Supplementation of intramuscular progesterone every third day to vaginal progesterone versus vaginal progesterone only in hormone replacement therapy cycles: Comparison of reproductive outcomes as analysed by percentiles of serum progesterone levels on the day of vitrified/thaw blastocyst transfer

Publication date: Available online 15 February 2020Source: Reproductive BioMedicine OnlineAuthor(s): Mehtap Polat, Sezcan Mumusoglu, Gurkan Bozdag, Irem Yarali Ozbek, Peter Humaidan, Hakan YaraliABSTRACTResearch QuestionDoes intramuscular progesterone supplementation (imP4-suppl), secures ongoing pregnancy rates (OPRs) compared to vaginal progesterone-only (VP4) in hormone replacement therapy (HRT) cycles for frozen/thaw embryo transfer (FET); and moreover, is there a possible window of serum progesterone concentration out of which reproductive outcomes may be negatively impacted?DesignRetrospective longitudinal cohort study carried-out at a single IVF clinic. In total, 475 consecutive, Day 5/6 vitrified/thaw cycles employing HRT regimen were included. VP4-only was used in 143 patients; supplementation of VP4 with imP4 every third day (imP4-suppl) was employed in 332 patients. On the 6th day of progesterone administration, immediately before FET, circulating progesterone levels were measured. Main outcome measure was OPR.ResultsThe baseline demographic features and embryological data of the VP4-only and imP4-suppl groups were comparable. The OPRs were 48.3% and 51.8%, respectively (p=0.477). Neither the circulating progesterone level nor the type of progesterone administration were independent predictors of OPR. The impact of serum progesterone levels on OPR was evaluated by percentiles (90%), taking 50 - 90% as the reference sub-group. In the VP4-group, there was a trend for...
Source: Reproductive BioMedicine Online - Category: Reproduction Medicine Source Type: research

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Abstract BACKGROUND: Endometrial preparation with hormone replacement therapy (HRT) is the preferred regimen for clinicians due to the opportunity to schedule the day of embryo transfer and for patients due to the requirement of fewer visits for frozen-warmed embryo transfers (FET). The increasing number of FETs raises the question of the serum P levels required to optimize the pregnancy outcome on the embryo transfer day. METHODS: This prospective cohort study includes patients who underwent single euploid FET. All patients received HRT with oestradiol valerate (EV) and 100 mg of intramuscular (IM) pr...
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