scholarly journals Relationship between pregnancy rate and serum progesterone concentration in cases of porcine embryo transfer

2014 ◽  
Vol 15 (1) ◽  
pp. 167 ◽  
Author(s):  
JoonHo Moon ◽  
Ji-Yei Choi ◽  
Jung-Taek Kang ◽  
Sol Ji Park ◽  
Su Jin Kim ◽  
...  
2021 ◽  
Author(s):  
Manuel Álvarez ◽  
Sofía Gaggiotti-Marre ◽  
Francisca Martínez ◽  
Lluc Coll ◽  
Sandra García ◽  
...  

Abstract STUDY QUESTION Does an individualised luteal phase support (iLPS), according to serum progesterone (P4) level the day prior to euploid frozen embryo transfer (FET), improve pregnancy outcomes when started on the day previous to embryo transfer? SUMMARY ANSWER Patients with low serum P4 the day prior to euploid FET can benefit from the addition of daily subcutaneous P4 injections (Psc), when started the day prior to FET, and achieve similar reproductive outcomes compared to those with initial adequate P4 levels. WHAT IS KNOWN ALREADY The ratio between FET/IVF has spectacularly increased in the last years mainly thanks to the pursuit of an ovarian hyperstimulation syndrome free clinic and the development of preimplantation genetic testing (PGT). There is currently a big concern regarding the endometrial preparation for FET, especially in relation to serum P4 levels around the time of embryo transfer. Several studies have described impaired pregnancy outcomes in those patients with low P4 levels around the time of FET, considering 10 ng/ml as one of the most accepted reference values. To date, no prospective study has been designed to compare the reproductive outcomes between patients with adequate P4 the day previous to euploid FET and those with low, but restored P4 levels on the transfer day after iLPS through daily Psc started on the day previous to FET. STUDY DESIGN, SIZE, DURATION A prospective observational study was conducted at a university-affiliated fertility centre between November 2018 and January 2020 in patients undergoing PGT for aneuploidies (PGT-A) IVF cycles and a subsequent FET under hormone replacement treatment (HRT). A total of 574 cycles (453 patients) were analysed: 348 cycles (leading to 342 euploid FET) with adequate P4 on the day previous to FET, and 226 cycles (leading to 220 euploid FET) under iLPS after low P4 on the previous day to FET, but restored P4 levels on the transfer day. PARTICIPANTS/MATERIALS, SETTING, METHODS Overall we included 574 HRT FET cycles (453 patients). Standard HRT was used for endometrial preparation. P4 levels were measured the day previous to euploid FET. P4 > 10.6 ng/ml was considered as adequate and euploid FET was performed on the following day (FET Group 1). P4 < 10.6 ng/ml was considered as low, iLPS was added in the form of daily Psc injections, and a new P4 analysis was performed on the following day. FET was only performed on the same day when a restored P4 > 10.6 ng/ml was achieved (98.2% of cases) (FET Group 2). MAIN RESULTS AND THE ROLE OF CHANCE Patient’s demographics and cycle parameters were comparable between both euploid FET groups (FET Group 1 and FET Group 2) in terms of age, weight, oestradiol and P4 levels and number of embryos transferred. No statistically significant differences were found in terms of clinical pregnancy rate (56.4% vs 59.1%: rate difference (RD) −2.7%, 95% CI [−11.4; 6.0]), ongoing pregnancy rate (49.4% vs 53.6%: RD −4.2%, 95% CI [−13.1; 4.7]) or live birth rate (49.1% vs 52.3%: RD −3.2%, 95% CI [−12; 5.7]). No significant differences were also found according to miscarriage rate (12.4% vs 9.2%: RD 3.2%, 95% CI [−4.3; 10.7]). LIMITATIONS, REASONS FOR CAUTION Only iLPS through daily Psc was evaluated. The time for Psc injection was not stated and no serum P4 determinations were performed once the pregnancy was achieved. WIDER IMPLICATIONS OF THE FINDINGS Our study provides information regarding an ‘opportunity window’ for improved ongoing pregnancy rates and miscarriage rates through a daily Psc injection in cases of inadequate P4 levels the day previous to FET (P4 < 10.6 ng/ml) and restored values the day of FET (P4 > 10.6 ng/ml). Only euploid FET under HRT were considered, avoiding one of the main reasons of miscarriage and implantation failure and overcoming confounding factors such as female age, embryo quality or ovarian stimulation protocols. STUDY FUNDING/COMPETING INTEREST(S) No external funding was received. B.C. reports personal fees from MSD, Merck Serono, Ferring Pharmaceuticals, IBSA and Gedeon Richter outside the submitted work. N.P. reports grants and personal fees from MSD, Merck Serono, Ferring Pharmaceuticals, Theramex and Besins International and personal fees from IBSA and Gedeon Richter outside the submitted work. The remaining authors have no conflicts of interest to declare. TRIAL REGISTRATION NUMBER NCT03740568.


