scholarly journals Possibility of Live Birth in Patients with Low Serum β-hCG 14 Days After Blastocyst Transfer

2020 ◽  
Author(s):  
Yixuan Wu ◽  
Haiying Liu
Keyword(s):  
Live Birth ◽  
Roc Curve ◽  
Pregnancy Outcomes ◽  
Luteal Phase ◽  
Clinical Pregnancy ◽  
Blastocyst Transfer ◽  
Luteal Phase Support ◽  
Live Births ◽  
Β Hcg ◽  
Low Serum

Abstract Background: Although prior work has attempted to predict pregnancy outcomes by assaying serum β-hCG levels after blastocyst transfer, no study has focused on pregnancy outcomes in those with initially low serum β-hCG levels. This study sought to investigate pregnancy outcomes of patients with low serum β-hCG levels 14 days after blastocyst transfer.Methods: A retrospective study was conducted at the Third Affiliated Hospital of Guangzhou Medical University to study patients whose serum β-hCG levels were at 5-299 mIU/ml 14 days after frozen blastocyst transfer. Rates of live birth, early miscarriage, biochemical pregnancy loss and ectopic pregnancy were analyzed according to the female patients’ age by Chi-squared analysis. Receiver operating characteristic (ROC) curves were plotted to explore the threshold of predicting clinical pregnancy and live births. Results: 312 patients had serum β-hCG levels <300 mIU/ml at 14 days after frozen blastocyst transfer, among which, 18.6% were live births, 47.4% were early miscarriages, 22.8% were biochemical pregnancies and 9.6% were ectopic pregnancies. Live birth rates were higher in the <38 years of age group as compared those > 38 years (19.0% vs.16.6%; P=0.045). ROC curve analysis showed that a predicted value of β-hCG for clinical pregnancy was 58.8 mIU/ml with an area under the ROC curve (AUC) of 0.752, a sensitivity of 95.0% and specificity of 53.5%. The threshold for live births was 108.6 mIU/ml with an AUC of 0.649, a sensitivity of 93.1% and a specificity of 37.0%. For the β-hCG fold increase over 48 hours, the cut-off for clinical pregnancy was 1.4 with an AUC of 0.899, a sensitivity of 90.3% and a specificity of 77.8%. The threshold for live birth was 1.9 with an AUC of 0.808, a sensitivity of 88.5% and specificity of 64.5%.Conclusions: Initially low serum β-hCG levels 14 days after frozen blastocyst transfer indicated minimal chances of live birth. For patients having an initial β-hCG >58.8 mIU/ml, luteal phase support should continue. Another serum β-hCG test and ultrasound should be performed one week later. When an initial serum β-hCG is < 58.8 mIU/ml, luteal phase support should be discontinued and serum β-hCG measured with ultrasound one week later.

scholarly journals Possibility of live birth in patients with low serum β-hCG 14 days after blastocyst transfer

2020 ◽  
Vol 13 (1) ◽  
Author(s):  
Yixuan Wu ◽  
Haiying Liu
Keyword(s):  
Live Birth ◽  
Roc Curve ◽  
Pregnancy Outcomes ◽  
Luteal Phase ◽  
Clinical Pregnancy ◽  
Blastocyst Transfer ◽  
Luteal Phase Support ◽  
Live Births ◽  
Β Hcg ◽  
Low Serum

