Department of Obstetrics Gynecology and Reproductive Medicine, Dexeus University Hospital, Barcelona, Spain.
Facultad de Medicina Universitat de Vic-Universitat Central de Catalunya, Vic, Spain.
Front Endocrinol (Lausanne). 2023 Feb 1;14:1090105. doi: 10.3389/fendo.2023.1090105. eCollection 2023.
The main objective of the study is to define the optimal trade-off progesterone (P4) values on the day of embryo transfer (ET), to identify low P4-human chorionic gonadotropin (hCG), and to establish whether P4 supplementation started on the hCG day can increase the success rate of the frozen embryo transfer (FET) cycle.
A single-center, cohort, retrospective study with 664 hormone replacement therapy (HRT)-FET cycles analyzed female patients who received vaginal 600 mg/day of P4 starting from 6 days before the FET, had normal P4 values on the day before ET, and whose P4 on the day of the pregnancy test was assessed.
Of the 664 cycles, 69.6% of cycles showed P4 10.6 ng/ml, while 30.4% showed P4 < 10.6 ng/ml on the day of the hCG. Of the 411 chemical pregnancies detected, 71.8% had P4-hCG 10.6 ng/ml (group A), while 28.2% had P4-hCG < 10.6 ng/ml. Of the cycles with P4-hCG < 10.6 ng/ml, 64.7% (group B) were supplemented with a higher dose of vaginal P4 (1,000 mg/day), while 35.3% (group C) were maintained on the same dose of vaginal micronized P4. The live birth rate was 71.9%, 96%, and 7.3% for groups A, B, and C, respectively.
The likelihood to detect P4-hCG < 10.6 ng/ml decreased as the level of serum P4 the day before ET increased. The live birth rate (LBR) was shown to be significantly lower when P4 was low and not supplemented.
本研究的主要目的是确定胚胎移植（ET）日孕激素（P4）的最佳折衷值，确定低 P4-人绒毛膜促性腺激素（hCG），并确定在 hCG 日开始补充 P4 是否可以提高冷冻胚胎移植（FET）周期的成功率。
一项单中心、队列、回顾性研究，分析了 664 例接受阴道 600mg/天 P4 治疗的激素替代疗法（HRT）-FET 周期的女性患者，这些患者从 FET 前 6 天开始接受治疗，ET 前一天 P4 值正常，并且评估了妊娠试验当天的 P4 值。
在 664 个周期中，69.6%的周期显示 P4 > 10.6ng/ml，而 30.4%的周期在 hCG 日显示 P4 < 10.6ng/ml。在检测到的 411 例化学妊娠中，71.8%的患者 P4-hCG > 10.6ng/ml（A 组），而 28.2%的患者 P4-hCG < 10.6ng/ml。在 P4-hCG < 10.6ng/ml 的周期中，64.7%（B 组）补充了更高剂量的阴道 P4（1000mg/天），而 35.3%（C 组）维持相同剂量的阴道微粒化 P4。A、B 和 C 组的活产率分别为 71.9%、96%和 7.3%。
随着 ET 前一天血清 P4 水平的升高，检测到 P4-hCG < 10.6ng/ml 的可能性降低。当 P4 水平较低且未补充时，活产率（LBR）明显较低。
