Better pregnancy outcomes in women with day 2 or day 3 fresh embryo transfer when progesterone supplementation for luteal phase support is initiated on the day of oocyte retrieval

IF 2 4区医学 Q2 OBSTETRICS & GYNECOLOGY

Taiwanese Journal of Obstetrics & Gynecology Pub Date : 2025-07-01 DOI:10.1016/j.tjog.2023.12.006

Chia-Chen Lee, Kuan-Sheng Lee, Christine Shan-Chi Chiu, Robert Kuo-Kuang Lee, Ming-Huei Lin

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Abstract

Objective

To analyze the pregnancy outcomes in women undergoing fresh embryo transfer (ET) with the initiation of luteal phase support (LPS) on the day of oocyte retrieval (OR) compared with LPS 1 day after OR.

Materials and Methods

Overall, 872 patients underwent fresh ET at Mackay Memorial Hospital between January 2017 and August 2021. Eligible patients were divided into two cleavage-stage (day 2 or day 3) ET and day 5 elective single ET (e-SET) groups. Pregnancy outcomes were analyzed with the initiation of LPS on the OR day and 1 day after OR. The subgroup with diminished ovarian reserve (DOR) (anti-Mullerian hormone ≤1.1 ng/mL) on cleavage-stage ET group was analyzed between the two LPS initiation time points.

Results

The cleavage-stage ET group that received LPS on the OR day showed significantly higher implantation (27.8 % vs. 17.6 %, p = 0.002), clinical pregnancy (46.3 % vs. 34.4 %, p = 0.022), and livebirth (33.7 % vs. 23.6 %, p = 0.037) rates. In the subgroup analysis of DOR in the cleavage-stage ET group, LPS initiated on the OR day led to significantly higher rates of implantation (30.7 % vs. 16.2 %, p = 0.048), clinical pregnancy (50.0 % vs. 26.5 %, p = 0.023), and nonstatistically significant but higher livebirth (38.6 % vs. 20.6 %, p = 0.067). In the day 5 e-SET group, no significant differences in clinical pregnancy (51 % vs. 59.4 %, p = 0.294) and livebirth (41 % vs. 44.4 %, p = 0.665) rates were found between the two LPS initiation time points.

Conclusion

Women undergoing day 2 or day 3 ET appear to have better pregnancy outcomes including clinical pregnancy, livebirth, and implantation rates when LPS was initiated on the OR day than those undergoing LPS initiated 1 day after OR, particularly for women with DOR. However, in the day 5 e-SET group, clinical outcomes are comparable between the two initiation time points.

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当在取卵当天开始补充黄体期支持的黄体酮时，进行第2天或第3天新鲜胚胎移植的妇女妊娠结局更好

目的分析新鲜胚胎移植（ET）患者在卵母细胞取出（OR）当天开始黄体期支持（LPS）与卵母细胞取出（OR）后1天开始使用LPS的妊娠结局。材料与方法2017年1月至2021年8月，共有872名患者在Mackay纪念医院接受了新鲜ET治疗。符合条件的患者被分为两个卵裂期（第2天或第3天）ET和第5天选择性单ET （e-SET）组。在手术当天和手术后1天开始LPS对妊娠结局进行分析。分析两个LPS起始时间点卵裂期ET组卵巢储备减少亚组（DOR）（抗苗勒管激素≤1.1 ng/mL）。结果卵裂期ET组在OR日接受LPS治疗的胚胎着床率（27.8% vs. 17.6%, p = 0.002）、临床妊娠率（46.3% vs. 34.4%, p = 0.022）和活产率（33.7% vs. 23.6%, p = 0.037）显著高于对照组。在卵裂期ET组DOR的亚组分析中，在OR日启动的LPS导致着床率（30.7% vs. 16.2%, p = 0.048），临床妊娠率（50.0% vs. 26.5%, p = 0.023）和更高的活产率（38.6% vs. 20.6%, p = 0.067）。在第5天的e-SET组中，两个LPS起始时间点的临床妊娠率（51% vs. 59.4%, p = 0.294）和活产率（41% vs. 44.4%, p = 0.665）无显著差异。结论：与术后1天开始LPS相比，术后第2天或第3天进行ET治疗的妇女具有更好的妊娠结局，包括临床妊娠、活产和着床率，特别是对于DOR的妇女。然而，在第5天的e-SET组中，两个起始时间点的临床结果具有可比性。

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

Taiwanese Journal of Obstetrics & Gynecology OBSTETRICS & GYNECOLOGY-

CiteScore

3.60

自引率

23.80%

发文量

207

审稿时长

4-8 weeks

期刊介绍： Taiwanese Journal of Obstetrics and Gynecology is a peer-reviewed journal and open access publishing editorials, reviews, original articles, short communications, case reports, research letters, correspondence and letters to the editor in the field of obstetrics and gynecology. The aims of the journal are to: 1.Publish cutting-edge, innovative and topical research that addresses screening, diagnosis, management and care in women''s health 2.Deliver evidence-based information 3.Promote the sharing of clinical experience 4.Address women-related health promotion The journal provides comprehensive coverage of topics in obstetrics & gynecology and women''s health including maternal-fetal medicine, reproductive endocrinology/infertility, and gynecologic oncology. Taiwan Association of Obstetrics and Gynecology.