Abstract Background Although prior work has attempted to predict pregnancy outcomes by assaying serum β-hCG levels after blastocyst transfer, no study has focused on pregnancy outcomes in those with initially low serum β-hCG levels. This study sought to investigate pregnancy outcomes of patients with low serum β-hCG levels 14 days after blastocyst transfer. Methods A retrospective study was conducted at the Third Affiliated Hospital of Guangzhou Medical University to study patients whose serum β-hCG levels were at 5–299 mIU/ml 14 days after frozen blastocyst transfer. Rates of live birth, early miscarriage, biochemical pregnancy loss and ectopic pregnancy were analyzed according to the female patients’ age by Chi-squared analysis. Receiver operating characteristic (ROC) curves were plotted to explore the threshold of predicting clinical pregnancy and live births. Results 312 patients had serum β-hCG levels < 300 mIU/ml at 14 days after frozen blastocyst transfer, among which, 18.6% were live births, 47.4% were early miscarriages, 22.8% were biochemical pregnancies and 9.6% were ectopic pregnancies. ROC curve analysis showed that a predicted value of β-hCG for clinical pregnancy was 58.8 mIU/ml with an area under the ROC curve (AUC) of 0.752, a sensitivity of 95.0% and specificity of 53.5%. The threshold for live births was 108.6 mIU/ml with an AUC of 0.649, a sensitivity of 93.1% and a specificity of 37.0%. For the β-hCG fold increase over 48 h, the cut-off for clinical pregnancy was 1.4 with an AUC of 0.899, a sensitivity of 90.3% and a specificity of 77.8%. The threshold for live birth was 1.9 with an AUC of 0.808, a sensitivity of 88.5% and specificity of 64.5%. Conclusions Initially low serum β-hCG levels 14 days after frozen blastocyst transfer indicated minimal chances of live birth. For patients having an initial β-hCG > 58.8 mIU/ml, luteal phase support should continue. Another serum β-hCG test and ultrasound should be performed one week later. When an initial serum β-hCG is < 58.8 mIU/ml, luteal phase support should be discontinued and serum β-hCG measured with ultrasound one week later.

scholarly journals Possibility of Live Birth in Patients with Low Serum β -hCG 14 Days After Blastocyst Transfer

2020 ◽  
Author(s):  
Yixuan Wu ◽  
Haiying Liu
Keyword(s):  
Live Birth ◽  
Roc Curve ◽  
Pregnancy Outcomes ◽  
Luteal Phase ◽  
Clinical Pregnancy ◽  
Blastocyst Transfer ◽  
Luteal Phase Support ◽  
Live Births ◽  
Β Hcg ◽  
Low Serum

Abstract Background: Although prior work has attempted to predict pregnancy outcomes by assaying serum β-hCG levels after blastocyst transfer, no study has focused on pregnancy outcomes in those with initially low serum β-hCG levels. This study sought to investigate pregnancy outcomes of patients with low serum β-hCG levels 14 days after blastocyst transfer.Methods: A retrospective study was conducted at the Third Affiliated Hospital of Guangzhou Medical University to study patients whose serum β-hCG levels were at 5-299 mIU/ml 14 days after frozen blastocyst transfer. Rates of live birth, early miscarriage, biochemical pregnancy loss and ectopic pregnancy were analyzed according to the female patients’ age by Chi-squared analysis. Receiver operating characteristic (ROC) curves were plotted to explore the threshold of predicting clinical pregnancy and live births. Results: 312 patients had serum β-hCG levels <300 mIU/ml at 14 days after frozen blastocyst transfer, among which, 18.6% were live births, 47.4% were early miscarriages, 22.8% were biochemical pregnancies and 9.6% were ectopic pregnancies. ROC curve analysis showed that a predicted value of β-hCG for clinical pregnancy was 58.8 mIU/ml with an area under the ROC curve (AUC) of 0.752, a sensitivity of 95.0% and specificity of 53.5%. The threshold for live births was 108.6 mIU/ml with an AUC of 0.649, a sensitivity of 93.1% and a specificity of 37.0%. For the β-hCG fold increase over 48 hours, the cut-off for clinical pregnancy was 1.4 with an AUC of 0.899, a sensitivity of 90.3% and a specificity of 77.8%. The threshold for live birth was 1.9 with an AUC of 0.808, a sensitivity of 88.5% and specificity of 64.5%.Conclusions: Initially low serum β-hCG levels 14 days after frozen blastocyst transfer indicated minimal chances of live birth. For patients having an initial β-hCG >58.8 mIU/ml, luteal phase support should continue. Another serum β-hCG test and ultrasound should be performed one week later. When an initial serum β-hCG is < 58.8 mIU/ml, luteal phase support should be discontinued and serum β-hCG measured with ultrasound one week later.

