Department of Obstetrics and Gynecology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam; IVFMD, My Duc Hospital, Ho Chi Minh City, Vietnam.
IVFMD, My Duc Hospital, Ho Chi Minh City, Vietnam.
Reprod Biomed Online. 2019 Mar;38(3):387-396. doi: 10.1016/j.rbmo.2018.12.012. Epub 2018 Dec 21.
What are the roles of serum progesterone and endometrial thickness as biomarkers in the decision between a freeze-only and fresh embryo transfer in IVF for women without polycystic ovary syndrome (PCOS)?
This was a secondary analysis of a randomized controlled trial including 782 couples who were followed up until the end of the first completed cycle. Couples scheduled for their first or second IVF cycle with a FSH/gonadotrophin-releasing hormone antagonist protocol were randomized to a freeze-only (n = 391) or fresh embryo transfer (n = 391) strategy. The endpoint for this analysis was live birth rate (LBR) after the first embryo transfer.
There was no significant difference in LBR after the first cycle between a freeze-only and fresh transfer strategy. When serum progesterone levels at trigger were in the third quartile (Q3, 1.14-1.53 ng/ml), LBR was significantly higher in the freeze-only versus fresh transfer group (P = 0.01); when serum progesterone was ≥1.14 ng/ml, LBR was significantly better in the freeze-only group (37.4% versus 23.8% in the fresh transfer group; P = 0.004). LBRs in the freeze-only and fresh embryo transfer groups were similar across all quartiles of endometrial thickness, although a small advantage for freeze-only in women with a very thin endometrium could not be excluded.
Serum progesterone level on the day of trigger may have potential as a biomarker on which to base a prospective decision about whether to use a freeze-only or fresh embryo transfer strategy in women undergoing IVF.
在没有多囊卵巢综合征（PCOS）的妇女的体外受精（IVF）中，作为冷冻保存和新鲜胚胎移植之间决策的生物标志物，血清孕激素和子宫内膜厚度的作用是什么？
这是一项随机对照试验的二次分析，纳入了 782 对夫妇，随访至第一个完成周期结束。计划进行第一次或第二次 IVF 周期且使用促卵泡激素/促性腺激素释放激素拮抗剂方案的夫妇被随机分为仅冷冻（n=391）或新鲜胚胎移植（n=391）策略组。本分析的终点是第一次胚胎移植后的活产率（LBR）。
仅冷冻和新鲜移植策略之间，第一次周期后的 LBR 没有显著差异。当触发时血清孕激素水平处于第三四分位（Q3，1.14-1.53ng/ml）时，仅冷冻组的 LBR 明显高于新鲜移植组（P=0.01）；当血清孕激素≥1.14ng/ml 时，仅冷冻组的 LBR 明显更好（37.4%比新鲜移植组的 23.8%；P=0.004）。在所有四分位的子宫内膜厚度中，仅冷冻和新鲜胚胎移植组的 LBR 相似，尽管不能排除非常薄的子宫内膜患者中仅冷冻具有微小优势。
触发日的血清孕激素水平可能有潜力作为生物标志物，用于预测是否在接受 IVF 的妇女中使用仅冷冻或新鲜胚胎移植策略。
