Impact of low serum progesterone levels on the day of embryo transfer on pregnancy outcome: a prospective cohort study in artificial cycles with vaginal progesterone
| Autor: | Ernesto Bosch, I. Olmo, Cristina Rodríguez-Varela, Juan Giles, Giulia Mariani, José Remohí, Paula Celada, C. Vidal, José Bellver, Alicia Marzal, Stefania Paolelli, Pilar Alamá, Fabio Cruz, Elena Labarta |
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| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty Pregnancy Rate Population Luteal phase Endometrium 03 medical and health sciences 0302 clinical medicine Pregnancy medicine Humans Prospective Studies education Prospective cohort study Progesterone Retrospective Studies Gynecology education.field_of_study 030219 obstetrics & reproductive medicine Oocyte Donation business.industry Rehabilitation Estradiol valerate Obstetrics and Gynecology Middle Aged Embryo Transfer medicine.disease Embryo transfer Pregnancy rate 030104 developmental biology medicine.anatomical_structure Reproductive Medicine Female business Live Birth medicine.drug |
| Zdroj: | Human Reproduction. 36:683-692 |
| ISSN: | 1460-2350 0268-1161 |
| DOI: | 10.1093/humrep/deaa322 |
| Popis: | STUDY QUESTION Is there a serum progesterone (P) threshold on the day of embryo transfer (ET) in artificial endometrium preparation cycles below which the chances of ongoing pregnancy are reduced? SUMMARY ANSWER Serum P levels WHAT IS KNOWN ALREADY We previously found that serum P levels STUDY DESIGN, SIZE, DURATION This prospective cohort study was performed between September 2017 and November 2018 and enrolled 1205 patients scheduled for ET after an artificial endometrial preparation cycle with estradiol valerate and micronized vaginal P (MVP, 400 mg twice daily). PARTICIPANTS/MATERIALS, SETTING, METHODS Patients ≤50 years old with a triple-layer endometrium ≥6.5 mm underwent transfer of one or two blastocysts. A total of 1150 patients treated with own oocytes without preimplantation genetic testing for aneuploidies (PGT-A) (n = 184), own oocytes with PGT-A (n = 308) or donated oocytes (n = 658) were analyzed. The primary endpoint was the OPR beyond pregnancy week 12 based on serum P levels measured immediately before ET. MAIN RESULTS AND THE ROLE OF CHANCE Women with serum P levels LIMITATIONS, REASONS FOR CAUTION Only women with MVP were included. Extrapolation to other P administration forms needs to be validated. WIDER IMPLICATIONS OF THE FINDINGS This study identified the threshold of serum P as 8.8 ng/ml on the day of ET for artificial endometrial preparation cycles necessary to optimize outcomes, in cycles with own or donated oocytes. One-third of patients receiving MVP show inadequate levels of serum P that, in turn, impact the success of the ART cycle. Monitoring P levels in the mid-luteal phase is recommended when using MVP to adjust the doses according to the needs of the patient. STUDY FUNDING/COMPETING INTEREST(S) None. TRIAL REGISTRATION NUMBER NCT03272412. |
| Databáze: | OpenAIRE |
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