Progesterone levels on pregnancy test day after hormone replacement therapy-cryopreserved embryo transfer cycles and related reproductive outcomes

Alsbjerg, Birgit; Thomsen, Lise; Elbæk, Helle Olesen; Laursen, Rita Jakubcionyte; Povlsen, Betina Boel; Haahr, Thor; Humaıdan, Peter

doi:10.1016/j.rbmo.2018.08.022

Cited by 86 publications

(78 citation statements)

References 13 publications

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“…Consequently, the serum progesterone levels in this study only reflected vaginal progesterone administration. The P levels widely varied in this study, which were also observed in previous studies [26][27][28]30]. Although all women receive the same dose of vaginal progesterone, the uptake, absorption and metabolism of each hormone can vary among women ( [26].…”

Section: Discussionsupporting

confidence: 77%

“…In a previous study [26], the optimal progesterone range needed to achieve a live birth was found to be 70-99 nmol/l, while values outside this range were significantly related to lower pregnancy rates. Furthermore, two very recent studies found that there is an optimal serum P value around the time of ET (≥ 10 ng/ml) and on the day of the pregnancy test (≥ 35 nmol/l) [27,30]. In line with the above two studies, one study [28] showed that patients with serum P < 9.2 ng/ml on the day of ET after an artificial endometrial preparation cycle with vaginal micronized P had a significantly reduced OPR, which was observed in the oocyte donation cycle context.…”

Section: Discussionmentioning

confidence: 99%

“…Recently, it has been reported that a range of serum progesterone concentrations during the implantation period is associated with an optimal live birth rate [25][26][27][28][29][30][31]. Although these results are controversial, they suggest an optimal serum P threshold for the LBR of artificial cycles when using intravaginal or intramuscular progesterone; however, different cut-off levels have been suggested.…”

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confidence: 99%

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Association between serum progesterone levels on the day of frozen-thawed embryo transfer and pregnancy outcomes after artificial endometrial preparation

Zhu

Huang

et al. 2020

Preprint

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Background Previous studies have examined that a range of optimal serum P level during the implantation period was associated with optimal live birth rates. However, those results obtained with vaginal or intramuscular route of progesterone administration for LPS alone. Is there a relationship between the serum progesterone (P) on the day of frozen-thawed embryo transfer (FET) with the likelihood of a live birth(LB) in artiﬁcial cycles(AC) when using a combination of oral dydrogesterone and vaginal progesterone for luteal phase support (LPS)? Methods This was a retrospective study of 3659 FET cycles with artiﬁcial endometrial preparation in a Chinese tertiary-care academic medical centre from January 2015 to February 2017. Endometrial preparation was performed using estradiol (E 2 ) valerate (Fematon-red tablets) 8 mg/d beginning on day 3 of the cycle, followed by administration of P both orally (40 mg dydrogesterone and 8 mg E 2 twice per day, Fematon-yellow tablets) and vaginally (400 mg/d; Utrogestan). The primary endpoint was LBR. The association between the serum P level on the embryo transfer day and pregnancy outcomes was evaluated by univariable and multivariable logistic regression analysis. Results Mean serum P on the day of embryo transfer was 10.30 ± 3.88 ng/ml (percentiles: 25, 7.9; 50, 9.7; 75, 12.1). The LBRs according to the serum P quartiles were as follows: Q1, 35.7%; Q2, 37.4%; Q3, 39.1%; and Q4: 38.9%. Logistic regression analysis showed that the odds of a LB were not significantly different between the low (P <7.9 ng/mL) and high (P ≥7.9 ng/mL) progesterone groups before or after adjustment (crude odds ratio [OR] = 0.89, 95% confidence interval [CI]: 0.76-1.04; adjusted OR = 0.89, 95% CI: 0.75-1.04). Conclusions The present study suggests that the serum P levels on the day of ET do not correlate with the likelihood of a LB in artiﬁcial cycles when using a combination of oral dydrogesterone and vaginal progesterone for luteal phase support. In addition, prospective, randomized, controlled, blinded trials are merited to determine the optimal dosing regimen for oral dydrogesterone in in AC-FET for LPS.

