles. Although some clinicians withdraw LPS on the day of a positive pregnancy test, most clinicians continue its administration at least up to the 8th week of gestation. In this literature review, we included several randomized clinical trials comparing early and late cessation of LPS. Most studies have found no benefit in extended administration. These studies, however, were limited by their small sample size and selection bias. Until now, only a few attempts have been made to indicate when LPS can be safely stopped based on individual patient characteristics. In conclusion, the quality and quantity of the evidence regarding LPS duration in fresh IVF cycles is currently insufficient to justify early cessation in all patients. Individualization of LPS should receive high priority in future research.

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Early stop of progesterone supplementation after confirmation of pregnancy in IVF/ICSI fresh embryo transfer cycles of poor responders does not affect pregnancy outcome

Cited by 10 publications

References 36 publications

Individualized luteal phase support after fresh embryo transfer: unanswered questions, a review

Individualized luteal phase support after fresh embryo transfer: unanswered questions, a review

Implantation Failures and Miscarriages in Frozen Embryo Transfers Timed in Hormone Replacement Cycles (HRT): A Narrative Review

When Can We Safely Stop Luteal Phase Support in Fresh IVF Cycles? A Literature Review

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