Can combining vaginal and rectal progesterone achieve the optimum progesterone range required for implantation in the HRT-FET model?

Publication date: Available online 20 February 2020Source: Reproductive BioMedicine OnlineAuthor(s): Alsbjerg B, Thomsen L, Elbaek HO, Laursen R, Povlsen BB, Haahr T, Humaidan PAbstractResearch question: What is the ongoing pregnancy rate (OPR) in Frozen Embryo Transfer (FET) cycles, using combined rectal and vaginal progesterone in Hormonal Replacement Therapy (HRT)?Design: Prospective cohort study (n=277), including 239 HRT-FET cycles with serum progesterone (P4) measurements. Combined vaginal (90mg/12h) and rectal (90mg/12h) progesterone regimen and single blastocyst transfer on the 6th day of progesterone administration. A total of 134 patients answered questionnaires, covering convenience and possible side effects.Results: The median serum P4 level was 45nmol/l (range 2–150 nmol/l). The overall positive hCG rate, OPR week 12 and pregnancy loss rate was 62%, 44% and 29%, respectively. A non-linear relationship between serum P4 levels and OPR was found. OR for OPR in the high P4 group (>45 nmol/l) was 0.56 (95%CI [0.32-0.98], p=0.04) compared to the intermediate P4 group (28-45 nmol/l).Discomfort by rectal administration was reported on the embryo transfer day and on the day of pregnancy scan five weeks later by a total of 18% (16/87) and 17% (8/47) of patients, respectively. Interestingly, discomfort related vaginal administration increased significantly by time and was reported by 18% (16/87) on the embryo transfer day as compared to 45% (21/47) on the day of pr...
Source: Reproductive BioMedicine Online - Category: Reproduction Medicine Source Type: research

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DiscussionThis review will assess whether current published data reporting either a single or combination of tests in late pregnancy can accurately predict adverse pregnancy outcome(s) associated with placental dysfunction. Accurate prediction could allow targeted management and possible intervention for high-risk pregnancies, ultimately avoiding adverse outcomes associated with placental disease.Systematic review registrationPROSPEROCRD42018107049
Source: Systematic Reviews - Category: International Medicine & Public Health Source Type: research
ABSTRACTAt birth, the neonatal skeleton contains 20 to 30  g calcium (Ca). It is hypothesized maternal bone mineral may be mobilized to support fetal skeletal development, although evidence of pregnancy‐induced mineral mobilization is limited. We recruited healthy pregnant (n = 53) and non ‐pregnant non‐lactating (NPNL;n = 37) women aged 30 to 45  years (mean age 35.4 ± 3.8 years) and obtained peripheral quantitative computed tomography (pQCT) and high‐resolution pQCT (HR‐pQCT) scans from the tibia and radius at 14 to 16 and 34 to 36 weeks of pregnancy, with a simi...
Source: Journal of Bone and Mineral Research - Category: Orthopaedics Authors: Tags: Original Article Source Type: research
ConclusionsAlthough the majority of mothers were discharged without any major complications, severe maternal morbidity as a result of COVID ‐19 and perinatal deaths were reported. Vertical transmission of the COVID‐19 could not be ruled out. Careful monitoring of pregnancies with COVID‐19 and measures to prevent neonatal infection are warranted.
Source: Acta Obstetricia et Gynecologica Scandinavica - Category: OBGYN Authors: Tags: SYSTEMATIC REVIEW Source Type: research
ConclusionsThe proportion of women experiencing pregnancy loss has only changed little throughout four decades and is still primarily influenced by female age. More than 75% of pregnant women are never recorded with a pregnancy loss, and less than 1.5% will experience three or more losses.
Source: Acta Obstetricia et Gynecologica Scandinavica - Category: OBGYN Authors: Tags: ORIGINAL RESEARCH ARTICLE Source Type: research
CONCLUSION: International Literature is very scant about the treatment of patients affected by hemorrhoids in particular situations. A word of caution and concern even about the indication for minor outpatient procedures must be expressed in these patients, in order to avoid possible lifethreatening complications. The first line treatment is the conservative medical approach associated with the treatment of the primary disease. PMID: 32250231 [PubMed - as supplied by publisher]
Source: Reviews on Recent Clinical Trials - Category: Cancer & Oncology Authors: Tags: Rev Recent Clin Trials Source Type: research
ConclusionsA prior CD was associated with a decreased chance of live birth and an increased risk of early miscarriage in frozen ‐thawed embryo transfer cycles.
Source: Acta Obstetricia et Gynecologica Scandinavica - Category: OBGYN Authors: Tags: ORIGINAL RESEARCH ARTICLE Source Type: research
AbstractDespite a global pandemic, reports on pregnant women with Coronavirus disease 2019 (COVID ‐19) are few so far, testing strategies vary substantially and management guidelines are not uniform.
Source: Acta Obstetricia et Gynecologica Scandinavica - Category: OBGYN Authors: Tags: LETTER TO EDITOR Source Type: research
ConclusionsQuantitative fetal fibronectin measured from 22 to 27+6 weeks of gestation accurately predicts spontaneous preterm birth at
Source: Acta Obstetricia et Gynecologica Scandinavica - Category: OBGYN Authors: Tags: ORIGINAL RESEARCH ARTICLE Source Type: research
ConclusionsUse of balloon catheter in women with term PROM appears safe and was not associated with increased maternal or neonatal infectious morbidity.
Source: Acta Obstetricia et Gynecologica Scandinavica - Category: OBGYN Authors: Tags: ORIGINAL RESEARCH ARTICLE Source Type: research
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