scholarly journals Does Estradiol Orally and Vaginally Administered Together Impact Live Birth and Neonatal Outcome in Artificial Frozen-thawed Embryo Transfer Cycles: A Retrospective Cohort Study

2020 ◽  
Author(s):  
Yuan Liu ◽  
Yixia Yang ◽  
Xinting Zhou ◽  
Yanmei Hu ◽  
Yu Wu
Keyword(s):  
Pregnancy Rate ◽  
Preterm Delivery ◽  
Embryo Transfer ◽  
Live Birth ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
Delivery Rate ◽  
Serum Estradiol ◽  
Frozen Thawed Embryo Transfer ◽  
Thawed Embryo Transfer

Abstract Background: Previous studies have demonstrated that newborns from fresh embryo transfer are with higher risk of small for gestation (SGA) rate than those from frozen-thawed embryo transfer (FET). It is suggested that supraphysiologic serum estradiol in controlled ovarian stimulation (COS)is one of reasons. Out study aims to investigate whether exogenous estradiol delivered regimens have an impact on live birth rate and singleton birthweight in hormone replacement (HRT)-FET cycles.Methods:This retrospective study involved patients undergoing their first FET with HRT endometrium preparation followed by two cleavage-staged embryos transfer, comparing orally and vaginal estradiol tablets (OVE) group versus oral estradiol tablets (OE) group from January 2015 to December 2018 at our center. A total of 792 patients fulfilled the criteria, including 282 live birth singletons. Live birth was the primary outcome. Secondary outcome included clinical pregnancy rate, singleton birthweight, large for gestational age (LGA) rate, SGA rate, preterm delivery rate. Results:Patients in OVE group achieved higher serum estradiol level with more days of estradiol treatment. No difference in live birth (Adjusted OR 1.327; 95%CI 0.982, 1.794, p=0.066) and clinical pregnancy rate (Adjusted OR 1.278; 95%CI 0.937, 1.743, p=0.121) was found between OVE and OE groups. Estradiol route did not affect birth weight (β=-30.962, SE=68.723, p=0.653), the odds of LGA (Adjusted OR 1.165; 95%CI 0.545, 2.490, p=0.694), the odds of SGA (Adjusted OR 0.569; 95%CI 0.096, 3.369, p=0.535) or the preterm delivery rate (Adjusted OR 0.969; 95%CI 0.292, 3.214, p=0.959).Conclusion:Estrogen orally and vaginally together did not have an impact on clinical outcomes and singleton birthweight compared to estrogen orally taken, but was accompanied with relative higher serum E2 level and potential maternal undesirable risks.

scholarly journals Twice vitrification-warming procedures has no effect on frozen-thawed embryo transfer outcomes

2021 ◽  
Author(s):  
xiaoyue Shen ◽  
Min Ding ◽  
Yuan Yan ◽  
Shanshan Wang ◽  
jianjun Zhou ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Embryo Transfer ◽  
Live Birth ◽  
Birth Rate ◽  
Live Birth Rate ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
Miscarriage Rate ◽  
Frozen Thawed Embryo Transfer ◽  
Thawed Embryo Transfer

Abstract Background To evaluate the frozen-thawed embryo transfer (FET) outcomes of repeated cryopreservation by vitrification of blastocysts derived from vitrified-warmed day3 embryos in patients who experienced implantation failure previously. Methods We retrospect the files of patients who underwent single frozen-thawed blastocyst transfer cycles in our reproductive medical center from January 2013 to December 2019. 127 patients transfer of vitrified-warmed blastocysts derived from vitrified-warmed day3 embryos were defined as twice-cryopreserved group. 1567 patients who transfer blastocysts that had experienced once vitrified-warmed were used as once-cryopreserved group. None of them was pregnant at the previous FET. The outcomes were compared between two groups after a 1:1 propensity score matching (PSM). Results The clinical pregnancy rate was 52.76%, live birth rate was 43.31% in twice-cryopreserved group. After PSM,108 pairs of patients were generated for comparison. The clinical pregnancy rate, live birth rate or miscarriage rate was not significantly different between two groups. Logistic regression analysis indicated that double vitrification-warming procedures did not affect FET outcomes in terms of clinical pregnancy rate (OR 0.83, 95%CI 0.47-1.42), live birth rate (OR 0.93, 95%CI 0.54-1.59), miscarriage rate (OR 0.72 95%CI 0.28-1.85). Furthermore, the pregnancy complications rate, gestational age or neonatal abnormalities rate between two groups was also comparable, while twice vitrification-warming procedures might increase the macrosomia rate (19.6% vs. 6.3%, P = 0.05). Conclusion Transfer of double vitrified-warmed embryo at cleavage stage and subsequent blastocyst stage did not affect live birth rate and neonatal abnormalities rate, but there was a tendency to increase macrosomia rate, which needs further investigation.