scholarly journals Possibility of Live Birth For Patients With Low Serum β-hCG 14 Days After Blastocyst Transfer

2020 ◽  
Author(s):  
Yixuan Wu ◽  
Haiying Liu
Keyword(s):  
Live Birth ◽  
Roc Curve ◽  
Pregnancy Outcomes ◽  
Luteal Phase ◽  
Clinical Pregnancy ◽  
Blastocyst Transfer ◽  
Biochemical Pregnancy ◽  
Early Miscarriage ◽  
Β Hcg ◽  
Low Serum

Abstract Background: Although many previous study investigated the prediction of pregnancy outcomes by serumβ-hCG levels after blastocyst transfer, no study focused on the pregnancy outcomes of patients with initially low serum β-hCG levels. The purpose of the study was to investigate the pregnancy outcomes of patients with low serum β- level 14 days after blastocyst transfer. Methods: A retrospective study was performed in the Third Affiliated Hospital of Guangzhou Medical University. The purpose was to investigate the patients whose serum β-hCG levels were between 5-299 mIU/ml 14 days after frozen blastocyst transfer. Rates of live birth, early miscarriage, biochemical pregnancy loss and ectopic pregnancy were analyzed according to the female patients’ age by chi-squared test. Receiver operating characteristic (ROC) curves were plotted to explore the threshold for prediction of clinical pregnancy and live birth. Results: A total of 312 patients had serum β-hCG levels <300 mIU/ml 14 days after frozen blastocyst transfer, among which 18.6% were live birth, 47.4% were early miscarriage, 22.8% were biochemical pregnancy and 9.6% were ectopic pregnancy. Pregnancy outcomes were comparable between the patients aged <38 years and ≥38 years. ROC curve analysis showed that the predicted value ofβ-hCG for clinical pregnancy was 58.8 mIU/ml with the AUC of 0.752(95%CI :0.680-0.823), sensitivity of 95.0% and specificity of 53.5%.The threshold for live birth was 108.6mIU/ml with the area under the ROC curve (AUC) of 0.649(95%CI:0.0.583-0.715), sensitivity of 93.1% and specificity of 37.0%.For the β-hCG fold increase over 48 hours, the cut-off for clinical pregnancy was 1.4 with the AUC of 0.899(95%CI :0.801-0.996), sensitivity of 90.3% and specificity of 77.8%; the threshold for live birth was 1.9 with the AUC of 0.808(95%CI :0.724-0.891), sensitivity of 88.5% and specificity of 64.5%. Conclusions: Initially low serum β-hCG level 14 days after frozen blastocyst transfer indicated minimal likelihood of live birth. For patients having initial β-hCG >58.8 mIU/ml, luteal phase support is suggested to continue. Another serum β-hCG test and ultrasound should be performed one week later. If the initial serum β-hCG is < 58.8 mIU/ml, luteal phase support is suggested to discontinue and measurement of serum β-hCG and ultrasound can be arranged one week later.

scholarly journals The effects of low-dose human chorionic gonadotropin for luteal phase support on pregnancy outcomes in poor ovarian responders: a randomized clinical trial

2021 ◽  
Author(s):  
Tahereh Madani ◽  
Arezoo Arabipoor ◽  
Fariba Ramezanali ◽  
Shabnam Khodabakhshi ◽  
Zahra Zolfaghari
Keyword(s):  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Live Birth ◽  
Pregnancy Outcomes ◽  
Luteal Phase ◽  
Clinical Pregnancy ◽  
Birth Rates ◽  
Luteal Phase Support ◽  
Live Birth Rates ◽  
Significant Difference

