High Progesterone levels in the beginning of ICSI antagonist cycles and clinical pregnancy: still a concern?

Panaino, Tatiana R; Silva, Joyce B da; Lima, Maria Augusta T de; Lira, Paloma; Areas, Patrícia; Mancebo, Ana Cristina Allemand; Souza, Marcelo Marinho de; Antunes, Roberto de Azevedo; Souza, María do Carmo Borges de

doi:10.5935/1518-0557.20170004

Cited by 8 publications

(7 citation statements)

References 13 publications

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“…It is known that an embryo implanted in an endometrium with early luteinization has a decrease in its fixation rate. Thus, once this diagnosis is confirmed, it is possible to freeze this embryo or even the oocytes and organize a new cycle for transfer with better conditions for obtaining the pregnancy ( Panaino et al , 2017 ).…”

Section: Discussionmentioning

confidence: 99%

Early serum progesterone and prolactin analysis at day 9 of oocyte retrieval as a predictor of success in fresh ICSI cycles

Pérez¹,

Ceschin²,

Moraes³

et al. 2018

JBRA Assisted Reproduction

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ObjectiveTo analyze progesterone and prolactin plasma levels nine days after oocyte retrieval and evaluate their correlation with pregnancy rates in in vitro fertilization cycles. To achieve pregnancy, several factors are analyzed before and during the in vitro fertilization cycle. Progesterone supplementation for adequate luteal phase support is indicated despite the presence of multiple corpus luteum in IVF stimulation cycles because of blockage caused by hypothalamic agonists and antagonists. The dosage of progesterone and prolactin on day 09 after follicular retrieval could function as a predictive marker of success in fertility treatments.MethodsA retrospective study was performed using data from 238 patients submitted to intracytoplasmic sperm injection (ICSI) at a private infertility clinic from January 2013 to December 2015. Hormonal measurements were performed on day 09 after follicular uptake. The data was compared to assess the correlation between prolactin and progesterone dosages and pregnancy rates. ResultsThe ICSI pregnancy rate was 40.8% (n=238). No statistically significant difference was observed when correlating the success of the procedure with the prolactin dosage (p=0.71). However, progesterone showed a significant difference (p=0.021). The cutoff point, indicated by the ROC curve fit according to which gestation would be identified, is 25.95ng/ml of progesterone. The sensitivity of this point is 61.9% and the specificity is 57.4%.ConclusionProgesterone dosage may be one of the indicators of gestation on day 09 after follicular uptake. Such data can help physicians to monitoring and provides suitable early gestational care. More studies are needed to corroborate the data found.

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Section: Discussionmentioning

confidence: 99%

Early serum progesterone and prolactin analysis at day 9 of oocyte retrieval as a predictor of success in fresh ICSI cycles

Pérez¹,

Ceschin²,

Moraes³

et al. 2018

JBRA Assisted Reproduction

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“…Elevated levels of P4 were observed in greater numbers in pregnant women at this study. In the literature, serum progesterone above 1.5 ng/ml on the day of the oocyte trigger suggests early luteinization, indicating embryo freezing and transfer to another cycle to potentiate the result (Panaino et al, 2017). A P4 dosage of 10 ng/ml on D4 after the trigger in frozen embryo transfer provides better pregnancy rates (Gaggiotti-Marre et al, 2020).…”

Section: Discussionmentioning

confidence: 99%

“…Some values of hormone dosages are established. On the human chorionic gonadotropin (hCG) day, values above 1.5ng/ml indicate early endometrial luteinization, allowing the choice to freeze the embryos and transfer them in another cycle (Panaino et al, 2017). In frozen embryo transfer, P4 values greater than 10 ng/ml on Day 4 (D4) of embryonic evolution are described as a predictor of success (Gaggiotti-Marre et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

Serum concentrations of progesterone and prolactin as predictors of success in in vitro fertilization: A retrospective cohort study

Santander-Pérez¹,

Ceschin²,

Ramos³

et al. 2022

JBRA

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Objective:The aim of this study is to determine whether the serum concentrations of progesterone and/or prolactin after fresh embryo transfer are associated with pregnancy rates in in vitro fertilization treatment.Methods: This retrospective cohort study evaluated in vitro fertilization treatments with fresh embryo transfer, which were performed between 2013 and 2019 in a private clinic in Curitiba, Brazil. The serum concentrations of progesterone and prolactin were evaluated by chemiluminescence nine days after oocyte retrieval. The type of progesterone supplementation and pituitary blockage during the cycle of oocyte stimulation were evaluated.Results: 330 fertilization cycles were performed in the 293 studied patients. The mean age of patients was 35.5±4.1years. The most seen isolated infertility factor was endometriosis (24.2% of the cases), while progesterone supplementation was performed intramuscularly in 73.9% of the cases. The progesterone values above 32.1ng/ ml at day 9 (D9) were associated with better pregnancy rates. In cycles using antagonist and intramuscular luteal phase supplementation, higher pregnancy rates with progesterone values above 37.83ng/ml were observed. Moreover, prolactin showed no significant association with any of the studied variables.Conclusions: The serum progesterone concentrations above 32.1ng/ml at D9 that were taken one week before pregnancy testing were associated with successful in vitro fertilization treatment. Furthermore, prolactin showed no significant association with any of the studied variables.

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“…For t-NC, transvaginal ultrasonography is performed on day 2 or 3 of menses to rule out any cyst or corpus luteum prevailing from the previous cycle. Cycle cancellation is usually undertaken in cycles with serum P 4 >1.5 ng/ml on day 2 or 3 of menses, even though this practice has been extrapolated from fresh embryo transfer cycles (48,49). To our knowledge, there is no study evaluating the impact of day 2/3 serum P 4 on success rates in t-NC, modified-NC, and mild-OS cycles.…”

Section: True-nc (T-nc)mentioning

confidence: 99%

Preparation of the Endometrium for Frozen Embryo Transfer: A Systematic Review

et al. 2021

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Despite the worldwide increase in frozen embryo transfer, the search for the best protocol to prime endometrium continues. Well-designed trials comparing various frozen embryo transfer protocols in terms of live birth rates, maternal, obstetric and neonatal outcome are urgently required. Currently, low-quality evidence indicates that, natural cycle, either true natural cycle or modified natural cycle, is superior to hormone replacement treatment protocol. Regarding warmed blastocyst transfer and frozen embryo transfer timing, the evidence suggests the 6th day of progesterone start, LH surge+6 day and hCG+7 day in hormone replacement treatment, true natural cycle and modified natural cycle protocols, respectively. Time corrections, due to inter-personal differences in the window of implantation or day of vitrification (day 5 or 6), should be explored further. Recently available evidence clearly indicates that, in hormone replacement treatment and natural cycles, there might be marked inter-personal variation in serum progesterone levels with an impact on reproductive outcomes, despite the use of the same dose and route of progesterone administration. The place of progesterone rescue protocols in patients with low serum progesterone levels one day prior to warmed blastocyst transfer in hormone replacement treatment and natural cycles is likely to be intensively explored in near future.

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High Progesterone levels in the beginning of ICSI antagonist cycles and clinical pregnancy: still a concern?

Cited by 8 publications

References 13 publications

Early serum progesterone and prolactin analysis at day 9 of oocyte retrieval as a predictor of success in fresh ICSI cycles

Early serum progesterone and prolactin analysis at day 9 of oocyte retrieval as a predictor of success in fresh ICSI cycles

Serum concentrations of progesterone and prolactin as predictors of success in in vitro fertilization: A retrospective cohort study

Preparation of the Endometrium for Frozen Embryo Transfer: A Systematic Review

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