Author(s):  
Sumit Singhal ◽  
Shiv Prasad ◽  
Rajesh Verma ◽  
H.P. Gupta ◽  
J.K. Prasad

Background: Limited elite buffalo population need to be propagated at faster rate to sustain the dairy industry in India. Faster propagation could be achieved through embryo transfer technology. Low serum progesterone concentrations during the start of superstimulatory treatment is major factor that hampers the success of multiple ovulation embryo transfer (MOET) in buffaloes. This study evaluated the effect of GnRH pretreatment before superovulatory regimen on progesterone profile, superovulation and correlation of progesterone with superstimulatory parameter in Murrah buffaloes. Methods: Buffaloes (n=27) were superstimulated using 600 mg Folltropin and divided into three groups on basis of pretreatment: Group I and group II were pretreated with GnRH @ 10 µg and 06 µg, respectively while no pretreatment was subjected in group III (control). Progesterone hormone concentration, superovulatory response, ovulation rate, embryo recovery were recorded. Result: Our study revealed that superovulatory response was non-significantly different in all three groups and ranged from 6-8 in terms of number of corpus luteum (CL). Average number of recovered embryos in this study was nearly 2.0. A positive correlation between progesterone concentrations at the initiation of FSH treatment with number of CL and embryo recovery was observed. The study indicated that GnRH pretreatment before superstimulation improve the serum progesterone concentration, superovulatory response and embryo recovery in Murrah buffaloes. 


2021 ◽  
Vol 12 (1) ◽  
pp. 407-415
Author(s):  
Dalal M. Al Jarrah ◽  
Manal Taha Al Obaidi ◽  
Itlal J. AL Asadi

Endometrial receptivity plays a basic role in successful embryo implantation and pregnancy outcomes and can be assessed by many of non-invasive markers. Our study evaluated the impact of two of these markers specifically serum progesterone and endometrial thickness at embryo transfer day in prediction pregnancy outcomes on (60) patients attempting medicated frozen embryo transfer (FET) cycles. All patients were received sequential estrogen & progesterone medications for endometrial preparation then submitted to measurements of endometrial thickness (EMT) by transvaginal-ultrasound (TV-US) & serums progesterone (P) analysis at the embryo transfer day, thereafter day 3 verified-thawed embryos grades (A±B) were transferred. Compacted (decreased) EMT was seen in 48.3% of patients with higher pregnancy rate (PR) of 58.6%t than non-compacted EMT (no change or increased) which was seen in 51.7% of patients with (PR) of 29.0%, (P value=0.021). However ongoing pregnancy rate (Ong PR) not differed significantly between both groups (44.8% in compacted vs 25.8% in non-compacted, P value=0.053), also the means of serum P not differed between pregnant and non-pregnant patients (P value=0.374). ROC curves for Ong PR prediction in relations to endometrial compaction & serum progesterone at embryo transfer day were poor (AUC= 0.630, & AUC=0.576, respectively). This study suggested that endometrial compaction or serum P levels measurements at embryo transfer day were poor predictors for ongoing pregnancy where any kind of EMT changes (decreased or not) seen after P administration not significantly affect pregnancy outcomes in frozen-thaw cycles of cleavage stage embryos transfer.