Abstract Purpose: The question that remains is, does changing the type of luteal phase support (LPS) improve the pregnancy outcomes in patients with poor ovarian response (POR) diagnosis?. Therefore, this study was designed to investigate and compare the efficiency of different methods of luteal phase support (progesterone alone or hCG alone and the combination of progesterone with hCG) in these patients.Methods: This randomized clinical trial evaluated three hundred seventy five patients who were diagnosed as POR on the basis of Bologna criteria undergoing intracytoplasmic sperm injection- embryo transfer (ICSI-ET) cycles at Royan institute from November 2015 to June 2019. The patients were allocated randomly into three different LPS groups on the day of oocyte pickup. In first group, 1500 IU of hCG IM on the ET day, as well as 4 days after that were administrated. In the second group, the patients received 1500 IU of hCG IM on the ET day, as well as 3 and 6 days after the ET along with vaginal suppositories 400 mg twice daily. For the third group, only vaginal suppositories twice daily was administrated from the day of oocyte pick up until the pregnancy test day.The clinical pregnancy, miscarriage and live birth rates were the main outcomes. Results: The data analysis showed that the three groups were comparable. In the following, there is no significant difference in terms of implantation, clinical pregnancy, and miscarriage and live birth rates among groups. The twin pregnancy rate in the hCG-only group was higher than those of in the other two groups, although this difference was not statistically significant (P=0.06).Conclusion: The type of LPS does not improve the pregnancy and live birth rates in POR patients. A multi-center clinical trial is warranted to confirm or refute these findings.Trial registration: The study was registered in the clinicaltrial.gov site on 14 June 2015. (NCT02798653 at www. clinicaltrials.gov, registered prospectively).

scholarly journals Effect of blastocyst morphology and developmental speed on transfer strategy for grade “C” blastocyst in vitrified‐warmed cycles

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Yuxia He ◽  
Shiping Chen ◽  
Jianqiao Liu ◽  
Xiangjin Kang ◽  
Haiying Liu
Keyword(s):  
Pregnancy Rate ◽  
Live Birth ◽  
Pregnancy Outcomes ◽  
Multiple Pregnancy ◽  
Poor Quality ◽  
Clinical Pregnancy ◽  
Neonatal Outcomes ◽  
Blastocyst Transfer ◽  
Blastocyst Development ◽  
Multiple Pregnancy Rate

Abstract Background High-quality single blastocyst transfer (SBT) is increasingly recommended to patients because of its acceptable pregnancy outcomes and significantly reduced multiple pregnancy rate compared to double blastocyst transfer (DBT). However, there is no consensus on whether this transfer strategy is also suitable for poor-quality blastocysts. Moreover, the effect of the development speed of poor-quality blastocysts on pregnancy outcomes has been controversial. Therefore, this study aimed to explore the effects of blastocyst development speed and morphology on pregnancy and neonatal outcomes during the frozen embryo transfer (FET) cycle of poor-quality blastocysts and to ultimately provide references for clinical transfer strategies. Methods A total of 2,038 FET cycles of poor-quality blastocysts from patients 40 years old or less were included from January 2014 to December 2019 and divided based on the blastocyst development speed and number of embryos transferred: the D5-SBT (n = 476), D5-DBT (n = 365), D6-SBT (n = 730), and D6-DBT (n = 467) groups. The SBT group was further divided based on embryo morphology: D5-AC/BC (n = 407), D5-CA/CB (n = 69), D6-AC/BC (n = 580), and D6-CA /CB (n = 150). Results When blastocysts reach the same development speed, the live birth and multiple pregnancy rates of DBT were significantly higher than those of SBT. Moreover, there was no statistical difference in the rates of early miscarriage and live birth between the AC/BC and CA/CB groups. When patients in the SBT group were stratified by blastocyst development speed, the rates of clinical pregnancy (42.44 % vs. 20.82 %) and live birth (32.35 % vs. 14.25 %) of D5-SBT group were significantly higher than those of D6-SBT group. Furthermore, for blastocysts in the same morphology group (AC/BC or CA/CA group), the rates of clinical pregnancy and live birth in the D5 group were also significantly higher than those of D6 group. Conclusions For poor-quality D5 blastocysts, SBT can be recommended to patients because of acceptable pregnancy outcomes and significantly reduced multiple pregnancy rate compared with DBT. For poor-quality D6, the DBT strategy is recommended to patients to improve pregnancy outcomes. When blastocysts reach the same development speed, the transfer strategy of selecting blastocyst with inner cell mass “C” or blastocyst with trophectoderm “C” does not affect the pregnancy and neonatal outcomes.

