Successful pregnancy and live birth despite discontinuation of hormone replacement therapy at 3 weeks and 5 days of gestation following vitrified-warmed embryo transfer under a hormone replacement therapy cycle: a case report and literature review.

IF 2.8 2区 医学 Q1 OBSTETRICS & GYNECOLOGY
Shoko Katsumata, Kuniaki Ota, Toshifumi Takahashi, Junichiro Mitsui, Nozomi Uchida, Kenichiro Hiraoka, Akira Komiya, Kiyotaka Kawai
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Abstract

Background: In freeze-thawed embryo transfer (FET) cycles, hormone replacement treatment (HRT) is crucial for implantation and pregnancy maintenance. HRT typically continues until the 10th week of pregnancy owing to a luteoplacental shift, although a definitive HRT regimen remains undetermined. We present the case of a woman who underwent FET during an HRT cycle and ceased HRT after a negative pregnancy test at 3 weeks and 5 days, who went on to deliver a healthy baby.

Case presentation: A 30-year-old Japanese woman with primary infertility was scheduled for FET. Estrogen supplementation was initiated as part of the HRT cycle for endometrial preparation. After achieving an endometrial thickness of 8 mm, progesterone supplementation was commenced, and the transfer of a 4BB blastocyst occurred 5 days after initiating progesterone treatment. At a gestational age of 3 weeks and 5 days, her serum human chorionic gonadotropin (hCG) level was only 8.3 mIU/mL, leading to discontinuation of HRT due to the absence of pregnancy. However, at 6 weeks and 1 day, her serum hCG levels significantly rose to 9359 mIU/mL, prompting the resumption of HRT. Ultrasonography confirmed the presence of a gestational sac and cardiac activity in the uterus, and HRT was continued until the 10th week. Ultimately, she delivered a healthy female neonate vaginally, weighing 2601 g at 40 weeks and 6 days.

Conclusions: Progesterone supplementation is customary in FET with HRT cycles, although it has raised the possibility that there is demonstrating the potential for an ongoing pregnancy and resulting in a healthy baby under no progesterone replacement prior to the luteoplacental shift in this case. The duration and dosage of progesterone in luteal support for FET with HRT warrant further investigation.

在激素替代治疗周期下玻璃化加热胚胎移植后妊娠3周5天停止激素替代治疗后成功妊娠和活产:一例报告和文献综述。
背景:在冻融胚胎移植(FET)周期中,激素替代治疗(HRT)对着床和妊娠维持至关重要。由于黄体胎盘移位,HRT通常持续到妊娠第10周,尽管最终的HRT方案仍未确定。我们报告了一位在HRT周期中接受FET治疗的妇女,并在妊娠试验3周零5天阴性后停止HRT治疗,她继续分娩了一个健康的婴儿。病例介绍:一名30岁的日本女性,原发不孕症,计划进行FET治疗。雌激素补充开始作为子宫内膜准备HRT周期的一部分。在子宫内膜厚度达到8毫米后,开始补充孕激素,并在开始孕激素治疗5天后发生4BB囊胚的转移。在孕龄3周5天时,患者血清人绒毛膜促性腺激素(hCG)水平仅为8.3 mIU/mL,因未怀孕而终止HRT治疗。然而,在6周1天,她的血清hCG水平明显上升到9359 mIU/mL,促使恢复HRT。超声检查证实存在妊娠囊和子宫内心脏活动,HRT持续到第10周。最终,她顺产了一个健康的女婴,40周零6天重2601克。结论:在激素替代周期的FET中,补充黄体酮是惯例,尽管在这种情况下,在黄体胎盘移位之前不补充黄体酮,可能会导致持续妊娠并产生健康婴儿。黄体支持激素替代治疗FET的持续时间和黄体酮的剂量值得进一步研究。
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来源期刊
BMC Pregnancy and Childbirth
BMC Pregnancy and Childbirth OBSTETRICS & GYNECOLOGY-
CiteScore
4.90
自引率
6.50%
发文量
845
审稿时长
3-8 weeks
期刊介绍: BMC Pregnancy & Childbirth is an open access, peer-reviewed journal that considers articles on all aspects of pregnancy and childbirth. The journal welcomes submissions on the biomedical aspects of pregnancy, breastfeeding, labor, maternal health, maternity care, trends and sociological aspects of pregnancy and childbirth.
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