Murat Erden, Sezcan Mumusoglu, Irem Yarali Ozbek, Onur Ince, Sandro C Esteves, Peter Humaidan, Hakan Yarali
{"title":"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。","authors":"Murat Erden, Sezcan Mumusoglu, Irem Yarali Ozbek, Onur Ince, Sandro C Esteves, Peter Humaidan, Hakan Yarali","doi":"10.1007/s10815-024-03309-0","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To explore whether a 25 mg subcutaneous progesterone daily rescue daily improves the reproductive outcomes in patients with low serum progesterone (P<sub>4</sub>) levels (7-10 ng/mL), measured one day before true natural cycle (t-NC) frozen embryo transfer (FET).</p><p><strong>Methods: </strong>A cohort study of 192 women undergoing t-NC warmed blastocyst transfer. Patients were stratified into three different groups based on serum P<sub>4</sub> levels on the FET-1 day: patients who had serum P<sub>4</sub> levels of 7-10 ng/mL and underwent rescue progesterone administration (rescue group), patients with serum P<sub>4</sub> levels of 7-10 ng/mL without progesterone administration (non-rescue group), and patients with serum P<sub>4</sub> > 10 ng/mL on FET-1 day (control group). The primary outcome was possible differences in live birth rate (LBR) between groups.</p><p><strong>Results: </strong>The LBRs for the serum P<sub>4</sub> 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 P<sub>4</sub> 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.</p><p><strong>Conclusion: </strong>Serum P<sub>4</sub> 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 P<sub>4</sub> levels 7-10 ng/mL does not further enhance LBRs when compared to those patients with similar serum P<sub>4</sub> levels without rescue.</p>","PeriodicalId":15246,"journal":{"name":"Journal of Assisted Reproduction and Genetics","volume":" ","pages":""},"PeriodicalIF":3.2000,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Exogenous progesterone rescue in patients with low mid-luteal serum progesterone levels undergoing true natural vitrified-warmed blastocyst transfer.\",\"authors\":\"Murat Erden, Sezcan Mumusoglu, Irem Yarali Ozbek, Onur Ince, Sandro C Esteves, Peter Humaidan, Hakan Yarali\",\"doi\":\"10.1007/s10815-024-03309-0\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>To explore whether a 25 mg subcutaneous progesterone daily rescue daily improves the reproductive outcomes in patients with low serum progesterone (P<sub>4</sub>) levels (7-10 ng/mL), measured one day before true natural cycle (t-NC) frozen embryo transfer (FET).</p><p><strong>Methods: </strong>A cohort study of 192 women undergoing t-NC warmed blastocyst transfer. Patients were stratified into three different groups based on serum P<sub>4</sub> levels on the FET-1 day: patients who had serum P<sub>4</sub> levels of 7-10 ng/mL and underwent rescue progesterone administration (rescue group), patients with serum P<sub>4</sub> levels of 7-10 ng/mL without progesterone administration (non-rescue group), and patients with serum P<sub>4</sub> > 10 ng/mL on FET-1 day (control group). The primary outcome was possible differences in live birth rate (LBR) between groups.</p><p><strong>Results: </strong>The LBRs for the serum P<sub>4</sub> 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 P<sub>4</sub> 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.</p><p><strong>Conclusion: </strong>Serum P<sub>4</sub> 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 P<sub>4</sub> levels 7-10 ng/mL does not further enhance LBRs when compared to those patients with similar serum P<sub>4</sub> levels without rescue.</p>\",\"PeriodicalId\":15246,\"journal\":{\"name\":\"Journal of Assisted Reproduction and Genetics\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.2000,\"publicationDate\":\"2024-11-09\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Assisted Reproduction and Genetics\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s10815-024-03309-0\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"GENETICS & HEREDITY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Assisted Reproduction and Genetics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10815-024-03309-0","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GENETICS & HEREDITY","Score":null,"Total":0}
Exogenous progesterone rescue in patients with low mid-luteal serum progesterone levels undergoing true natural vitrified-warmed blastocyst transfer.
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.
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.
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