scholarly journals Does estradiol orally and vaginally administered together impact live birth and neonatal outcomes in artificial frozen-thawed embryo transfer cycles: a retrospective cohort study

2020 ◽  
Author(s):  
Yuan Liu ◽  
Yixia Yang ◽  
Jian Sun ◽  
Xinting Zhou ◽  
Yanmei Hu ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Embryo Transfer ◽  
Live Birth ◽  
Birth Rate ◽  
Live Birth Rate ◽  
Clinical Pregnancy ◽  
Neonatal Outcomes ◽  
Serum Estradiol ◽  
Frozen Thawed Embryo Transfer ◽  
Thawed Embryo Transfer

Abstract Background: Previous studies have demonstrated that newborns from fresh embryo transfer have higher risk of small for gestation (SGA) rate than those from frozen-thawed embryo transfer (FET). It is suggested that supraphysiologic serum estradiol in controlled ovarian stimulation (COS) is one of reasons. Our study aims to investigate whether exogenous estradiol delivered regimens have an impact on live birth rate and neonatal outcomes in hormone replacement (HRT)-FET cycles. Methods: This was a retrospective study involving patients undergoing their first FET with HRT endometrium preparation followed by the transfer of two cleavage-staged embryos, comparing estradiol administered orally and vaginally (OVE group) versus estradiol administered orally (OE group) from January 2015 to December 2018 at our center. A total of 792 patients fulfilled the criteria, including 228 live birth singletons. The live birth rate was the primary outcome measure. Secondary outcome measures included clinical pregnancy rate, singleton birthweight, large for gestational age (LGA) rate, SGA rate, preterm delivery rate. Results: Patients in OVE group achieved higher serum estradiol level with more days of estradiol treatment. No difference in live birth (Adjusted OR 1.327; 95%CI 0.982, 1.794, p = 0.066) and clinical pregnancy rate (Adjusted OR 1.278; 95%CI 0.937, 1.743, p = 0.121) was found between OVE and OE groups. Estradiol route did not affect singletons birth weight (β = -30.962, SE = 68.723, p = 0.653), the odds of LGA (Adjusted OR 1.165; 95%CI 0.545, 2.490, p = 0.694), the odds of SGA (Adjusted OR 0.569; 95%CI 0.096, 3.369, p = 0.535) or the preterm delivery (Adjusted OR 0.969; 95%CI 0.292, 3.214, p = 0.959). Conclusion: Estrogen taken orally and vaginally together did not change live birth rate and singleton neonatal outcomes compared to estrogen taken orally, but was accompanied with relative higher serum E2 level and potential maternal undesirable risks.

scholarly journals Pretreatment With a Long-acting GnRH Agonist in Early Follicular Phase Increases Clinical Pregnancy Rate in Frozen-thawed Embryo Transfer Cycles

2021 ◽  
Author(s):  
Bin xu ◽  
Jing Zhao ◽  
Zhaojuan Hou ◽  
Nenghui Liu ◽  
Yanping Li
Keyword(s):  
Pregnancy Rate ◽  
Embryo Transfer ◽  
Hormone Replacement ◽  
Follicular Phase ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
Early Follicular Phase ◽  
Long Acting ◽  
Frozen Thawed Embryo Transfer ◽  
Thawed Embryo Transfer

Abstract Background: It is controversial whether gonadotropin-releasing hormone agonist (GnRHa) pretreatment can benefit the pregnancy outcomes in frozen-thawed embryo transfer (FET) cycles. In most of studies, GnRHa was administered during the mid-luteal phase for pretreatment. Few studies focus on FET cycles with GnRHa administered in early follicle phase.Methods: The retrospective cohort study was conducted in a university-affiliated IVF center. 630 patients in the GnRHa FET group and 1141 patients in the hormone replacement treatment (HRT) FET without GnRHa group from October 2017 to March 2019 were included. The menstruation cycle of these patients was irregular. Results: There were no differences observed between the two groups in patient’s characteristics. However, the GnRHa FET group showed a higher percentage of endometrium with triple line pattern (94.8% vs 89.6%, p<0.001) on the day of progesterone administration, and an increased implantation rate (34.7% vs 30%, p<0.01), biochemical pregnancy rate (60.6% vs 54.3%, p = 0.009), and clinical pregnancy rate (49.8% vs 43.3%, p = 0.008), as compared to that in the HRT FET cycles with similar endometrial thickness, ectopic pregnancy rate, and early miscarriage rate. Binary logistic regression analysis showed the GnRHa FET group to be associated with an increased chance of clinical pregnancy rate compared with HRT FET without GnRHa group (P=0.014, odds ratio [OR] 1.30, 95% confidence interval [CI] 1.06-1.61).Conclusions: Pretreatment with a long-acting GnRHa in early follicular phase can improve the clinical outcome of the FET cycles. However, further randomized control trials (RCTs) will be needed to verify these results.

