The frozen–thawed embryo transfer timing determined by serum progesterone level: a retrospective follow-up study

Objective: In frozen-thawed embryo transfer (FET) cycles, preparing a synchronous endometrium for the embryo is essential. Aim of this study is to provide individualized luteal support in hormonally replaced FET cycles, and to evaluate mid-luteal serum progesterone levels and pregnancy outcomes.Study Design: In this prospective cohort study, 30 patients were included in a university hospital in six month-period. Serum progesterone level on embryo transfer day was monitored, and if it was found to be below the lower limits defined by previous studies (10 ng/mL), additional 100 mg intramuscular micronized progesterone was administered once.Mid-luteal progesterone levels and pregnancy outcomes were recorded.Results: There was no significant difference between mid-luteal progesterone levels of the patients whose transfer day progesterone was above and below 10 ng/mL (p=0.481). Although clinical pregnancy rate tended to be higher in patients whose mid-luteal progesterone was above 10 ng/mL, it was also not statistically significant.Conclusion: This is the first study in which vaginal progesterone treatment was supported by intramuscular progesterone according to serum progesterone values for the purpose of individualized progesterone support. Significant difference was not found in pregnancy outcomes. However, further studies are required to optimize management and improve pregnancy rates in hormonally treated FET cycles.

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Progesterone Intramuscularly or Vaginally Administration May Not Change Live Birth Rate or Neonatal Outcomes in Artificial Frozen-Thawed Embryo Transfer Cycles

Frontiers in Endocrinology ◽

10.3389/fendo.2020.539427 ◽

2020 ◽

Vol 11 ◽

Author(s):

Yuan Liu ◽

Yu Wu

Keyword(s):

Preterm Delivery ◽

Live Birth ◽

Birth Rate ◽

Live Birth Rate ◽

Neonatal Outcomes ◽

Progesterone Level ◽

Delivery Rate ◽

Serum Progesterone ◽

Frozen Thawed Embryo Transfer ◽

Thawed Embryo Transfer

BackgroundsPrevious studies suggested that singletons from frozen-thawed embryo transfer (FET) were associated with higher risk of large, post-date babies and adverse obstetrical outcomes compared to fresh transfer and natural pregnancy. No data available revealed whether the adverse perinatal outcomes were associated with aberrantly high progesterone level from different endometrium preparations in HRT-FET cycle. This study aimed to compare the impact of progesterone intramuscularly and vaginally regimens on neonatal outcomes in HRT-FET cycles.MethodsA total of 856 HRT-FET cycles from a fertility center from 2015 to 2018 were retrospectively analyzed. All patients had their first FET with two cleavage-staged embryos transferred. Endometrial preparation was performed with sequential administration of estrogen followed by progesterone intramuscularly 60 mg per day or vaginal gel Crinone 90 mg per day. Pregnancy outcomes including live birth rate, singleton birthweight, large for gestational age (LGA) rate, small for gestational age (SGA) rate, and preterm delivery rate were analyzed. 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.ResultsNo 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 singleton birthweight (p = 0.744), preterm delivery rate (Adjusted OR 1.920, 95% CI 0.603, 6.11, p = 0.269), SGA (Adjusted OR 0.227, 95% CI 0.027, 1.934, p = 0.175), and LGA rate (Adjusted OR 0.862, 95% CI 0.425, 1.749, p=0.681) 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 ≤41.82 pmol/L in HRT-FET cycles when progesterone was intramuscularly delivered (Adjusted OR 1.690, 95% CI 1.002, 2.849, p = 0.049). But singleton birthweight, preterm delivery rate, SGA and LGA rate were not different between these two groups.ConclusionsRelatively higher serum progesterone level induced by intramuscular regimen did not change live birth rate or neonatal outcomes compared to vaginal regimen. Monitoring serum progesterone level and optimizing progesterone dose of intramuscular progesterone as needed in HRT-FET cycles has a role in improving live birth rate without impact on neonatal outcomes.

