Baldini D, Savoia M V, Sciancalepore A G, Malvasi A, Vizziello D, Beck R, Vizziello G
Momò Fertilife Clinic, Bisceglie.
Santa Maria Hospital, GVM Care & Research, Bari.
Clin Ter. 2018 May-Jun;169(3):e91-e95. doi: 10.7417/T.2018.2060.
The aim of this study was to evaluate the impact of pre- mature progesterone rise on the day of human chorionic gonadotropin (hCG) administration on the outcome of in vitro fertilization (IVF) of frozen embryo transfer (FET) cycles using cleavage-stage embryos.
This was a retrospective, cohort study of 131 ovarian stimulation cycles followed by cleavage-stage frozen embryo transfers. The first group consisted of women undergoing FET due to premature luteinization during controlled ovarian stimulation (n = 56, P ≥1.2 ng/ml). The controls were represented by women undergoing FET not complicated by high progesterone levels at induction (n = 75, P < 1.2 ng/ml). For both groups, the progesterone was measured on the day of hCG administration and the fertilization rate, cleavage rate, implantation rate, clinical pregnancy rate, ongoing pregnancy rate and Top-Quality Embryos (TQE) rates were compared.
The increase of progesterone in patients of the Group A had no significant effects on the number of oocytes retrieved or available for the insemination. The fertilization rate, cleavage rate and implantation rates, as well as the clinical pregnancy rate and ongoing pregnancy were very similar in both study groups. The analysis of TQE rates between the two groups indicated a roughly comparable result.
The results of this study showed that progesterone elevation on the day of hCG administration did not affect the outcomes of IVF with frozen embryos at cleavage stage. This study therefore confirms that for patients with high progesterone levels the right way to obtain a healthy pregnancy should be to delay the embryo transfer at a successive FET cycle, not associated with the ovarian stimulation.
本研究旨在评估人绒毛膜促性腺激素(hCG)给药当天孕酮过早升高对使用卵裂期胚胎的冷冻胚胎移植(FET)周期体外受精(IVF)结局的影响。
这是一项对131个卵巢刺激周期后进行卵裂期冷冻胚胎移植的回顾性队列研究。第一组由因控制性卵巢刺激期间过早黄素化而接受FET的女性组成(n = 56,孕酮≥1.2 ng/ml)。对照组为诱导时未合并高孕酮水平而接受FET的女性(n = 75,孕酮<1.2 ng/ml)。两组均在hCG给药当天测量孕酮,并比较受精率、卵裂率、着床率、临床妊娠率、持续妊娠率和优质胚胎(TQE)率。
A组患者孕酮升高对获取的或可用于受精的卵母细胞数量无显著影响。两个研究组的受精率、卵裂率和着床率,以及临床妊娠率和持续妊娠情况非常相似。两组之间TQE率的分析表明结果大致相当。
本研究结果表明,hCG给药当天孕酮升高不影响卵裂期冷冻胚胎IVF的结局。因此,本研究证实,对于孕酮水平高的患者,获得健康妊娠的正确方法应该是在连续的FET周期推迟胚胎移植,且不与卵巢刺激相关。