Department of Reproductive Medicine, Centre Hospitalier Universitaire (CHU) and University of Montpellier, Montpellier, France.
Department of Reproductive Medicine, Centre Hospitalier Universitaire (CHU) Carémeau, Nîmes, France.
Front Endocrinol (Lausanne). 2022 Jun 10;13:892753. doi: 10.3389/fendo.2022.892753. eCollection 2022.
Progesterone plays a key role in implantation. Several studies reported that lower luteal progesterone levels might be related to decreased chances of pregnancy. This systematic review was conducted using appropriate key words, on MEDLINE, EMBASE, and the Cochrane Library, from 1990 up to March 2021 to assess if luteal serum progesterone levels are associated with ongoing pregnancy (OP) and live birth (LB) rates (primary outcomes) and miscarriage rate (secondary outcome), according to the number of corpora lutea (CLs). Overall 2,632 non-duplicate records were identified, of which 32 relevant studies were available for quantitative analysis. In artificial cycles with no CL, OP and LB rates were significantly decreased when the luteal progesterone level falls below a certain threshold (risk ratio [RR] 0.72; 95% confidence interval [CI] 0.62-0.84 and 0.73; 95% CI 0.59-0.90, respectively), while the miscarriage rate was increased (RR 1.48; 95% CI 1.17-1.86). In stimulated cycles with several CLs, the mean luteal progesterone level in the no OP and no LB groups was significantly lower than in the OP and LB groups [difference in means 68.8 (95% CI 45.6-92.0) and 272.4 (95% CI 10.8-533.9), ng/ml, respectively]. Monitoring luteal serum progesterone levels could help in individualizing progesterone administration to enhance OP and LB rates, especially in cycles without corpus luteum.
https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=139019, identifier 139019.
孕激素在着床中起着关键作用。有几项研究报告称，黄体期孕激素水平较低可能与妊娠机会减少有关。本系统评价使用适当的关键词，在 1990 年至 2021 年 3 月期间，在 MEDLINE、EMBASE 和 Cochrane 图书馆进行检索，以评估黄体期血清孕激素水平是否与持续妊娠（OP）和活产（LB）率（主要结局）以及流产率（次要结局）相关，依据是黄体数（CL）。共确定了 2632 份非重复记录，其中 32 项相关研究可进行定量分析。在没有 CL 的人工周期中，当黄体期孕激素水平低于一定阈值时，OP 和 LB 率显著下降（风险比 [RR] 0.72；95%置信区间 [CI] 0.62-0.84 和 0.73；95%CI 0.59-0.90），而流产率增加（RR 1.48；95%CI 1.17-1.86）。在有多个 CL 的刺激周期中，无 OP 和无 LB 组的黄体期孕激素平均水平显著低于 OP 和 LB 组[均值差分别为 68.8（95%CI 45.6-92.0）和 272.4（95%CI 10.8-533.9）ng/ml]。监测黄体期血清孕激素水平有助于个体化孕激素治疗，提高 OP 和 LB 率，尤其是在无黄体周期。
https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=139019，标识符 139019。
