NYU Langone Health, 660 First Avenue, 5th Floor, New York, NY, 10016, USA.
NYU Langone Fertility Center, NYU Langone Health, New York, NY, USA.
J Assist Reprod Genet. 2021 Apr;38(4):901-905. doi: 10.1007/s10815-021-02074-8. Epub 2021 Feb 10.
In the era of personalized medicine and the increased use of frozen embryo transfer (FET), assay of the endometrium's receptivity prior to transfer has gained popularity, especially among patients. However, the optimal timing for single thawed euploid embryo transfers (STEET) in a programmed FET has yet to be determined Mackens et al. (Hum Reprod. 32(11):2234-42, 2017). We sought to examine the outcomes of euploid FETs by length of progesterone (P4) exposure.
Prospective cohort study of programmed FETs of single euploid embryos between June 1, 2018, and December, 18, 2018, at our center. Subjects reported the exact start time for initiating progesterone. The transfer time was noted to calculate the primary independent variable, duration of progesterone exposure. Statistical analysis included ANOVA and Spearman's rho correlation, with p < 0.05 considered significant.
Inclusion criteria were met for 253 programmed STEET cycles in the analysis. There was no significant difference in P4 duration when comparing outcome groups (112.8 ± 3.1 ongoing pregnancy (OP), 112.4 ± 4.4 spontaneous abortion (SAB), 111.6 ± 1.7 biochemical pregnancy (BP), 113.9 ± 5.7 no pregnancy (NP), F 1.76, df 3, p = 0.16). An ROC curve assessing the ability of P4 duration to predict ongoing pregnancy (OP) had an area under the curve of 0.467 (p = 0.38).
Duration of P4 was not associated with outcome. Of the cycles, 65.6% resulted in ongoing pregnancy with our center's instructions resulting in an average progesterone exposure of 112.8 h, with a range of 98.3-123.7 h. With growing popularity for individualized testing, these results provide evidence for patient counseling of the high likelihood of ongoing pregnancy without personalized testing.
在个性化医学和冷冻胚胎移植（FET）使用增加的时代，在移植前评估子宫内膜的接受能力受到了欢迎，尤其是在患者中。然而，程序化 FET 中单冻胚移植（STEET）的最佳时间尚未确定（Mackens 等人，Hum Reprod. 32(11):2234-42, 2017）。我们试图通过孕激素（P4）暴露时间来检查整倍体 FET 的结果。
对 2018 年 6 月 1 日至 12 月 18 日期间在本中心进行的单整倍体胚胎程序化 FET 的前瞻性队列研究。受试者报告了开始孕激素的准确起始时间。记录移植时间以计算主要的独立变量，即孕激素暴露时间。统计分析包括方差分析和斯皮尔曼 rho 相关性分析，p<0.05 被认为具有统计学意义。
在分析中，符合 253 个程序化 STEET 周期的纳入标准。比较结局组时，P4 持续时间没有显著差异（112.8±3.1 持续妊娠（OP）、112.4±4.4 自然流产（SAB）、111.6±1.7 生化妊娠（BP）、113.9±5.7 未妊娠（NP），F1.76，df3，p=0.16）。评估 P4 持续时间预测持续妊娠（OP）能力的 ROC 曲线下面积为 0.467（p=0.38）。
P4 的持续时间与结局无关。根据本中心的指示，65.6%的周期导致持续妊娠，平均孕激素暴露时间为 112.8 小时，范围为 98.3-123.7 小时。随着个体化检测的普及，这些结果为患者提供了证据，即无需个体化检测，持续妊娠的可能性也很高。