P–629 Is spontaneous ovulation better than induced ovulation for frozen-thawed embryo transfer cycle?

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
P K Sim ◽  
P Nadkarni
Keyword(s):  
Pregnancy Rate ◽  
Embryo Transfer ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
Ongoing Pregnancy ◽  
Ongoing Pregnancy Rate ◽  
Significance Level ◽  
Induced Ovulation ◽  
Frozen Thawed Embryo Transfer ◽  
Thawed Embryo Transfer

Abstract Study question Between spontaneous ovulation (SPO) and induced ovulation (INO) comparing clinical pregnancy rate and ongoing pregnancy rate for frozen-thawed embryo transfer (FET) cycle, which is better? Summary answer Both spontaneous ovulation and induced ovulation protocols showed no significant difference in clinical pregnancy rates and ongoing pregnancy rates. What is known already Recent practice worldwide is moving towards elective freezing of all embryos and subsequent frozen-thawed transfer, both for a perceived higher pregnancy rate as well as the significant reduction of ovarian hyperstimulation. The timing of FET can be determined by either detecting the spontaneous Luteinizing Hormone surge (SPO group) or by the administration of hCG (INO group). There is still an ongoing debate to determine which is the best protocol for frozen-thawed embryo transfer in the non-hormone replacement therapy (non-HRT) cycle. Study design, size, duration This retrospective study included 500 FET cycles for patients who had regular menses between June 2017 and June 2020. The FET cycles were grouped by type as follows: SPO (n = 281) and INO (n = 219). The primary outcome was the clinical pregnancy rate and the secondary outcome was ongoing pregnancy rate. Ongoing pregnancy is defined as a viable intrauterine pregnancy at 12 weeks of gestation confirmed on an ultrasound scan. Participants/materials, setting, methods This study was conducted in a single IVF centre. Vitrification was used as the cryopreservation method. To standardize outcome measures, only patients having single blastocyst transfer and aged under 38 years old were included. The average age of the patient was 32.9. Gamete donation, embryo donation, pre-implantation testing and assisted hatching cycles were also excluded from the analysis. Categorical data were analysed using Chi-square test SPSS version 25. Main results and the role of chance Clinical pregnancy rate for SPO group was 54.8% (154/281) versus 52.9% (116/219) in INO group. Even though clinical pregnancy rate was higher in SPO group as compared to INO group, it did not reach significance level (ꭓ2 = 0.17, p = 0.68). As all patients had single blastocyst transferred, the implantation rate was the same as clinical pregnancy rate. Ongoing pregnancy rate was also found higher in SPO group as compared to INO group (135/281, 48.0% and 97/219, 44.3% respectively) but again failed to reach significance level (ꭓ2 = 0.70, p = 0.40). Limitations, reasons for caution The retrospective nature of the study and therefore, the analysis was not adjusted for confounding factors such as blastocyst grading, etiology of infertility, and ethnicity of patients. Wider implications of the findings: In natural cycle, both spontaneous ovulation and induced ovulation protocols had the same pregnancy outcomes for frozen-thawed embryo transfer. However, induced ovulation can facilitate in scheduling FET timing to avoid weekends and public holidays, if necessary. Trial registration number Not applicable

Endometrium immunomodulation by intrauterine insemination administration of treated peripheral blood mononuclear cell prior frozen/thawed embryos in patients with repeated implantation failure

Zygote ◽  
2019 ◽  
Vol 27 (4) ◽  
pp. 214-218 ◽  
Author(s):  
Fattaneh Farifteh Nobijari ◽  
Seyedeh Soheila Arefi ◽  
Ashraf Moini ◽  
Robabeh Taheripanah ◽  
Elham Fazeli ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Embryo Transfer ◽  
Peripheral Blood ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
Control Group ◽  
Peripheral Blood Mononuclear ◽  
Significant Difference ◽  
Frozen Thawed Embryo Transfer ◽  
Thawed Embryo Transfer

