“Does serum estrogen level have an impact on outcomes in hormonal replacement frozen-warmed embryo transfer cycles?”

2021 ◽  
pp. 1-4
Author(s):  
Sita Garimella ◽  
Sandeep Karunakaran ◽  
Durga Rao Gedela
Keyword(s):  
Embryo Transfer ◽  
Hormonal Replacement ◽  
Estrogen Level

Measurement of urinary estrogen level with the urinary estrogen micrometry method in in vitro fertilization and embryo transfer therapy

1984 ◽  
Vol 42 (2) ◽  
pp. 204-210 ◽  
Author(s):  
Hiroshi Hoshiai ◽  
Shigeki Uehara ◽  
Akira Tsuiki ◽  
Yoko Hirose ◽  
Toshihiko Momma ◽  
...  
Keyword(s):  
In Vitro Fertilization ◽  
Embryo Transfer ◽  
Vitro Fertilization ◽  
Estrogen Level

scholarly journals Natural micronized progesterone for hormonal replacement therapy in reproductive medicine

2000 ◽  
Vol 49 (1) ◽  
pp. 45-49
Author(s):  
M. A. Repina ◽  
N. V. Kornilov
Keyword(s):  
Replacement Therapy ◽  
Pregnancy Rate ◽  
Embryo Transfer ◽  
Reproductive Medicine ◽  
Hormonal Replacement Therapy ◽  
Embryo Donation ◽  
Hormonal Replacement ◽  
Gestational Week ◽  
Micronized Progesterone

A total of 64 artificial cycles with natural micronized progesterone replacement therapy were studied. Progesterone zoos used from day 4-5 before embryo transfer till gestational week 8-11 in different programmes (ovum/embryo donation, surrogacy, thawed embryos transfer after previous IVF/ICSI failures). Pregnancy rate was 43.5%. The HRT by natural micronized progesterone in artificial cycles could be stopped on gestational week 9 without any risk.

P–404 Low serum progesterone on the day of frozen blastocyst transfer is associated with a diminished ongoing pregnancy rate in hormonal replacement therapy cycles

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
C Maignien ◽  
B Mathilde ◽  
B Valérie ◽  
C Ahmed ◽  
C Charles ◽  
...  
Keyword(s):  
Replacement Therapy ◽  
Pregnancy Rate ◽  
Embryo Transfer ◽  
Frozen Embryo Transfer ◽  
Blastocyst Transfer ◽  
Progesterone Level ◽  
Ongoing Pregnancy ◽  
Ongoing Pregnancy Rate ◽  
Serum Progesterone ◽  
Hormonal Replacement

Abstract Study question Is there a relationship between progesterone levels on the day of frozen blastocyst transfer and ongoing pregnancy rate (OPR), in hormonal replacement therapy (HRT) cycles? Summary answer Women undergoing HRT-frozen embryo transfer with progesterone levels≤9.76ng/ml on the day of blastocyst transfer had a significantly lower OPR than those with progesterone levels>9.76 ng/ml. What is known already The importance of serum progesterone levels around the time of frozen embryo transfer (FET) is a burning issue, in view of the growing number of FET worldwide. However, the optimal range of serum progesterone levels is not clearly determined and discrepancies arise from the current literature. Study design, size, duration: Observational cohort study with 915 patients undergoing HRT-FET at a tertiary care university hospital, between January 2019 and March 2020. Participants/materials, setting, methods Patients undergoing single autologous blastocyst FET under HRT using exogenous estradiol and vaginal micronized progesterone for endometrial preparation. Women were only included once during the study period. The serum progesterone level was measured in the morning of the FET, in a single laboratory. The primary endpoint was OPR beyond pregnancy week 12. Statistical analysis was conducted using univariate and multivariate logistic regression models. Main results and the role of chance Mean serum progesterone level on the day of FET was 12.90 ± 4.89 ng/ml). The OPR was 35.5% (325/915) in the overall population. Patients with a progesterone level ≤ 25th percentile (≤9.76ng/ml) had a significantly lower OPR and a higher miscarriage rate (MR) compared with women with progesterone level over Centile 25 (29.6% versus 37.4%; p = 0.033 and 34.8% versus 21.3%; p = 0.008, respectively). After adjustment for the potential confounders in a multivariate analysis, a serum progesterone level ≤ 9.76 ng/ml on the day of FETand FET of a Day 6-blastocyst (versus Day 5-blastocyst) were found as independent risks factor of lower OPR. Limitations, reasons for caution The main limitation of our study is linked to its observational design. Extrapolation of our results to other laboratories, or other routes and/or doses of administering progesterone also needs to be validated. Wider implications of the findings: This study suggests that a minimum serum progesterone level is needed to optimize reproductive outcomes in autologous blastocyst FET, in HRT-cycles. Further studies are needed to evaluate if modifications of progesterone routes and/or doses may improve pregnancy chances, in an approach to individualize the management of ART patients. Trial registration number NA

