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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Main Authors: Snigdha Alur-Gupta, Margaret Hopeman, Dara S. Berger, Kurt T. Barnhart, Suneeta Senapati, Clarisa Gracia
Format: Article
Language:English
Published: BMC 2020-04-01
Series:Fertility Research and Practice
Subjects:
Online Access:http://link.springer.com/article/10.1186/s40738-020-00075-2
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spelling 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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