SummaryIn assisted reproductive technology (ART) programmes, approximately 10% of infertile patients have at least two or three repeated implantation failures (RIFs) after an in vitro fertilization (IVF) protocol. Successful implantation mainly depends on local immune tolerance mechanisms involving a spectrum of cytokines, interleukins and growth factors. The latter have played pivotal roles in the recruitment of immune cells (and notably T-lymphocyte cells). In total, 250 couples participating in frozen–thawed embryo transfer programme were incorporated in a randomized clinical trial (peripheral blood mononuclear cells (PBMC) subgroup: n=122; control subgroup: n=128). In the PBMC group, a blood sample was collected 5 days before the scheduled frozen–thawed embryo transfer; PBMCs were isolated using Ficoll separation and then cultured for 72 h. Two days prior to embryo transfer, 0.4 ml of cultured PBMCs were transferred into the patient’s uterus. Although the clinical pregnancy rate was higher in the PBMC group (34.4%) than in the control group (23.4%), this difference was not statistically significant (P=0.05 in a chi-squared test). Nevertheless, when we limited the analysis to patients with ≥3 RIFs (n=138), there was a significant difference in the clinical pregnancy rate between the PBMC group (38.6%) and the control group (19.7%; P=0.01). Our results imply that PBMC transfer can be part of effective fertility treatment for patients with RIF.

scholarly journals A Novel Promising Endometrial Preparation Protocol for Frozen-Thawed Embryo Transfer: A Randomized Controlled Trial

2021 ◽  
Vol 12 ◽  
Author(s):  
Jian-Chun Li ◽  
Yan-Hong Wang ◽  
li-Ying Peng ◽  
Yun Zhou ◽  
Shi-Bin Chao
Keyword(s):  
Pregnancy Rate ◽  
Embryo Transfer ◽  
Pilot Trial ◽  
Implantation Rate ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
Randomized Controlled ◽  
Endometrial Preparation ◽  
Frozen Thawed Embryo Transfer ◽  
Thawed Embryo Transfer

BackgroundIn recent years frozen-thawed embryo transfer (FET) has played an increasingly important role in ART, but there is limited consensus on the most effective method of endometrial preparation (EP) for FET. Inspired by significantly higher implantation rate and clinical pregnancy rate of the depot GnRH-a protocol, we proposed a novel EP protocol named down-regulation ovulation-induction (DROI) aimed to improve pregnancy outcomes of FET.MethodsThis was a single-center, randomized controlled pilot trial. A total of 307 patients with freeze-all strategy scheduled for first FET were enrolled in the study. A total 261 embryos were transferred in DROI-FET group including 156 patients and 266 embryos were transferred in mNC-FET group including 151 patients. Reproductive outcomes were compared between the two groups.ResultsThe basic characteristics of patients, and the average number, quality and stage of embryos transferred were comparable between the two groups. Our primary outcome, implantation rate(IR) in DROI-FET group, was significantly higher than that of the mNC-FET group (54.41% versus 35.71%, P&lt;0.01). The clinical pregnancy rate (CPR) and ongoing pregnancy rate (OPR) in DROI-FET group was also higher than that in mNC-FET group (69.87% versus 50.33%, P&lt;0.01; 64.10% versus 42.38%, P&lt;0.01).Conclusion(s)Compared to existing endometrial preparation methods, the DROI protocol might be the more efficient and promising protocol.

scholarly journals Impact of Luteinized Unruptured Follicles on Clinical Outcomes of Natural Cycles for Frozen/Thawed Blastocyst Transfer

2021 ◽  
Vol 12 ◽  
Author(s):  
Song Li ◽  
Lokwan Liu ◽  
Tian Meng ◽  
Benyu Miao ◽  
Mingna Sun ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Clinical Outcomes ◽  
Live Birth ◽  
Birth Rate ◽  
Live Birth Rate ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
Frozen Thawed Embryo Transfer ◽  
Natural Cycles ◽  
Thawed Embryo Transfer

ObjectiveTo investigate the impact of luteinized unruptured follicles (LUF) on clinical outcomes of frozen/thawed embryo transfer (FET) of blastocysts.MethodsIn this retrospective cohort study, 2,192 patients who had undergone blastocyst FET treatment with natural cycles from October 2014 to September 2017 were included. Using propensity score matching, 177 patients diagnosed with LUF (LUF group) were matched with 354 ovulating patients (ovulation group). The LUF group was further stratified by the average LH peak level of 30 IU/L. Clinical pregnancy rate and live birth rate were retrospectively analyzed between the LUF and ovulation groups, as well as between LUF subgroups.ResultsAfter propensity score matching, general characteristics were similar in the LUF and ovulation groups. Clinical pregnancy rate in the LUF group was significantly lower than that in the ovulation group (47.46 vs. 58.76%, respectively, adjusted P = 0.01, OR 0.60, 95% CI 0.42–0.87). However, no significant difference was detected in live birth rate, although it was lower in the LUF group (43.50 vs. 50.00%, adjusted P = 0.19, OR 0.76, 95% CI 0.51–1.14). In the LUF subgroup analysis, both clinical pregnancy rate (43.02 vs. 62.30%, adjusted P = 0.02, OR 0.45, 95% CI 0.23–0.87) and live birth rate (37.21 vs. 59.02%, adjusted P = 0.01, OR 0.40, 95% CI 0.20–0.78) in the LH &lt;30 IU/L subgroup were significantly lower than those in the LH ≥30 IU/L subgroup.ConclusionLUF negatively affected clinical outcomes of frozen/thawed embryo transfer of blastocysts, particularly when the LH surge was inadequate.