P–672 Higher pregnancy outcomes in patients undergoing embryo transfer-under hormonal replacement therapy where an individualised Progesterone supplementation was applied on the day of β-hCG

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
M Alvarez ◽  
A Racca ◽  
S García ◽  
F Martínez ◽  
I González-Foruria ◽  
...  
Keyword(s):  
Replacement Therapy ◽  
Pregnancy Rate ◽  
Embryo Transfer ◽  
Pregnancy Outcomes ◽  
Pregnancy Rates ◽  
Hormonal Replacement Therapy ◽  
Miscarriage Rate ◽  
Hormonal Replacement ◽  
Progesterone Supplementation ◽  
Β Hcg

Abstract Study question Does progesterone-supplementation (PS) from the day of β-hCG assessment improve pregnancy rates in embryo transfer-under hormonal replacement therapy (ET-HRT) in patient with Progesterone (P)<10.6 ng/mL? Summary answer Reduced P on the β-hCG day is associated with lower pregnancy-rates and higher miscarriage-rate. PS from the same day showed significant increase of reproductive outcomes. What is known already Up until now, in ART, very little has been done to understand whether the P intake should be personalized during the luteal phase. Most recent studies on the topic showed that low P levels on the day of ET-HRT or on the day before are associated with decreased pregnancy rates; however, when low P values are supplemented from the day before embryo-transfer (ET), similar results to cases with adequate P are reported. Nevertheless, little is known about the association between low P level, on the day of β-hCG (P- β-hCG) and PS from this day in ET-HRT, and pregnancy outcomes. Study design, size, duration This is a single centre, cohort, retrospective study conducted at a university-affiliated fertility centre between January 2018 and June 2020 where PS took place from the day of positive β-hCG determination when P < 10.6 ng/mL. In total 789 ET-HRT cycles were analysed of which 239 were performed in both fresh and frozen heterologous ET-HRT (het-ET), 336 in homologous ET-HRT (hom-FET) and 214 in euploid ET-HRT (eu-FET) after preimplantation genetic testing for aneuploidies IVF cycles (PGT-A). Participants/materials, setting, methods Women undergoing ET-HRT with normal P (>10.6ng/mL) on the day before ET were screened for P on the day of β-hCG. All women received vaginal P 200 mg/8 hours for the second part of HRT. PS was performed by adding P to the HRT when P- β-hCG was considered low (<10.6 ng/mL). Primary outcome: ongoing-pregnancy-rate (OPR); secondary outcome: miscarriage-rate (MR). Both were evaluated by considering PS on the day of β-hCG as a categorical variable. Main results and the role of chance Patients characteristics were comparable between groups (het-ET, hom-FET and eu-FET) although significantly lower body mass index was found when P- β-hCG>10.6 ng/mL compared to the subgroup with P- β-hCG<10.6 ng/mL and no PS (p = 0.012). Overall clinical pregnancy rate was 52.1% with no-significant differences between groups (48.5% in het-ET, 52.9% in hom-FET and 54.7% in eu-FET). P- β-hCG was considered as adequate in 75.7% (311/411) ET-HRT with positive β-hCG and low in 24.3% (100/411), with no differences between groups. In case of positive β-hCG and P- β-hCG >10.6 ng/mL, OPR was 83.6% and MR was 16.4%, with no-significant differences between groups. Among the 100 low P- β-hCG, 80 ET-HRT received PS. In this subgroup OPR was 96.2% and MR was 3.8%, with no-significant differences between groups. In 20 out of 100 ET with P- β-hCG <10.6 ng/mL, no PS was added for different reasons. This group showed the lowest OPR (30%) and the highest MR (70%), again with no between-group differences according to het-ET, hom-FET or eu-FET. Miscarriage rate was significantly higher (p < 0.001) when P- β-hCG was <10.6 ng/mL and no PS was added to HRT compared to P- β-hCG <10.6 ng/mL but with PS, and also compared to the P- β-hCG >10.6 ng/mL group. Limitations, reasons for caution The main limitation of the study is due to its retrospective nature and the small sample of patients with P- β-hCG<10.6 ng/mL that was not supplemented. Furthermore, the cut-off of P- β-hCG was arbitrarily decided upon previous studies, and lastly different routes of administration were considered for the PS. Wider implications of the findings: The results of this study showed that individualization of Progesterone supplementation in ET-HRT may be a crucial turn point in order to increase the pregnancy rates and decrease the miscarriage rates. An adequate PS should be considered in case of low P- β-hCG levels for both het-ET, hom-FET and eu-FET. Trial registration number Not applicable

