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

IF 3.2 3区医学 Q2 GENETICS & HEREDITY

Journal of Assisted Reproduction and Genetics Pub Date : 2024-11-09 DOI:10.1007/s10815-024-03309-0

Murat Erden, Sezcan Mumusoglu, Irem Yarali Ozbek, Onur Ince, Sandro C Esteves, Peter Humaidan, Hakan Yarali

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引用次数: 0

Abstract

Purpose: To explore whether a 25 mg subcutaneous progesterone daily rescue daily improves the reproductive outcomes in patients with low serum progesterone (P₄) 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 P₄ levels on the FET-1 day: patients who had serum P₄ levels of 7-10 ng/mL and underwent rescue progesterone administration (rescue group), patients with serum P₄ levels of 7-10 ng/mL without progesterone administration (non-rescue group), and patients with serum P₄ > 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 P₄ 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 P₄ 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 P₄ 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 P₄ levels 7-10 ng/mL does not further enhance LBRs when compared to those patients with similar serum P₄ levels without rescue.

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对黄体中期血清孕酮水平低的患者进行外源性孕酮救助，以进行真正的自然玻璃化温化囊胚移植。

目的：探讨在真正的自然周期（t-NC）冷冻胚胎移植（FET）前一天测量血清孕酮（P4）水平较低（7-10 ng/mL）的患者，每天皮下注射 25 mg 黄体酮是否能改善其生殖结局：对 192 名接受 t-NC 冷藏囊胚移植的女性进行队列研究。根据 FET-1 日的血清 P4 水平将患者分为三个不同组别：血清 P4 水平为 7-10 纳克/毫升并接受黄体酮治疗的患者（治疗组）、血清 P4 水平为 7-10 纳克/毫升但未接受黄体酮治疗的患者（非治疗组）以及 FET-1 日血清 P4 > 10 纳克/毫升的患者（对照组）。主要结果是各组间活产率（LBR）可能存在的差异：血清 P4 为 7-10 毫微克/毫升且无抢救措施组、血清 P4 为 7-10 毫微克/毫升且有抢救措施组和血清 P4 > 10 毫微克/毫升组（对照组）的活产率分别为 41%、46% 和 52%（P = 0.61）。血清 P4 为 7-10 纳克/毫升（无抢救）组、7-10 纳克/毫升（有抢救）组和 > 10 纳克/毫升（对照）组的估计调整后活产概率也相当：分别为 43.5%（95% CI，20.0-70.4%）、49.8%（95% CI，28.1-71.6%）和 57.4%（95% CI，44.0-69.8%）：血清P4水平高于7纳克/毫升似乎可确保接受t-NC FET的患者获得LBR。对于血清 P4 水平为 7-10 纳克/毫升的患者，采取每天皮下注射 25 毫克黄体酮的抢救措施与血清 P4 水平相似但未采取抢救措施的患者相比，并不会进一步提高 LBR。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Assisted Reproduction and Genetics 医学-妇产科学

CiteScore

5.70

自引率

9.70%

发文量

286

审稿时长

1 months

期刊介绍： The Journal of Assisted Reproduction and Genetics publishes cellular, molecular, genetic, and epigenetic discoveries advancing our understanding of the biology and underlying mechanisms from gametogenesis to offspring health. Special emphasis is placed on the practice and evolution of assisted reproduction technologies (ARTs) with reference to the diagnosis and management of diseases affecting fertility. Our goal is to educate our readership in the translation of basic and clinical discoveries made from human or relevant animal models to the safe and efficacious practice of human ARTs. The scientific rigor and ethical standards embraced by the JARG editorial team ensures a broad international base of expertise guiding the marriage of contemporary clinical research paradigms with basic science discovery. JARG publishes original papers, minireviews, case reports, and opinion pieces often combined into special topic issues that will educate clinicians and scientists with interests in the mechanisms of human development that bear on the treatment of infertility and emerging innovations in human ARTs. The guiding principles of male and female reproductive health impacting pre- and post-conceptional viability and developmental potential are emphasized within the purview of human reproductive health in current and future generations of our species. The journal is published in cooperation with the American Society for Reproductive Medicine, an organization of more than 8,000 physicians, researchers, nurses, technicians and other professionals dedicated to advancing knowledge and expertise in reproductive biology.