O-232 Higher clinical pregnancy rate after oxytocin-receptor antagonist administration around the time of embryo transfer: A systematic review and meta-analysis of eleven RCTs

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
K Neumann ◽  
G Griesinger
Keyword(s):  
Relative Risk ◽  
Receptor Antagonist ◽  
Pregnancy Rate ◽  
Embryo Transfer ◽  
Live Birth ◽  
Meta Analysis ◽  
Oxytocin Receptor ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
Receptor Antagonists

Abstract Study question Does the administration of an oxytocin-receptor antagonist around time of embryo transfer in IVF impact the likelihood to achieve a clinical pregnancy? Summary answer Administration of oxytocin-receptor antagonists around embryo transfer increases the likelihood of clinical pregnancy achievement. What is known already Uterine contractions occurring around time of embryo transfer have been described as one possible mechanism of failure of implantation of an embryo in the context of in-vitro fertilization (IVF). Hence the utilization of oxytocin-receptor antagonists was evaluated in randomized clinical trials (RCT) as a therapeutic approach. The compound Atosiban was studied by most RCTs (summarized in Huang et al. 2017). Recently further studies have become available which also investigated the novel agents Barusiban and Nolasiban. This systematic review collates the evidence of all drugs functioning as oxytocin-receptor antagonists which have been investigated in RCTs on IVF treatment so far. Study design, size, duration Multiple literature databases were searched for randomized controlled studies comparing the outcome of IVF cycles with administration of an oxytocin-receptor antagonist in the time period before, during or after embryo transfer versus placebo or nil in IVF patients. Meta-analyses were performed using standard procedures in the software program RevMan v.5.4. All analyses were done per randomized patient, wherever feasible. Participants/materials, setting, methods Eleven RCTs were identified and included in the meta-analysis. Seven utilized the agent Atosiban, one Barusiban and three Nolasiban. These drugs were administered either intravenously, subcutaneously or orally. The patient populations were heterogenous (fresh cycle, frozen-thawed cycle, endometriosis, implantation failure or general IVF-population) between trials. Only four studies reported live birth rates whereas all RCTs reported clinical pregnancy rate. Main results and the role of chance Administration of an oxytocin-receptor antagonist around embryo transfer increases the likelihood of live birth (relative risk: 1.1, 95% CI: 0.99-1.22, p = 0.06, I2=31%, four RCTs, n = 2,510). Accordingly, the ongoing pregnancy rate is increased (relative risk: 1.14, 95% CI: 1.03-1.26, p = 0.01, I2=18%, four RCTs, n = 2,510) as well as the clinical pregnancy rate (relative risk: 1.31, 95% CI: 1.13-1.51, p = 0.0002, I2=61%, eleven RCTs, n = 3,611) by administration of an oxytocin-receptor antagonist. The risk to suffer a miscarriage, however, is not influenced by an oxytocin-receptor antagonist administration (relative risk: 0.90, 95% CI: 0.72-1.12, p = 0.35, I2=0%, seven RCTs, n = 2,936). The risk of multiple pregnancy is not different between groups (relative risk: 1.05 95% CI: 0.81-1.36, p = 0.73, I2=5%, seven RCTs, n = 3,014) as is the risk for an ectopic pregnancy (relative risk: 0.88 95% CI: 0.43-1.8, p = 0.73, I2=0%, four RCTs, n = 2,714). Limitations, reasons for caution Methodological rigor is heterogenous between trials and some of the evidence is of poor quality. Evaluation of included studies is still ongoing and queries are pending. Additionally, there is heterogeneity between patient populations and definition of outcomes; only four RCTs report ongoing pregnancies and live births. Wider implications of the findings The administration of oxytocin-receptor antagonists around embryo transfer increases the pregnancy rate and may be a promising approach to enhance the likelihood to achieve a live birth per embryo transfer. Trial registration number n.a.

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

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 &lt; 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 &gt;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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