Author(s):  
Merihan Mohamed Elewa ◽  
Ayman Abdelaziz Eldorf ◽  
Shahinaz Hamdy Elshorbagy ◽  
Manal Mostafa Abdallah

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.


2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
C Maignien ◽  
B Mathilde ◽  
B Valérie ◽  
C Ahmed ◽  
C Charles ◽  
...  

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&gt;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


2021 ◽  
Vol 49 ◽  
Author(s):  
Ayşe Merve Köse ◽  
Ece Koldaş Ürer ◽  
Mustafa Kemal Sarıbay ◽  
Gökhan Doğruer ◽  
Fikret Karaka ◽  
...  

Background: Following the induction of oestrus out of season in small ruminants, low fertility and variations in fertility rates are associated with embryonic losses. One of the main causes of embryonic loss is luteal dysfunction. Gonadotropin Releasing Hormone (GnRH) supports the luteal structure, and increasing progesterone levels may be beneficial in terms of promoting embryonic life. The main objective of the present study was to evaluate the efficacy of GnRH administration following an oestrus induction protocol in the anoestrus season for preventing embryonic loss in goats having failure to conceive during the season. Materials, Methods & Results: In the study, 106 Damascus goats aged 3-5 years and weighing 45-60 kg were used. The oestrus of 106 goats in the anoestrous group was stimulated with progesterone and pregnant mare serum gonadotropin (PMSG) treatment. Out of breeding season, goats were divided into the 4 following groups: GnRH0 (n = 27), GnRH7 (n = 26), GnRH0+7 (n = 27) and control (n = 26). In each goat, an intravaginal sponge (IS) containing 20 mg of fluorogestone acetate (FGA) was placed into the vagina and left for 9 days. With the withdrawal of the sponge, 550IU PMSG and 125 μg of d-cloprostenol were injected intramuscularly. Oestrus detection was made via teaser bucks for 3 days starting 24 h after withdrawal of the IS. Eighteen bucks known to be fertile were used for breeding. Goats in the oestrus period were mated via natural breeding. The GnRH analogue lecirelin was injected intramuscularly at breeding in the GnRH0 group, on day 7 post-breeding in the GnRH7 group, and both at breeding and on day 7 post-breeding in the GnRH0+7 group. No injections were given to the control group. Blood samples for progesterone measurement were taken by jugular vena puncturing on days 3, 6, 7, 10, 13, 16, and 19 after breeding from 10 randomly chosen goats in all groups. The goats with a level of > 3.5 ng/mL of progesterone on day 21 post-breeding were evaluated as pregnant. Pregnancy was also viewed on day 50 after breeding by real-time ultrasonography (USG) with a 5-7.5 MHz convex probe. The oestrus rate was 96.23% (102/106) in the goats. The rates of onset of oestrus between 36-48 h, 48-60 h and 60 h and beyond were 38.7% (41/106), 21.7% (23/106) and 35.8% (38/106), respectively. The total pregnancy rate was 35.8% (38/106). There were no statistically significant differences (P > 0.05) found for the pregnancy rate, embryonic death rate or progesterone concentration of the groups. However, serum progesterone levels were statistically different in the GnRH7 group compared with the control group (P < 0.05).Discussion: After synchronisation, various anti-luteolytic strategies can be used to support corpus luteum development and elevate progesterone concentration in the luteal phase to decrease embryonic loss and increase reproductive performance. Therefore, application of GnRH to support the luteal structure and to increase progesterone levels may be beneficial in terms of supporting embryonic life. The results showed that GnRH treatment on the day 7 post-breeding following oestrus induction, including FGA and PMSG, can increase serum progesterone levels in Damascus goats in the anoestrus period. However, following oestrus induction in the anoestrus period, it was seen that GnRH treatment at breeding or on day 7 after breeding did not have any positive effect on embryonic loss or reproductive performance. In conclusion, it was considered that this protocol could be implemented successfully, yielding a 35% pregnancy rate in Damascus goats in the anoestrus period, but embryonic loss must be deeply studied in detail.


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