Katsumata Shoko, Ota Kuniaki, Takahashi Toshifumi, Mitsui Junichiro, Uchida Nozomi, Hiraoka Kenichiro, Komiya Akira, Kawai Kiyotaka
Kameda IVF Clinic Makuhari, Makuhari, 261-8501, Japan.
Fukushima Medical Center for Children and Women, Fukushima Medical University, 1 Hikarigaoka, Fukushima, 960-1295, Japan.
BMC Pregnancy Childbirth. 2024 Dec 20;24(1):831. doi: 10.1186/s12884-024-07059-w.
In freeze-thawed embryo transfer (FET) cycles, hormone replacement treatment (HRT) is crucial for implantation and pregnancy maintenance. HRT typically continues until the 10th week of pregnancy owing to a luteoplacental shift, although a definitive HRT regimen remains undetermined. We present the case of a woman who underwent FET during an HRT cycle and ceased HRT after a negative pregnancy test at 3 weeks and 5 days, who went on to deliver a healthy baby.
A 30-year-old Japanese woman with primary infertility was scheduled for FET. Estrogen supplementation was initiated as part of the HRT cycle for endometrial preparation. After achieving an endometrial thickness of 8 mm, progesterone supplementation was commenced, and the transfer of a 4BB blastocyst occurred 5 days after initiating progesterone treatment. At a gestational age of 3 weeks and 5 days, her serum human chorionic gonadotropin (hCG) level was only 8.3 mIU/mL, leading to discontinuation of HRT due to the absence of pregnancy. However, at 6 weeks and 1 day, her serum hCG levels significantly rose to 9359 mIU/mL, prompting the resumption of HRT. Ultrasonography confirmed the presence of a gestational sac and cardiac activity in the uterus, and HRT was continued until the 10th week. Ultimately, she delivered a healthy female neonate vaginally, weighing 2601 g at 40 weeks and 6 days.
Progesterone supplementation is customary in FET with HRT cycles, although it has raised the possibility that there is demonstrating the potential for an ongoing pregnancy and resulting in a healthy baby under no progesterone replacement prior to the luteoplacental shift in this case. The duration and dosage of progesterone in luteal support for FET with HRT warrant further investigation.
在冻融胚胎移植（FET）周期中，激素替代疗法（HRT）对于着床和维持妊娠至关重要。由于黄体-胎盘转换，HRT通常持续至妊娠第10周，尽管尚未确定明确的HRT方案。我们报告了一例在HRT周期中接受FET的女性病例，该女性在3周零5天妊娠试验阴性后停止了HRT，但最终产下了一名健康婴儿。
一名30岁的日本原发性不孕女性计划接受FET。作为子宫内膜准备的HRT周期的一部分，开始补充雌激素。在子宫内膜厚度达到8mm后，开始补充孕酮，并在开始孕酮治疗5天后移植了一枚4BB囊胚。在妊娠3周零5天时，她的血清人绒毛膜促性腺激素（hCG）水平仅为8.3mIU/mL，由于未妊娠而停止了HRT。然而，在6周零1天时，她的血清hCG水平显著升至9359mIU/mL，促使恢复HRT。超声检查证实子宫内有妊娠囊和心脏活动，HRT持续至第10周。最终，她在40周零6天时经阴道分娩了一名健康的女婴，体重2601g。
在FET的HRT周期中补充孕酮是惯例，尽管在这种情况下，这增加了在黄体-胎盘转换前没有孕酮替代的情况下仍显示持续妊娠并产下健康婴儿的可能性。FET的HRT黄体支持中孕酮的持续时间和剂量值得进一步研究。
