A study on the timing of the initiation of luteal phase progesterone supplementation in frozen embryo transfere cycle after spontaneous ovulation

Abstract Background: More than 67% of all embryos transferred in the United States involve frozen-thawed embryos. Progesterone supplementation is necessary in medicated cycles in order to luteinize the endometrium and prepare it for implantation, but little data is available if this is necessary in true natural cycles. We evaluated the use of progesterone luteal phase supplementation for cryopreserved/warmed blastocyst transfers in natural cycles not using an ovulatory trigger.Methods: Retrospective cohort study in a single academic medical center. We studied the use of progesterone supplementation beginning in the luteal phase and continued until 10 weeks gestational age in patients undergoing true natural cycle cryopreserved blastocyst transfer. Our outcome measures were ongoing pregnancy rate, positive serum beta human chorionic gonadotropin (HCG) level, implantation rate, clinical pregnancy rate, miscarriage/abortion rate, ectopic pregnancy rate, and multifetal gestation rate. Categorical data were analyzed utilizing Fisher’s exact test and non-parametric data were analyzed using the Wilcoxon rank sum test. We a priori adjusted for age.Results: 229 patients were included in the analysis with 149 receiving luteal phase progesterone supplementation and 80 receiving no luteal phase support. Patient demographic and cycle characteristics, and embryo quality were similar between the two groups. No difference was seen in ongoing pregnancy rate (49.0% vs. 47.5%, p=0.8738), clinical pregnancy rate (50.3% vs. 47.5%, p= 0.7483), positive HCG rate (62.4% vs. 57.5%, p=0.5965), miscarriage/abortion rate (5.4% vs. 2.5%, p=0.2622), ectopic pregnancy rate (0% vs. 1.3%, p=0.3493), or multifetal gestations (7.4% vs. 3.8%, p=0.3166).Conclusion(s): The addition of progesterone luteal phase support in true natural cycle cryopreserved blastocyst transfers does not improve cycle outcomes. Capsule: Progesterone supplementation as luteal phase support in true natural cycle cryopreserved blastocyst transfers does not improve ongoing pregnancies.

Download Full-text

P-240. HMG versus oral progesterone supplementation in the treatment of early repeated pregnancy loss due to luteal phase insufficiency

Human Reproduction ◽

10.1093/humrep/14.suppl_3.261 ◽

1999 ◽

Vol 14 (Suppl_3) ◽

pp. 261-261

Author(s):

H.N. Sallam ◽

A.N. Sallam ◽

F. Ezzeldin ◽

A.A. Abou-Ali ◽

A. Khanfour

Keyword(s):

Luteal Phase ◽

Pregnancy Loss ◽

Progesterone Supplementation ◽

Repeated Pregnancy Loss

Download Full-text

Estradiol and progesterone supplementation during luteal phase improved the receptivity of the endometrium in a patient with a history of diethylstilboestrol exposure in-utero

HORMONES ◽

10.14310/horm.2002.11178 ◽

2006 ◽

Vol 5 (2) ◽

pp. 147-150 ◽

Cited By ~ 1

Author(s):

Dimitris Loutradis ◽

Konstantinos Stefanidis ◽

Erasmia Kiapekou ◽

Evangelia Zapanti ◽

Chrisoula Panitsa-Faflia ◽

...

Keyword(s):

Luteal Phase ◽

In Utero ◽

History Of ◽

Progesterone Supplementation

Download Full-text

The Clinical Relevance of Luteal Phase Progesterone Support in True Natural Cycle Cryopreserved Blastocyst Stage Embryo Transfers: A Retrospective Cohort Study

10.21203/rs.3.rs-31243/v3 ◽

2021 ◽

Author(s):

Ian Waldman ◽

Catherine Racowsky ◽

Emily Disler ◽

Ann Thomas ◽

Lanes Andrea ◽

...

Keyword(s):

Cohort Study ◽

Pregnancy Rate ◽

Pregnancy Outcomes ◽

Luteal Phase ◽

Retrospective Cohort ◽

Natural Cycle ◽

Ongoing Pregnancy ◽

Ongoing Pregnancy Rate ◽

Progesterone Supplementation ◽

Natural Cycles

Abstract Background: More than 67% of all embryos transferred in the United States involve frozen-thawed embryos. Progesterone supplementation is necessary in medicated cycles to luteinize the endometrium and prepare it for implantation, but little data is available to show if this is beneficial in true natural cycles. We evaluated the use of luteal phase progesterone supplementation for cryopreserved/warmed blastocyst transfers in true natural cycles not using an ovulatory trigger.Methods: Retrospective cohort study in a single academic medical center. We studied the use of luteal phase progesterone supplementation in patients undergoing true natural cycle cryopreserved blastocyst embryo transfers. Our primary outcome measure was ongoing pregnancy rate, with other pregnancy outcomes being evaluated (i.e. implantation rate, miscarriage rate, ectopic rate, and multifetal gestation). Categorical data were analyzed utilizing Fisher’s exact test and all binary variables were analyzed using log-binomial regression to produce a risk ratio. Results: 229 patients were included in the analysis with 149 receiving luteal phase progesterone supplementation and 80 receiving no luteal phase support. Patient demographic and cycle characteristics, and embryo quality were similar between the two groups. No difference was seen in ongoing pregnancy rate (49.0% vs. 47.5%, p=0.8738), clinical pregnancy rate (50.3% vs. 47.5%, p= 0.7483), positive HCG rate (62.4% vs. 57.5%, p=0.5965), miscarriage/abortion rate (5.4% vs. 2.5%, p=0.2622), ectopic pregnancy rate (0% vs. 1.3%, p=0.3493), or multifetal gestations (7.4% vs. 3.8%, p=0.3166).Conclusion(s): The addition of luteal phase progesterone support in true natural cycle cryopreserved blastocyst embryo transfers did not improve pregnancy outcomes and therefore the routine use in practice cannot be recommended based on this study, but the utilization should not be discouraged without further studies. Capsule: Progesterone supplementation as luteal phase support in true natural cycle cryopreserved blastocyst transfers does not improve ongoing pregnancies.

Download Full-text