The effect of elevated progesterone levels before HCG triggering in modified natural cycle frozen-thawed embryo transfer cycles

Groenewoud, Eva R.; Macklon, Nick S.; Cohlen, Ben J; Al-Oraiby, Amani; Brinkhuis, Egbert A.; Broekmans, Frank J.; Bruin, Jan Peter de; Dool, Grada van der; Fleisher, Kathrin; Friederich, Jaap; Goddijn, Mariëtte; Hoek, Annemieke; Hoozemans, Diederik A.; Kaaijk, Eugenie M.; Koks, Carolina A. M.; Laven, Joop; Linden, Paul J.Q. van der; Manger, Petra A. P.; Rumpste, Minouche van; Spinder, T.

doi:10.1016/j.rbmo.2017.02.008

Cited by 27 publications

(15 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…For natural endometrial preparations, some clinicians use serial LH tests. However, the role of serial LH monitoring with ultrasonogram has been a subject of much debate in natural endometrial preparations and there is no clear definition of or consensus regarding LH surge (42)(43)(44). Furthermore, serial LH tests are not covered by the national health insurance.…”

Section: Discussionmentioning

confidence: 99%

Obstetric, Neonatal, and Clinical Outcomes of Day 6 vs. Day 5 Vitrified-Warmed Blastocyst Transfers: Retrospective Cohort Study With Propensity Score Matching

et al. 2020

View full text Add to dashboard Cite

Despite the large number of studies on blastocyst transfers, it is unclear whether day 6 blastocysts have similar pregnancy rates and safety with day 5 blastocysts. Thus, this study aimed to compare the obstetric, neonatal, and clinical outcomes of day 5 and day 6 vitrified blastocyst transfers (VBT). In this retrospective cohort study with propensity score matching, we evaluated 1,313 cycles of VBT performed between January 2014 and December 2015 at the Fertility Center of CHA Gangnam Medical Center. All cycles underwent natural endometrial preparation. We used propensity score matching to compare day 5 and day 6 VBTs in a matched comparison. After propensity score matching, there were 465 cycles of day 5 VBT and 155 cycles of day 6 VBT. Implantation rate (IR), clinical pregnancy rate (CPR), and live birth rate (LBR) were significantly lower in day 6 VBTs (44.2 vs. 53.1%, p = 0.023; 48.4 vs. 60.4%, p = 0.009; 33.5 vs. 51.8%, p < 0.001). Miscarriage rate was significantly higher in day 6 VBTs (29.3 vs. 10.7%, p < 0.001). Rate of multiple gestations was similar between the two groups (29.3 vs. 30.2%, p = 0.816). Assessing 241 and 52 babies from day 5 and day 6 VBTs, no differences were found in neonatal outcomes including rates of low birth weight, preterm birth, and congenital malformations. In propensity score-matched analysis, obstetric, and neonatal outcomes between day 5 and day 6 VBTs were similar so that day 6 VBTs are as safe as day 5 VBTs. IR, CPR, and LBR were are all significantly lower in day 6 VBTs. Therefore, if there are no differences in the morphological grade between day 5 and day 6 blastocysts, transfer of day 5 vitrified blastocysts should be considered first.

show abstract

Section: Discussionmentioning

confidence: 99%

Obstetric, Neonatal, and Clinical Outcomes of Day 6 vs. Day 5 Vitrified-Warmed Blastocyst Transfers: Retrospective Cohort Study With Propensity Score Matching

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Premature progesterone elevations driven by the patient's own unsuppressed cycle has been reported, although, whether it does affect pregnancy outcomes is still debatable. 9,16 In the current study, all FET cycles were HRT cycles.…”

Section: Discussionmentioning

confidence: 98%

“…The premature proges- terone elevations have also been reported in frozen cycles, causing the implantation window to shift, although few studies regarding these effects have been published. 10,16 Early progesterone elevation has been reported in both natural cycles and HRT-induced protocols of frozen cycles. Premature progesterone elevations driven by the patient's own unsuppressed cycle has been reported, although, whether it does affect pregnancy outcomes is still debatable.…”

Section: Discussionmentioning

confidence: 99%

Do High Progesterone Levels Affect Clinical Pregnancy Rates in Freeze-All Cycles?

