Measuring serum estradiol and progesterone one day prior to frozen embryo transfer improves live birth rates
Abstract Background Given no consensus in the literature, this study sought to determine if a protocol of measuring serum estradiol and progesterone the day prior to frozen embryo transfer (FET) improves likelihood of pregnancy and livebirth. Methods This was a retrospective time-series study of wom...
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doaj-51857603400943518167fed1a8f37a342020-11-25T03:00:38ZengBMCFertility Research and Practice2054-70992020-04-01611710.1186/s40738-020-00075-2Measuring serum estradiol and progesterone one day prior to frozen embryo transfer improves live birth ratesSnigdha Alur-Gupta0Margaret Hopeman1Dara S. Berger2Kurt T. Barnhart3Suneeta Senapati4Clarisa Gracia5Division of Reproductive Endocrinology and Infertility, University of PennsylvaniaDivision of Reproductive Endocrinology and Infertility, University of PennsylvaniaDivision of Reproductive Endocrinology and Infertility, University of PennsylvaniaDivision of Reproductive Endocrinology and Infertility, University of PennsylvaniaDivision of Reproductive Endocrinology and Infertility, University of PennsylvaniaDivision of Reproductive Endocrinology and Infertility, University of PennsylvaniaAbstract Background Given no consensus in the literature, this study sought to determine if a protocol of measuring serum estradiol and progesterone the day prior to frozen embryo transfer (FET) improves likelihood of pregnancy and livebirth. Methods This was a retrospective time-series study of women undergoing autologous vitrified-warmed blastocyst programmed FETs at an academic institution. Live birth rates were compared between a surveillance protocol, where serum estrogen and progesterone surveillance are performed the day prior to a programmed FET, and a standard protocol, whereby no hormonal lab evaluation is performed the day prior. Results Three hundred seventy-nine standard FET and 524 surveillance FET cycles were performed. Patients in the surveillance protocol were significantly more likely to achieve live birth (51% vs. 39%; aOR 1.6, 95%CI [1.2, 2.2]). Obese women were noted to be more likely to have lower progesterone hormone levels on surveillance labs (OR 3.2, 95%CI [2.0, 5.3]). However those whose hormonal medication dose was modified because of pre-transfer labs were as likely to achieve live birth as those whose dose was not modified (47% vs. 53%; aOR 0.8, 95%CI [0.6, 1.2]). Conclusions Cycles with the surveillance protocol were more likely to result in live birth. Patients with low levels of pre-transfer hormones, such as obese patients, likely have lower pregnancy rates. It is possible that when these levels were corrected after measurement, pregnancy rates improved to match those whose levels were not low enough to warrant intervention.http://link.springer.com/article/10.1186/s40738-020-00075-2Assisted reproductive technologyFrozen embryo transferHormone surveillanceLive birthPregnancyProgesterone level |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Snigdha Alur-Gupta Margaret Hopeman Dara S. Berger Kurt T. Barnhart Suneeta Senapati Clarisa Gracia |
spellingShingle |
Snigdha Alur-Gupta Margaret Hopeman Dara S. Berger Kurt T. Barnhart Suneeta Senapati Clarisa Gracia Measuring serum estradiol and progesterone one day prior to frozen embryo transfer improves live birth rates Fertility Research and Practice Assisted reproductive technology Frozen embryo transfer Hormone surveillance Live birth Pregnancy Progesterone level |
author_facet |
Snigdha Alur-Gupta Margaret Hopeman Dara S. Berger Kurt T. Barnhart Suneeta Senapati Clarisa Gracia |
author_sort |
Snigdha Alur-Gupta |
title |
Measuring serum estradiol and progesterone one day prior to frozen embryo transfer improves live birth rates |
title_short |
Measuring serum estradiol and progesterone one day prior to frozen embryo transfer improves live birth rates |
title_full |
Measuring serum estradiol and progesterone one day prior to frozen embryo transfer improves live birth rates |
title_fullStr |
Measuring serum estradiol and progesterone one day prior to frozen embryo transfer improves live birth rates |
title_full_unstemmed |
Measuring serum estradiol and progesterone one day prior to frozen embryo transfer improves live birth rates |
title_sort |
measuring serum estradiol and progesterone one day prior to frozen embryo transfer improves live birth rates |
publisher |
BMC |
series |
Fertility Research and Practice |
issn |
2054-7099 |
publishDate |
2020-04-01 |
description |
Abstract Background Given no consensus in the literature, this study sought to determine if a protocol of measuring serum estradiol and progesterone the day prior to frozen embryo transfer (FET) improves likelihood of pregnancy and livebirth. Methods This was a retrospective time-series study of women undergoing autologous vitrified-warmed blastocyst programmed FETs at an academic institution. Live birth rates were compared between a surveillance protocol, where serum estrogen and progesterone surveillance are performed the day prior to a programmed FET, and a standard protocol, whereby no hormonal lab evaluation is performed the day prior. Results Three hundred seventy-nine standard FET and 524 surveillance FET cycles were performed. Patients in the surveillance protocol were significantly more likely to achieve live birth (51% vs. 39%; aOR 1.6, 95%CI [1.2, 2.2]). Obese women were noted to be more likely to have lower progesterone hormone levels on surveillance labs (OR 3.2, 95%CI [2.0, 5.3]). However those whose hormonal medication dose was modified because of pre-transfer labs were as likely to achieve live birth as those whose dose was not modified (47% vs. 53%; aOR 0.8, 95%CI [0.6, 1.2]). Conclusions Cycles with the surveillance protocol were more likely to result in live birth. Patients with low levels of pre-transfer hormones, such as obese patients, likely have lower pregnancy rates. It is possible that when these levels were corrected after measurement, pregnancy rates improved to match those whose levels were not low enough to warrant intervention. |
topic |
Assisted reproductive technology Frozen embryo transfer Hormone surveillance Live birth Pregnancy Progesterone level |
url |
http://link.springer.com/article/10.1186/s40738-020-00075-2 |
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