Is there a critical LH level for hCG trigger after the detection of LH surge in modified natural frozen-thawed single blastocyst transfer cycles?

Kahraman, Semra; Sahin, Yucel

doi:10.1007/s10815-020-01974-5

Cited by 10 publications

(10 citation statements)

References 31 publications

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“…When the dominant follicle reached 15 mm, serum estradiol and LH levels were monitored every 24 h until LH surge was detected. When the endometrial thickness reached above 8 mm and the LH level rose above, a critical threshold level (> 15 IU/L), r-hCG (Ovitrelle, Merck-Serono, Switzerland) was administered [ 14 ]. Frozen embryo transfer was performed 6 days after rhCG administration.…”

Section: Methodsmentioning

confidence: 99%

What to advise to patients with only one good quality blastocyst, PGT-A or not? Outcomes of 2064 cycles

Kahraman

Duzguner

Sahin

et al. 2022

J Assist Reprod Genet

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Purpose To evaluate whether preimplantation genetic testing for aneuploidy (PGT-A) is beneficial for patients who have only one blastocyst available for biopsy or transfer. Methods This retrospective study was based on 1126 single blastocyst PGT-A and 938 non-PGT-A cycles, a total of 2064 ART cycles which resulted in a single good quality blastocyst in women between 20 and 45 years old. The PGT-A group had 225 single euploid embryo transfer cycles and the non-PGT-A group had 938 single blastocyst embryo transfer cycles. Results In the generalized linear mixed model (GLMM), female age and PGT-A variables were found to be significant variables on pregnancy outcomes. In the PGT-A cases, regardless of the effect of other variables, the probabilities of clinical pregnancy and live birth were found to be 3.907 and 3.448 fold higher respectively than in the non-PGT-A cases (p < 0.001). In non PGT-A cases, the probability of a total pregnancy loss was found to be 1.943 fold higher (p = 0.013). Conclusion PGT-A in the presence of a single blastocyst significantly increases clinical pregnancy and live birth rates and decreases total pregnancy losses regardless of age. In addition, aneuploid embryo transfer cancelations prevent ineffective and potentially risky transfers.

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Section: Methodsmentioning

confidence: 99%

What to advise to patients with only one good quality blastocyst, PGT-A or not? Outcomes of 2064 cycles

Kahraman

Duzguner

Sahin

et al. 2022

J Assist Reprod Genet

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“…To our knowledge, there is no study comparing different doses of hCG for triggering in modified-NC; in theory, the lowest effective dose to induce ovulation will result in a lower early serum P 4 , which should reduce the risk of endometrial advancement, known to have a negative impact on endometrial receptivity. The place for endocrine monitoring in modified-NC is controversial (51,52). Whether monitoring of serum P 4 and LH levels in modified-NC FET cycles has added clinical value needs to be explored.…”

Section: Modified-ncmentioning

confidence: 99%

“…The study was interrupted prematurely. However, the impact of an impending LH surge on reproductive outcomes in modified-NC is controversial, some reporting a negative impact (66) and others no impact at all (51,52).…”

Section: Comparison Of T-nc Versus Modified-ncmentioning

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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“…On the other hand, studies have also shown that abnormal luteinizing hormone (LH) levels will lead to poor endometrial hyperplasia and affect pregnancy outcomes (14)(15)(16). However, the effects of P and LH levels on pregnancy outcomes in the mNC-thawed embryo transfer (mNC-FET) remain controversial (6,17,18). Therefore, we conducted a retrospective study of the mNC-FET cycles in our reproductive medicine centre at Nanjing Drum Tower Hospital to investigate the relationships between serum P and LH levels before the hCG trigger and clinical pregnancy outcomes.…”

Section: Introductionmentioning

confidence: 99%

“…Since the natural cycles and modified natural cycles do not require ovarian stimulation and meet the physiological requirements of embryo implantation, they can avoid the endometrial synchronization disorder caused by superphysiological levels of oestrogen and have become the most common endometrial preparation protocols ( 4 , 5 ). In modified natural cycles, dominant follicle development is detected by ultrasound and changes in hormone levels are measured to detect the human chorionic gonadotropin (hCG) trigger time, which is especially critical for the correct transformation of the endometrium ( 6 , 7 ).…”

Section: Introductionmentioning

confidence: 99%

Adverse impact of elevated serum progesterone and luteinizing hormone levels on the hCG trigger day on clinical pregnancy outcomes of modified natural frozen-thawed embryo transfer cycles

et al. 2022

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Research questionThe relationship between serum progesterone (P) and luteinizing hormone (LH) levels on the human chorionic gonadotropin (hCG) trigger day and the clinical pregnancy outcomes in modified natural frozen-thawed embryo transfer (mNC-FET) cycles are controversial.DesignThis was a retrospective study of 788 mNC-FET cycles. A smooth fitting curve and threshold effect analysis was performed to identify the effect of serum P and LH levels measured on the hCG day on the clinical pregnancy rate (CPR) and live birth rate (LBR) of mNC-FET cycles.ResultsThe CPR and LBR decreased significantly when the LH level on the hCG day was greater than or equal to 32 IU/L. Further subgroup analysis showed that the CPR decreased significantly when the P level on the hCG day was equal to or greater than 1 ng/mL. When the P level was lower (< 1 ng/mL), the patients with an LH level greater than or equal to 32 IU/L had reduced CPR and LBR in mNC-FET cycles.ConclusionApplying the hCG trigger on a day with a higher P level (≥ 1 ng/mL) leads to a decreased CPR and LBR. hCG administration with a higher LH level (≥ 32 IU/L) also leads to a decreased CPR and LBR in mNC-FET cycles when the P level is less than 1 ng/mL.

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Is there a critical LH level for hCG trigger after the detection of LH surge in modified natural frozen-thawed single blastocyst transfer cycles?

Cited by 10 publications

References 31 publications

What to advise to patients with only one good quality blastocyst, PGT-A or not? Outcomes of 2064 cycles

What to advise to patients with only one good quality blastocyst, PGT-A or not? Outcomes of 2064 cycles

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

Adverse impact of elevated serum progesterone and luteinizing hormone levels on the hCG trigger day on clinical pregnancy outcomes of modified natural frozen-thawed embryo transfer cycles

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