Özdemir¹,

Gülümser²,

Türkmen³

et al. 2019

JCOG

View full text Add to dashboard Cite

n patients undergoing controlled ovarian hyperstimulation for in-vitro fertilization (IVF), elevated progesterone levels may cause early maturation of the endometrium, negatively affecting pregnancy rates. The effects of progesterone hypersecretion on frozen embryo transfers (FET), however, remain unclear. Nowadays, FETs are often preferred in IVF, although scant data are available on the effects of elevated progesterone in these cycles. A decrease in pregnancy rates correlated with elevated progesterone during the late follicular phase has been reported. 1,2 Altered gene expression and cytokine profiles in the endometrium lead to its early maturation, which are triggered by elevated progesterone. 1,3,4 This results in unsuccessful embryo implantation due to asynchronization. 5 Premature progesterone elevation may be caused by high estrogen at induction, high doses of follicle-stimulating hormone (FSH) during stimulation, and increased numbers of pre-ovulatory follicles. [6][7][8] In FET, the embryo is transferred after preparing the endometrium without inducing ovulation, and therefore, there is no supraphysiological hormonal environment. However, reports suggest that progesterone elevation in FETs is possible, thus progesterone levels are monitored so that embryo transfer could be postponed in case of high progesterone levels. 9 The endometrium may be prepared for FET by different methods. The patient's endogenous JCOG 2019;29(3):81-5 81 Do High Progesterone Levels Affect Clinical Pregnancy Rates in Freeze-All Cycles? A AB BS ST TR RA AC CT T O Ob bj je ec ct ti iv ve e: : To evaluate the effect of early progesterone elevation on clinical pregnancy and abortion rates in freeze-all cycles. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s:: Assessments were carried out on patients who underwent frozen embryo transfer (FET) between 2015 and 2018 after tertiary referral at the Ondokuz Mayıs University In-Vitro Fertilization (IVF) Center, Samsun, Turkey. Serum progesterone levels were measured at the beginning (p1) and on the 11 th day (p2) of the HRT cycle, and two subgroups were identified as <1.5 ng/L and ≥1.5 ng/L. R Re es su ul lt ts s: : FET was indicated for 204 women with symptoms of unexplained infertility (n=130), male factor (n=54), or poor ovarian reserve (n=20). No significant correlation was found between clinical pregnancy rates and progesterone levels on the 2 nd to 3 rd day (p=0.389) nor on the 11 th day of the HRT cycle (p=0.407). Similar results were also obtained for the correlation between the abortion rates and progesterone levels on the second, third, or 11 th days of the cycle (p=1.000, not significant). C Co on nc cl lu us si io on n: : Although progesterone elevation is believed to cause early maturation of the endometrium, the present findings indicate clinically nonsignificant effects of progesterone levels on pregnancy and abortion rates in frozen cycles. K Ke ey yw wo or rd ds s: : Embryo transfer; progesterone; infertility

show abstract

“…This method, however, yields contradictory results ( Table 3). The optimal value, for instance, was 0.9 ng/ml for Urman et al [109] [126], and 1.2 for Bosch et al [59]. A recent retrospective study from the same author including more than 4000 cycles, selected 1.5 ng/ml as the critical cut-off after conducting a trend analysis, concluding that the AUC may be insufficient to predict success rates as there is a non-linear relationship between progesterone values and pregnancy outcome [76].…”

Section: Progesterone Cut-off Valuementioning

confidence: 99%

The curious case of premature luteinization

Kaponis

Chronopoulou

Decavalas

2018

J Assist Reprod Genet

View full text Add to dashboard Cite

Authors need to speak the same language when studying PL in order to facilitate comparisons. The terminology, progesterone cut-off, measurement methods and days of measurement should be standardized and globally accepted; otherwise, there can be no scientific dialog. Future research should focus on specific patient profiles that may require a tailored approach. Progesterone measurements throughout the follicular phase possibly depict the progesterone exposure better than an isolated measurement on the day of hCG. Adequately powered randomized controlled trials should confirm which the best prevention and management plan of PL is, before introducing any strategy into clinical practice.

show abstract

The effect of elevated progesterone levels before HCG triggering in modified natural cycle frozen-thawed embryo transfer cycles

Cited by 27 publications

References 41 publications

Obstetric, Neonatal, and Clinical Outcomes of Day 6 vs. Day 5 Vitrified-Warmed Blastocyst Transfers: Retrospective Cohort Study With Propensity Score Matching

Obstetric, Neonatal, and Clinical Outcomes of Day 6 vs. Day 5 Vitrified-Warmed Blastocyst Transfers: Retrospective Cohort Study With Propensity Score Matching

Do High Progesterone Levels Affect Clinical Pregnancy Rates in Freeze-All Cycles?

The curious case of premature luteinization

Contact Info

Product

Resources

About