Increased live births among patients using intamuscular versus vaginal progesterone for luteal phase support during frozen blastocyst transfer

2013 ◽  
Vol 100 (3) ◽  
pp. S459-S460 ◽  
Author(s):  
R.J. Heitmann ◽  
K.S. Richter ◽  
K. Devine ◽  
J. McKeeby ◽  
A.H. DeCherney ◽  
...  
Keyword(s):  
Luteal Phase ◽  
Blastocyst Transfer ◽  
Luteal Phase Support ◽  
Live Births ◽  
Vaginal Progesterone

scholarly journals Effect of Blastocyst Morphology and Developmental Speed on Transfer Strategy for Grade “C” Blastocyst in Vitrified-warmed Cycles

2021 ◽  
Author(s):  
yuxia He ◽  
shiping Chen ◽  
jianqiao Liu ◽  
xiangjin Kang ◽  
haiying Liu
Keyword(s):  
Pregnancy Rate ◽  
Live Birth ◽  
Pregnancy Outcomes ◽  
Multiple Pregnancy ◽  
Poor Quality ◽  
Clinical Pregnancy ◽  
Neonatal Outcomes ◽  
Blastocyst Transfer ◽  
Blastocyst Development ◽  
Multiple Pregnancy Rate

Abstract Background: High-quality single blastocyst transfer (SBT) is increasingly recommended to patients because of its acceptable pregnancy outcomes and significantly reduced multiple pregnancy rate compared to double blastocyst transfer (DBT). However, there is no consensus on whether this transfer strategy is also suitable for poor-quality blastocysts. Moreover, the effect of the development speed of poor-quality blastocysts on pregnancy outcomes has been controversial. Therefore, this study aimed to explore the effects of blastocyst development speed and morphology on pregnancy and neonatal outcomes during the frozen embryo transfer (FET) cycle of poor-quality blastocysts and to ultimately provide references for clinical transfer strategies.Methods: A total of 2,038 FET cycles of poor-quality blastocysts were analyzed from January 2014 to December 2019 and divided based on the blastocyst development speed and number of embryos transferred: the D5-SBT (n=476), D5-DBT (n=365), D6-SBT (n=730), and D6-DBT (n=467) groups. The SBT group was further divided based on embryo morphology: D5-AC/BC (n=407), D5-CA/CB (n=69), D6-AC/BC (n=580), and D6-CA /CB (n=150).Results: When blastocysts reach the same development speed, the live birth and multiple pregnancy rates of DBT were significantly higher than those of SBT. Moreover, there was no statistical difference in the rates of early miscarriage and live birth between the AC/BC and CA/CB groups. When patients in the SBT group were stratified by blastocyst development speed, the rates of clinical pregnancy (42.44% vs. 20.82%) and live birth (32.35% vs. 14.25%) of D5-SBT group were significantly higher than those of D6-SBT group. Furthermore, for blastocysts in the same morphology group (AC/BC or CA/CA group), the rates of clinical pregnancy and live birth in the D5 group were also significantly higher than those of D6 group. Conclusion: For poor-quality D5 blastocysts, SBT can be recommended to patients because of acceptable pregnancy outcomes and significantly reduced multiple pregnancy rate compared with DBT. For poor-quality D6, the DBT strategy is recommended to patients to improve pregnancy outcomes. When blastocysts reach the same development speed, the transfer strategy of selecting blastocyst with inner cell mass “C” or blastocyst with trophectoderm “C” does not affect the pregnancy and neonatal outcomes.

scholarly journals Pregnancy Outcomes of Patients with Low Serum β-hCG Level 14 Days After Fresh Embryo Transfer

