Serum progesterone concentration and live birth rate in frozen–thawed embryo transfers with hormonally prepared endometrium

Cédrin‐Durnerin, Isabelle; Isnard, Tiphaine; Mahdjoub, Sarah; Sonigo, Charlotte; Seroka, Alice; Comtet, Marjorie; Herbemont, C.; Sifer, C.; Grynberg, Michaël

doi:10.1016/j.rbmo.2018.11.026

Cited by 102 publications

(100 citation statements)

References 23 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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“…It is noteworthy that there is a minimum concentration of progesterone which is required to induce normal secretory endometrial development and receptivity [68]. This is supported by a previous study which revealed a signi cant decrease in clinical pregnancy and live birth rate with serum progesterone level <10 ng/ml [69].…”

Section: Outcome Measures Selectionsupporting

confidence: 62%

Effectiveness of Electroacupuncture for Thin Endometrium in Infertile Women: Study Protocol for A Single-Blind, Randomized Controlled Trial

Liu

Wang

et al. 2020

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Background: Thin endometrium negatively impacts the reproductive function. Current treatments for thin endometrium do not always improve endometrial receptivity. Preliminary evidence suggests that electroacupuncture could have potential therapy for thin endometrium in infertile women. Thus, this randomized controlled trial was designed to test whether electroacupuncture can improve endometrial receptivity in infertile women with thin endometrium.Methods: This study is a randomized, single-blinded, controlled, clinical trial. A total of 142 eligible patients will be recruited and randomly assigned to the electroacupuncture (EA) group or the sham electroacupuncture (SEA) group in a 1:1 ratio. Participants will receive 36 sessions over three menstrual cycles (12 weeks in total), with the same acupoint prescription. The primary outcome of this trial is endometrial thickness in the midluteal phase. The secondary outcomes include endometrial pattern, resistance index (RI) and pulsatility index (PI) of bilateral uterine artery and endometrium blood flow, serum estradiol (E2) and progesterone (P), and pregnancy rate. The pregnancy rate will be evaluated during a six-month follow-up after completion of the trial. All other outcomes will be evaluated before treatment, during the treatment of 1st, 2nd, and 3rd menstrual cycle, and 6 months after treatment.Discussion: If the outcome confirms the effectiveness of electroacupuncture for thin endometrium in infertile women, this treatment will be proposed for application in clinical practice.Trial registration: Trial registration: Chinese Clinical Trials Registry, ChiCTR2000029983. Registered on 18 February 2020, http://www.chictr.org.cn

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“…However, results on the rate of miscarriages with substituted cycles are contradictory [4][5][6] , and there is no apparent difference in the rate of ongoing pregnancies or birth rate according to cycle type 7 . Some research teams have shown that AC results in fewer clinical pregnancies when the progesterone level on the day of the FET is lower, especially below a threshold of 9.2 ng/mL 8,9 . Another team recently proposed a higher progesterone threshold of 20.6 ng/mL 10 .…”

Section: Introductionmentioning

confidence: 99%

Comparison of Serum Progesterone Levels of the Day of Frozen Embryo Transfers According to Type of Endometrial Preparation: A Monocentric, Retrospective Study

Pouget

Zuna

Bonneau

et al. 2020

Preprint

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Background: Live birth rate following embryo transfer is comparable between natural cycle and hormonal therapy. However, pregnancy loss rate appears elevated with hormonal therapy, possibly due to luteal insufficiency, characterised by a low level of serum progesterone in the luteal phase. The primary objective of this study, was to determine whether serum progesterone level on transfer day differed according to endometrial preparation method in patients undergoing frozen embryo transfer (FET). Secondary objectives were to compare the clinical pregnancy with foetal heartbeat rate and pregnancy loss rate according to endometrial preparation method and to compare the level of serum progesterone on the transfer day between pregnancy loss and pregnancy with foetal heartbeat.Methods: Forty-seven natural/stimulated cycles and 68 artificial cycle FET were retrospectively studied from May to December 2019 from a single French hospital. The primary endpoint was the level of serum progesterone on the day of FET. The type of infertility, aetiology, serum basal FSH, LH, oestradiol and AMH dosage, endometrial thickness, clinical pregnancy rate, pregnancy loss rate, and maternal and embryo characteristics were compared between natural/stimulated cycle (OS group) and artificial cycle (AC group). Results: Mean serum progesterone level on embryo transfer day was 25.47 ng/mL in the OS group versus 14.32 ng/mL AC group (p <0.0001). There was no significant difference in demographic and hormone characteristics (age, type of embryo, type of infertility, basal FSH, LH, oestradiol and AMH levels), endometrial thickness, number and type of embryos transferred, duration of infertility, pregnancy rate and pregnancy loss rate. Body mass index was lower in the OS group than AC group (22.9 kg/m2 vs 24.8 kg/m2, p=0.03). No difference was found in serum progesterone level between clinical pregnancy with foetal heartbeat and pregnancy loss (respectively 17.48 ng/mL vs 20.82 ng/mL, p=0.7 and 22 ongoing pregnancies and 12 pregnancy loss).Conclusions: Serum progesterone level on FET day is lower with endometrial preparation with artificial cycle than with a natural/stimulated cycle. Further research is necessary to determine if this difference has any relation with higher pregnancy loss rate with artificial cycle.

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Serum progesterone concentration and live birth rate in frozen–thawed embryo transfers with hormonally prepared endometrium

Cited by 102 publications

References 23 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

Effectiveness of Electroacupuncture for Thin Endometrium in Infertile Women: Study Protocol for A Single-Blind, Randomized Controlled Trial

Comparison of Serum Progesterone Levels of the Day of Frozen Embryo Transfers According to Type of Endometrial Preparation: A Monocentric, Retrospective Study

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