Low serum progesterone the day prior to frozen embryo transfer of euploid embryos is associated with significant reduction in live birth rates

Abstract

A retrospective cohort study was performed to examine whether, in artificial endometrial preparation for frozen embryo transfer (FET) cycles, progesterone (P) levels the day prior to embryo transfer of euploid embryos have an impact on pregnancy outcomes. In a private university clinic, 244 FETs between January 2016 and June 2017 were analyzed. Endometrial preparation was achieved with estradiol valerate and vaginal micronized progesterone. Serum P and estradiol levels the day prior to embryo transfer were measured. A multivariable analysis to assess the relationship between serum P level and pregnancy outcomes was performed, adjusted for confounding variables. Mean P value was 11.3 ± 5.1 ng/ml. Progesterone levels were split in quartiles: Q1: ≤ 8.06 ng/ml; Q2: 8.07–10.64 ng/ml; Q3: 10.65–13.13 ng/ml; Q4: > 13.13 ng/ml. Patients included in the lower P quartile had a significantly higher miscarriage rate and significantly lower live birth rate (LBR) compared to the higher ones. A low serum P level (≤ 10.64 ng/ml) one day before FET is associated with a lower pregnancy and LBR following FET of euploid embryos.

摘要

采用回顾性队列研究方法, 探讨在人工子宫内膜冷冻胚胎移植（FET）周期中, 整倍体胚胎移植前血清孕酮水平对妊娠结局的影响。在一家私立大学诊所, 对2016年1月至2017年6月期间的244例FET进行了分析。采用戊酸雌二醇和阴道微粒孕酮作为子宫内膜的准备。测定胚胎移植前一天的血清孕酮和雌二醇水平。对血清孕酮水平与妊娠结局之间的关系进行了多变量分析, 并对混杂变量进行了调整。平均血清孕酮值为11.3±5.1 ng/ml。孕酮水平分为四个组：Q1：≤8.06 ng/ml；Q2：8.07-10.64 ng/ml；Q3：10.65-13.13 ng/ml；Q4：>13.13 ng/ml。血清孕酮低四分位数的患者流产率显着高于高四分位数的患者, 活产率显著低于高四分位数的患者。FET前1天血清孕酮水平低(≤10.64 ng/ml)与整倍体冷冻胚胎移植后低妊娠率和低活产率有关。

The Chinese abstracts are translated by Prof. Dr. Xiangyan Ruan and her team: Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China.

Keywords:

• Progesterone
• euploid embryo transfer
• miscarriage
• live birth rate
• FET

Disclosure of interest

The authors report no conflict of interest

Trial registration number: NCT03395665

Acknowledgements

This work was performed under the auspices of the Càtedra d’Investigació en Obstetrícia I Ginecologia of the Department of Obstetrics, Gynaecology, and Reproduction, Hospital Universitari Dexeus, Universitat Autònoma de Barcelona.