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Frozen-thawed embryo transfer and live birth: Long-term follow-up after one oocyte retrieval

Fertility and Sterility ◽

10.1016/j.fertnstert.2005.12.032 ◽

2006 ◽

Vol 86 (1) ◽

pp. 239-242 ◽

Cited By ~ 1

Author(s):

Ian S. Tummon ◽

Mark A. Wentworth ◽

Alan R. Thornhill

Keyword(s):

Embryo Transfer ◽

Live Birth ◽

Oocyte Retrieval ◽

Long Term Follow Up ◽

Frozen Thawed Embryo Transfer ◽

Thawed Embryo Transfer

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hCG day progesterone level has no impact on the frozen thawed embryo transfer cycle outcome

Journal of Gynecology Obstetrics and Human Reproduction ◽

10.1016/j.jogoh.2021.102120 ◽

2021 ◽

Vol 50 (6) ◽

pp. 102120

Author(s):

Khadijeh Pouya ◽

Yavuz Emre Şükür ◽

Gülar İsrafilova ◽

Batuhan Özmen ◽

Murat Sönmezer ◽

...

Keyword(s):

Embryo Transfer ◽

Progesterone Level ◽

Cycle Outcome ◽

Frozen Thawed Embryo Transfer ◽

Thawed Embryo Transfer

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Serum Progesterone Level at the Day Prior to Frozen Thawed Embryo Transfer and Pregnancy Rate

Journal of Advances in Medicine and Medical Research ◽

10.9734/jammr/2021/v33i1731047 ◽

2021 ◽

pp. 221-231

Author(s):

Merihan Mohamed Elewa ◽

Ayman Abdelaziz Eldorf ◽

Shahinaz Hamdy Elshorbagy ◽

Manal Mostafa Abdallah

Keyword(s):

Pregnancy Rate ◽

Embryo Transfer ◽

Endometrial Thickness ◽

Pregnancy Rates ◽

Observational Research ◽

Embryo Survival ◽

Serum Progesterone ◽

Laboratory Methods ◽

Frozen Thawed Embryo Transfer ◽

Thawed Embryo Transfer

Background: Cryopreservation's success rate varies depending on woman age, as low as 14.8% (if eggs were extracted from 40-year-old women), and as high as 31.5% with 25-year-old women. The goal of the research is to improve laboratory methods for freezing-thawing embryos, leading to elevated embryo survival rate. Yet, in hormonal replacement therapy frozen-thawed embryo transfer (HRT-FET) cycles, effective endometrial preparation before embryo transfer attracted less focus. The present research’s aim is to see whether there's a link between blood progesterone levels and pregnancy rates the day before frozen-thawed embryo transfer. Methods: This prospective observational research has investigated 120 patients of frozen-thawed embryo transfer cycle treatment, only 100 individuals subdivided to 2 groups for serum level of progesterone one day before frozen-thawed embryo transfer. The subjects visited both the Obstetrical and Gynecological Department of Tanta University as well as private centers between May 2020 and January 2021. Results: We discovered no correlation between maternal age with pregnancy test results. Yet, our study discovered highly significant variation among both groups regarding endometrial thickness one day preceding embryo transfer, and regarding pregnancy rate (p<0.05). Conclusion: The serum progesterone hormone preceding frozen embryo transfer has significant and direct relation and impact upon pregnancy rates. The present research detected low serum progesterone less than 10 nanograms/ml in the day before frozen-thawed embryo transfer in HRT-FET cycles significantly decreased probability of ongoing pregnancy post frozen-thawed embryo transfer.

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

10.21203/rs.3.rs-16976/v1 ◽

2020 ◽

Author(s):

Jing Zhu ◽

Qianqian Zhu ◽

Jialyu Huang ◽

Meiting Qiu ◽

Yanwen Zhu ◽

...

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Embryo Transfer ◽

Pregnancy Outcomes ◽

Luteal Phase ◽

Serum Progesterone ◽

Endometrial Preparation ◽

Vaginal Progesterone ◽

Frozen Thawed Embryo Transfer ◽

Thawed Embryo Transfer

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

10.21203/rs.2.23836/v1 ◽

2020 ◽

Author(s):

Yuan Liu ◽

Yu Wu

Keyword(s):

Cohort Study ◽

Preterm Delivery ◽

Embryo Transfer ◽

Live Birth ◽

Birth Rate ◽

Live Birth Rate ◽

Neonatal Outcomes ◽

Serum Progesterone ◽

Frozen Thawed Embryo Transfer ◽

Thawed Embryo Transfer

Abstract 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 improved live birth rate when progesterone concentration at day 14 post-FET was higher than 41.82pmol/L.

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