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Progesterone concentrations and dosage with frozen embryo transfers – What's best?
Author(s) -
Basnayake Surabhi Kumble,
Volovsky Michelle,
Rombauts Luk,
Osianlis Tiki,
Vollenhoven Beverley,
Healey Martin
Publication year - 2018
Publication title -
australian and new zealand journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.734
H-Index - 65
eISSN - 1479-828X
pISSN - 0004-8666
DOI - 10.1111/ajo.12757
Subject(s) - embryo transfer , pregnancy , medicine , live birth , in vitro fertilisation , embryo , odds ratio , pregnancy rate , assisted reproductive technology , andrology , hormone replacement therapy (female to male) , gynecology , hormone , obstetrics , endocrinology , biology , infertility , testosterone (patch) , genetics , microbiology and biotechnology
Background There is a lack of consensus on the optimal dose and form of progesterone supplementation during frozen‐thawed embryo transfer with hormone replacement therapy. Aims We aim to identify the serum progesterone concentration on day 16 most likely to result in positive pregnancy outcomes. Materials and methods We undertook a retrospective study of 4582 women who underwent frozen embryo transfer with hormone replacement therapy, or natural frozen embryo transfer, over 14 years at a multi‐site private in vitro fertilisation clinic. Embryos were 3–5 days of age at time of transfer. We extracted data on serum progesterone concentrations and outcomes, as well as dose and form of progesterone supplementation, from patient and pharmacy records. Results Increased live birth rates for frozen embryo transfer with hormone replacement therapy were seen with day 16 serum progesterone concentrations >50 nmol/L (26.4% vs 11.3% for <50 nmol/L; adjusted odds ratio (OR) 3.14 (95% CI 2.21–4.48)). Similarly, a decreased pregnancy loss rate was seen in this group (14.3% vs 32.6% for ≤50 nmol/L; adjusted OR 0.26 (95% CI 0.12–0.58)). There was a positive correlation between live births and the number of progesterone doses per day ( r = 0.119, P = 0.026) and day 16 progesterone concentrations ( r = 0.128, P = 0.011). Conclusion Improved pregnancy outcomes are seen with day 16 serum progesterone concentrations >50 nmol/L. There is a statistically significant correlation between live births, number of progesterone doses per day and day 16 serum progesterone concentrations in this study.