Exogenous progesterone rescue in patients with low mid-luteal serum progesterone levels undergoing true natural vitrified-warmed blastocyst transfer.

Autor: Erden M; Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, CT, USA., Mumusoglu S; Anatolia IVF and Women Health Centre, Ankara, Turkey., Ozbek IY; Anatolia IVF and Women Health Centre, Ankara, Turkey., Ince O; Department of Obstetrics and Gynecology, Hacettepe University School of Medicine, Ankara, Turkey.; Department of Statistics, Faculty of Arts and Science, Middle East Technical University, Ankara, Turkey., Esteves SC; Androfert, Andrology and Human Reproduction Clinic, Referral Center for Male Reproduction, Campinas, SP, Brazil.; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark., Humaidan P; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.; The Fertility Clinic, Skive Regional Hospital Resenvej 25, Skive, Denmark., Yarali H; Anatolia IVF and Women Health Centre, Ankara, Turkey. hyarali@anatoliatupbebek.com.tr.
Jazyk: angličtina
Zdroj: Journal of assisted reproduction and genetics [J Assist Reprod Genet] 2024 Nov 09. Date of Electronic Publication: 2024 Nov 09.
DOI: 10.1007/s10815-024-03309-0
Abstrakt: Purpose: To explore whether a 25 mg subcutaneous progesterone daily rescue daily improves the reproductive outcomes in patients with low serum progesterone (P 4 ) levels (7-10 ng/mL), measured one day before true natural cycle (t-NC) frozen embryo transfer (FET).
Methods: A cohort study of 192 women undergoing t-NC warmed blastocyst transfer. Patients were stratified into three different groups based on serum P 4 levels on the FET-1 day: patients who had serum P 4 levels of 7-10 ng/mL and underwent rescue progesterone administration (rescue group), patients with serum P 4 levels of 7-10 ng/mL without progesterone administration (non-rescue group), and patients with serum P 4  > 10 ng/mL on FET-1 day (control group). The primary outcome was possible differences in live birth rate (LBR) between groups.
Results: The LBRs for the serum P 4 7-10 ng/mL without rescue, 7-10 ng/mL with rescue, and > 10 ng/mL (control) groups were 41%, 46%, and 52%, respectively (p = 0.61). The estimated adjusted probability of live birth for serum P 4 7-10 ng/mL without rescue, 7-10 ng/mL with rescue, and > 10 ng/mL (control) groups were also comparable: 43.5% (95% CI, 20.0-70.4%), 49.8% (95% CI, 28.1-71.6%), and 57.4% (95% CI, 44.0-69.8%), respectively.
Conclusion: Serum P 4 levels higher than 7 ng/mL seem to secure LBRs in patients undergoing t-NC FET. A rescue policy consisting of a daily subcutaneous 25 mg progesterone dose in patients with serum P 4 levels 7-10 ng/mL does not further enhance LBRs when compared to those patients with similar serum P 4 levels without rescue.
Competing Interests: Declarations Ethics approval and consent to participate The Institutional Review Board of Hacettepe University approved the study protocol (Protocol number: KA-21116). All participants included in this manuscript provided written consent for their data to be used in retrospective studies. Conflict of interest S.M. declares honorarium for lectures from IBSA. S.C.E. declares receipt of unrestricted research grants from Merck and lecture fees from Merck and Med.E.A. P.H. declares unrestricted research grants from Gedeon-Richter and Merck, as well as honoraria for lectures from MSD, Merck, Gedeon–Richter, IBSA, and Med.E.A. H.Y. declares receipt of honorarium for lectures from Merck, IBSA, Ferring, Med.E.A., and unrestricted research grants from Merck and Ferring. The remaining authors declare that they have no conflict of interest.
(© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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