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Section: Discussionsupporting

confidence: 77%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Association between serum progesterone levels on the day of frozen-thawed embryo transfer and pregnancy outcomes after artificial endometrial preparation

Zhu

Huang

et al. 2020

Preprint

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“…The clinical implications of these findings suggest that an intervention is still possible at this stage, when the embryo has not yet been transferred into the uterus. Similarly, a recent study (Alsbjerg et al. , 2018) found that serum P value <11 ng/mL the day of pregnancy test was related to worse pregnancy outcomes.…”

mentioning

confidence: 76%

Serum progesterone screening for frozen embryo transfer: present and future perspectives

Coroleu¹,

Gaggiotti-Marre²

2019

JBRA Assisted Reproduction

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“…Our findings confirmed previous data that serum higher progesterone level during mid-luteal phase got higher successful rate than the lower P level counterparts in HRT-FET cycles. Luteal progesterone level outside the range limits reduced clinical pregnancy rate [24][25][26]. We further explored newborn birthweight and gestational age in intramuscular progesterone cohort.…”

Section: Discussionmentioning

confidence: 99%

Progesterone regimen impact on live birth rate and neonatal outcomes in artificial frozen-thawed embryo transfer cycles: a retrospective cohort study

Liu¹,

Wu²

2020

Preprint

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Background: Previous studies have demonstrated that singletons from frozen embryo transfer (FET) are heavier and longer-gestational-days at delivery than those from fresh embryo transfer. The amounts and routes of progesterone used in FET vary tremendously among different ART centers.Does different serum progesterone level induced by different progesterone regimens determine live birth rate and neonatal outcomes in hormone replacement therapy frozen-thawed embryo transfer (HRT-FET) cycles?Design: A cohort study of 856 HRT-FET cycles from a Chinese public fertility center. Data from patients undergoing their first FET cycles from 2015-2018 were extracted from the database. All patients had their first FET with two day2 or day3 embryos transferred. Endometrial preparation was performed with sequential administration of estrogen followed by progesterone 60mg per day intramuscularly or Crinone 90mg per day vaginally. Live birth was the primary outcome. Secondary outcome included clinical pregnancy rate, singleton birthweight, large for gestational age (LGA) rate, SGA rate and preterm delivery rate. Student's t test, Mann-Whitney U-test, Chi square analysis and multivariable logistic regression were used where appropriate. Differences were considered significant if p<0.05.Results: No significant difference of live birth rate was found between different progesterone regimens (Adjusted OR 1.128, 95%CI 0.842, 1.511, p=0.420). Neonatal outcomes like birthweight, preterm delivery rate, SGA and LGA rate were not different between two progesterone regimens.Serum P level >41.82 pmol/L at 14 day post-FET was associated with higher live birth rate than serum P level ≤41.82pmolL in HRT-FET cycles when progesterone was intramuscularly delivered (Adjusted OR 1.690, 95%CI 1.002, 2.849, p=0.049). Birthweight and gestational weeks were not different between these two different P level groups. Conclusions: Progesterone vaginally or intramuscularly didn't impact live birth rate and neonatal outcomes in artificial FET cycles. Relatively higher serum progesterone level induced by intramuscular regimen did not increase newborn birthweight or prolong gestational weeks compared to vaginal regimen. Intramuscular progesterone supplementation during HRT-FET cycles was associated with development in cows. Theriogenology 2011, 76:1594-1601. 17. Nogueira MF, Melo DS, Carvalho LM, Fuck EJ, Trinca LA, Barros CM: Do high progesterone concentrations decrease pregnancy rates in embryo recipients synchronized with PGF2alpha and eCG? Theriogenology 2004, 61:1283-1290. 18. Mitwally MF, Diamond MP, Abuzeid M: Vaginal micronized progesterone versus intramuscular progesterone for luteal support in women undergoing in vitro fertilization-embryo transfer. Fertil Steril 2010, 93:554-569. 19. Zarei A, Sohail P, Parsanezhad ME, Alborzi S, Samsami A, Azizi M: Comparison of four protocols for luteal phase support in frozen-thawed Embryo transfer progesterone on the day of embryo transfer is associated with a diminished ongoing pregnancy rate in oocyte donation ...

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Progesterone levels on pregnancy test day after hormone replacement therapy-cryopreserved embryo transfer cycles and related reproductive outcomes

Cited by 86 publications

References 13 publications

Association between serum progesterone levels on the day of frozen-thawed embryo transfer and pregnancy outcomes after artificial endometrial preparation

Association between serum progesterone levels on the day of frozen-thawed embryo transfer and pregnancy outcomes after artificial endometrial preparation

Serum progesterone screening for frozen embryo transfer: present and future perspectives

Progesterone regimen impact on live birth rate and neonatal outcomes in artificial frozen-thawed embryo transfer cycles: a retrospective cohort study

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