Endometriosis patients benefit from high serum progesterone in hormone replacement therapy-frozen embryo transfer cycles:a cohort study
| Autor: | Birgit Alsbjerg, Ulrik Schiøler Kesmodel, Peter Humaidan |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2023 |
| Předmět: |
Frozen embryo transfer
Pregnancy Rate Hormone Replacement Therapy Endometriosis Obstetrics and Gynecology Cohort Studies Reproductive Medicine Pregnancy Humans Female Endometriosis/drug therapy HRT-FET Serum progesterone Embryo Transfer/methods Live Birth Progesterone Developmental Biology Retrospective Studies |
| Zdroj: | Alsbjerg, B, Kesmodel, U S & Humaidan, P 2023, ' Endometriosis patients benefit from high serum progesterone in hormone replacement therapy-frozen embryo transfer cycles : a cohort study ', Reproductive BioMedicine Online, vol. 46, no. 1, pp. 92-98 . https://doi.org/10.1016/j.rbmo.2022.09.005 |
| Popis: | RESEARCH QUESTION: What is the optimal serum progesterone cut-off level in patients with endometriosis undergoing hormone replacement therapy frozen embryo transfer (HRT-FET) with intensive progesterone luteal phase support?DESIGN: A cohort study, including 262 HRT-FET cycles in 179 patients all diagnosed with endometriosis either by laparoscopy or by ultrasound in patients with visible endometriomas. Pre-treatment consisted of 42 days of oral contraceptive pills and 5 days' wash-out, followed by 6 mg oral oestrogen daily. Exogenous progesterone supplementation with vaginal progesterone gel 90 mg/12h commenced when the endometrium was 7 mm or thicker. From the fourth day of vaginal progesterone supplementation, patients also received intramuscular progesterone 50 mg daily. Blastocyst transfer was scheduled for the sixth day of progesterone supplementation.RESULTS: The overall positive HCG, live birth (LBR) and total pregnancy loss rates were 60%, 39% and 34%, respectively. The optimal progesterone cut-off level was 118 nmol/l (37.1 ng/ml) defined as the maximum of the Youden index. The unadjusted LBR was significantly higher in patients with progesterone measuring 118 nmol/l or above compared with patients with progesterone measuring less than 118 nmol/l (51% [44/86] versus 34% [59/176], P = 0.01), whereas the adjusted odds ratio for a live birth was 2.1 (95% CI 1.2 to 3.7) after adjusting for age, body mass index, blastocyst score, blastocyst age, quality and number of blastocysts transferred.CONCLUSIONS: Serum progesterone levels above 118 nmol/l (37.1ng/ml) resulted in significantly higher LBR compared with lower serum progesterone levels, suggesting that a threshold for optimal serum progesterone exists. |
| Databáze: | OpenAIRE |
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