2020 ◽  
Author(s):  
Yixuan Wu ◽  
Haiying Liu
Keyword(s):  
Embryo Transfer ◽  
Pregnancy Outcomes ◽  
Roc Curves ◽  
Clinical Pregnancy ◽  
Ongoing Pregnancy ◽  
Fresh Embryo Transfer ◽  
Biochemical Pregnancy ◽  
Β Hcg ◽  
Low Serum ◽  
Day 3 Embryo

Abstract Background: Although previous studies had successfully illustrated different pregnancy outcomes by different serum β-hCG levels after embryo transfer, prognosis of pregnancy outcomes remains elusive when the serum β-hCG level is extremely low (e.g., < 100 mIU/ml 14 days after embryo transfer). Therefore, the purpose of our study is to investigate the pregnancy outcomes of patients with low serum β-hCG level 14 days after day 3 embryo transfer. Methods: A retrospective study was performed with 723 patients with a serum β-hCG level between 5 and 100 mIU/ml 14 days after day 3 fresh embryo transfer. Pregnancy outcomes (ongoing pregnancy, early miscarriage, biochemical pregnancy loss, and ectopic pregnancy) were analyzed according to the female patients’ age. Receiver operating characteristic (ROC) curves were plotted to indicate the threshold for prediction of clinical pregnancy and ongoing pregnancy. Sensitivity and specificity were calculated according the ROC curves as well. Results: Of the 723 patients with serum β-hCG level <100 mIU/mL 14 days after day 3 embryo transfer, 85.6% (619) had biochemical pregnancy, and only 14.4% (104) had clinical pregnancy (including 4.7% with ongoing pregnancy, 3.7% with ectopic pregnancy, and 5.9% with early miscarriage). The rate of ongoing pregnancy was significantly lower in ≥ 38-year group compared with < 38-year group (1.3% vs. 5.6%, P =0.029). The serum β-hCG level to predict clinical pregnancy was 44.7 mIU/ml (sensitivity, 91.3%; specificity, 82.1%; area under the ROC curve (AUROC), 0.908). For ongoing pregnancy, the serum β-hCG level was 53.7 mIU/ml (sensitivity, 94.1%; specificity, 81.4%; AUROC, 0.902). Conclusions: Initially low serum β-hCG level 14 days after day 3 embryo transfer indicated poor prognosis with minimal likelihood of ongoing pregnancy. Keywords: assisted reproductive technology; human chorionic gonadotropin; pregnancy; live birth; embryo transfer

scholarly journals Effect of Blastocyst Morphology and Developmental Speed on Transfer Strategy for Grade “C” Blastocyst in Vitrified-Warmed Cycles

2021 ◽  
Author(s):  
Yuxia He ◽  
Shiping Chen ◽  
Jianqiao Liu ◽  
Xiangjin Kang ◽  
Haiying Liu
Keyword(s):  
Pregnancy Rate ◽  
Live Birth ◽  
Pregnancy Outcomes ◽  
Multiple Pregnancy ◽  
Poor Quality ◽  
Clinical Pregnancy ◽  
Neonatal Outcomes ◽  
Blastocyst Transfer ◽  
Blastocyst Development ◽  
Multiple Pregnancy Rate