scholarly journals Dynamics of proximal and distal transport of sodium in case of bilateral gonadectomy and the efficacy of hormonal replacement therapy

2021 ◽  
Vol 11 (1) ◽  
pp. 338-345
Author(s):  
I. I. Lutsiv ◽  
A. A. Hudyma ◽  
B. O. Pereviznyk ◽  
M. I. Marushchak
Keyword(s):  
Replacement Therapy ◽  
Sodium Transport ◽  
Hormonal Replacement Therapy ◽  
Female Rats ◽  
Skeletal Trauma ◽  
Control Groups ◽  
Hormonal Replacement ◽  
High Interest ◽  
Bilateral Ovariectomy ◽  
Estrogen Level

Introduction. The characteristic feature of current trauma in Ukraine and in the world is the prevalence of highly energetic skeletal trauma which is followed by the appearance of combined and multiple injuries with the formation of multiorgan dysfunction and failure. Because of the increase of life duration, the high interest of current traumatology is the investigation process of trauma course in older people. Among them the high interest is given to females in postmenopausal period. The decrease of estrogen level causes very unfavorable ground for the trauma course. However, the influence of severe trauma on changes in proximal and distal transport of sodium in case of hypoestrogenic state is not fully investigated. There is no available data concerning the effectiveness of hormonal replacement therapy in this condition.The goal of the study: is to investigate the influence of cranioskeletal injury on the dynamics of proximal and distal sodium transport in rats with bilateral ovariectomy in the period of late changes of traumatic disease and evaluate the effectiveness of hormonal replacement therapy.   Materials and methods. Experiments were performed on 42 non-linear white female rats with the weight of 200-220 g. The model of hypoestrogenic state was performed via surgical removal of the ovaries. 1 month after the gonadectomy in rats skeletal trauma was performed. As a treatment option in one subgroup of rats with gonadectomy and cranioskeletal injury we performed hormonal replacement therapy. The control groups were formed by intact rats and osteoporotic rats 1 month after gonadectomy which were not injured. In control groups and after 1 and 2 months of posttraumatic period we were investigating the functional state of kidneys by performing the water upload method. Afterwards we performed the laboratory checkup of creatinine and sodium levels in serum and urine and additionally calculated the values of proximal and distal sodium transport.   Results and its discussion. It was found that the level of proximal and distal sodium transport depends on the estrogen level, the decrease of its secretion leads to the decrease of sodium reabsorption in tubules and the increase in secretion. These changes were more prevalent in proximal tubules. In the course of trauma 1 month after posttraumatic period the value was decreasing in both research groups. However, in rats with gonadectomy the changes were much bigger and stayed at the same level until the 2nd month of the experiment. In rats without gonadectomy these values were achieving the same levels as control group until 2nd month. The use of combined hormonal replacement therapy caused the increase of proximal and distal sodium transport in comparison to the group without receiving treatment. The results that we got though was not achieving the level of rats without gonadectomy, but it showed the perspective for the use of combined hormonal replacement therapy in case of hypoestrogenic state for the decrease of renal dysfunction.     Conclusions: Bilateral ovariectomy in female rats after 1 month shows the decrease of proximal and distal sodium levels comparing to rats with preserved gonads. The cranioskeletal injury that happened 1 month after bilateral ovariectomy causes the much bigger decrease of proximal and distal sodium transport comparing to rats with preserved gonads. The use of combined hormonal replacement therapy caused lower changes in proximal and distal sodium transport comparing to rats without this treatment.

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