Abstract Background: High-quality single blastocyst transfer (SBT) is increasingly recommended to patients because of its acceptable pregnancy outcomes and significantly reduced multiple pregnancy rate compared to double blastocyst transfer (DBT). However, there is no consensus on whether this transfer strategy is also suitable for poor-quality blastocysts. Moreover, the effect of the development speed of poor-quality blastocysts on pregnancy outcomes has been controversial. Therefore, this study aimed to explore the effects of blastocyst development speed and morphology on pregnancy and neonatal outcomes during the frozen embryo transfer (FET) cycle of poor-quality blastocysts and to ultimately provide references for clinical transfer strategies.Methods: A total of 2,038 FET cycles of poor-quality blastocysts were analyzed from January 2014 to December 2019 and divided based on the blastocyst development speed and number of embryos transferred: the D5-SBT (n=476), D5-DBT (n=365), D6-SBT (n=730), and D6-DBT (n=467) groups. The SBT group was further divided based on embryo morphology: D5-AC/BC (n=407), D5-CA/CB (n=69), D6-AC/BC (n=580), and D6-CA /CB (n=150).Results: When blastocysts reach the same development speed, the live birth and multiple pregnancy rates of DBT were significantly higher than those of SBT. Moreover, there was no statistical difference in the rates of early miscarriage and live birth between the AC/BC and CA/CB groups. When patients in the SBT group were stratified by blastocyst development speed, the rates of clinical pregnancy (42.44% vs. 20.82%) and live birth (32.35% vs. 14.25%) of D5-SBT group were significantly higher than those of D6-SBT group. Furthermore, for blastocysts in the same morphology group (AC/BC or CA/CA group), the rates of clinical pregnancy and live birth in the D5 group were also significantly higher than those of D6 group. Conclusion: For poor-quality D5 blastocysts, SBT can be recommended to patients because of acceptable pregnancy outcomes and significantly reduced multiple pregnancy rate compared with DBT. For poor-quality D6, the DBT strategy is recommended to patients to improve pregnancy outcomes. When blastocysts reach the same development speed, the transfer strategy of selecting blastocyst with inner cell mass “C” or blastocyst with trophectoderm “C” does not affect the pregnancy and neonatal outcomes.

scholarly journals Strengthen Luteal Phase Support for the Patients With Low Serum Progesterone on the Day of Embryo Transfer in Artificial Endometrial Preparation Cycles: a Large-sample Retrospective Trial

2020 ◽  
Author(s):  
Hongyuan Gao ◽  
Jing Ye ◽  
Hongjuan Ye ◽  
Qingqing Hong ◽  
Lihua Sun ◽  
...  
Keyword(s):  
Embryo Transfer ◽  
Live Birth ◽  
Luteal Phase ◽  
Birth Rate ◽  
Live Birth Rate ◽  
Clinical Pregnancy ◽  
Serum Progesterone ◽  
Group A ◽  
Group B ◽  
Low Serum

Abstract Background: The low serum progesterone (P) on the day of frozen embryo transfer (FET) is associated with diminished pregnancy rates in artificial endometrium preparation cycles using vaginal micronized P, but it is no consensus whether the strengthened luteal phase support (LPS) for the patients with low P on the FET day in artificial cycles is beneficial. A single centric, large-sample retrospective trial was aimed to investigate the contribution of strengthened LPS to the pregnancy outcomes for the groups of low P levels on the FET day in artificial endometrium preparation cycles.Methods: Women who had undergone first artificial cycle for endometrium preparation after freeze-all in our clinic during 2016 and 2018 were classified into two groups depending on the serum P levels on the FET day, routine LPS was administered for group B (P ≥10.0ng/ml on the FET day, n=1261) and strengthened LPS (routine LPS+ im P 40mg daily) for group A (P <10.0 ng/ml on the FET day, n=1295), the primary endpoint was the live birth rate and secondary endpoints were clinical pregnancy, miscarriage and neonatal outcomes.Results: The results showed the clinical pregnancy rate in group A was lower than group B (48.4% vs 53.2%, aRR 0.81, 95% CI 0.68, 0.96), the miscarriage rate was similar between the two groups (16.0% vs 14.7%, aRR 1.09, 95%CI 0.77, 1.54). The live birth rate was slightly lower than group B (39.5% vs 43.3%, aRR 0.84, 95%CI 0.70, 1.0). The birthweights and other neonatal outcomes were found no difference between the two groups (P>0.05).Conclusions: The strengthened LPS for the section of patients of low P levels on the FET day might help to have a reasonable pregnancy outcome, although the live birth rate was slightly lower than the groups with normal serum P levels on the FET day and usage of routine LPS. Trial registration: no available.

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