Arzu YURCİ
(Memorial Hastanesi, Tüp Bebek Kliniği, Kayseri, Türkiye)
Nur Dokuzeylül GÜNGÖR
(Bahçeşehir Üniversitesi, Göztepe Medical Park Hastanesi, Kadın Hastalıkları ve Tüp Bebek Kliniği, İstanbul, Türkiye)
Tuğba GÜRBÜZ
(Medistate Hastanesi, Kadın Hastalıkları ve Doğum Kliniği, İstanbul, Türkiye)
Yıl: 2021Cilt: 4Sayı: 2ISSN: 2636-8579Sayfa Aralığı: 137 - 141İngilizce

81 0
Comparison of the efficacy of different progesterone regimens in blastocyst frozen-thawed embryo transfer cycles
Aim: The progesterone’s optimal route for luteal phase support (LPS) in frozen-thawed embryo transfer (FET) cycles iscontroversial. This study investigates the effect of three treatment regimens of progesterone: vaginal, oral, and subcutaneousform for LPS in FET cycles.Material and Method: Blastocyst cryopreserved FET cycles utilizing vaginal, subcutaneous, or oral forms of progesteronebetween December 2018 and May 2020 were included. The main outcome was to compare clinical pregnancy rates (CPR),ongoing pregnancy rates (OPR), and live birth rates (LBR) in different progesterone groups.Results: A total of 434 cycles were included, of which 200 utilized vaginal, 124 utilized subcutaneous, and 110 utilized oralforms. Demographic and cycle characteristics were similar between all three groups. Compared to cycles utilizing vaginal,subcutaneous, and oral forms, CPR, OPR, and LBR differ significantly between the three groups (p-value=0.000). Miscarriagewas calculated according to the number of days after embryo transfer, and it was shown that the subcutaneous group had thelowest rate of miscarriage with 11 cases (8.8%). The highest OPR was associated with the subcutaneous group with 67 (54%),followed by the vaginal group with 92 (46%). The highest LBR was in the subcutaneous group, with 59 (47.6%) cases. The oralgroup was significantly less successful 29 (26.4%) than the subcutaneous and vaginal groups.Conclusion: Our study results showed that subcutaneous and vaginal progesterone performed better than oral progesteronefor LPS in patients undergoing FET. All three forms of progesterone administration were safe and well-tolerated.
DergiAraştırma MakalesiErişime Açık
  • 1. Propst AM, Hill JA, Ginsburg ES, Hurwitz S, Politch J, Yanushpolsky EH. A randomized study comparing Crinone 8% and intramuscular progesterone supplementation in in vitro fertilization-embryo transfer cycles. Fertility and steril 2001; 76: 1144-9.
  • 2. Patki A, Pawar VC. Modulating fertility outcome in assisted reproductive technologies by the use of dydrogesterone. Gynecological Endocrin 2007; 23: 68-72.
  • 3. Nawroth F, Ludwig M. What is the ‘ideal’duration of progesterone supplementation before the transfer of cryopreserved–thawed embryos in estrogen/progesterone replacement protocols? Human Reprod 2005; 20: 1127-34.
  • 4. Ludwig M, Diedrich K. Evaluation of an optimal luteal phase support protocol in IVF. Acta Obstetricia Gynecologica Scandina 2001; 80: 452-66.
  • 5. Lee VCY, Li RHW, Ng EHY, Yeung WSB, Ho PC. Luteal phase support does not improve the clinical pregnancy rate of natural cycle frozen-thawed embryo transfer: a retrospective analysis. Eur J Obstet Gynecol Reprod Biol 2013; 169: 50-3.
  • 6. Lan VT, Tuan PH, Canh LT, Tuong HM, Howles CM. Progesterone supplementation during cryopreserved embryo transfer cycles: efficacy and convenience of two vaginal formulations. Reprod Biomed Online 2008; 17: 318-23.
  • 7. Kyrou D, Fatemi HM, Popovic-Todorovic B, Van den Abbeel E, Camus M, Devroey P. Vaginal progesterone supplementation has no effect on ongoing pregnancy rate in hCG-induced natural frozen–thawed embryo transfer cycles. Eur J Obstet Gynecol Reprod Biol 2010; 150: 175-9.
  • 8. Jing S, Li XF, Zhang S, Gong F, Lu G, Lin G. Increased pregnancy complications following frozen-thawed embryo transfer during an artificial cycle. J Assist Reprod Genet 2019; 36: 925-33.
  • 9. Ho CH, Chen SU, Peng FS, Chang CY, Yang YS. Luteal support for IVF/ICSI cycles with Crinone 8%(90 mg) twice daily results in higher pregnancy rates than with intramuscular progesterone. J Chinese Medical Assoc 2008; 71: 386-91.
  • 10.Vaisbuch E, Leong M, Shoham Z. Progesterone support in IVF: is evidence-based medicine translated to clinical practice? A worldwide web-based survey. Reprod Biomed Online 2012; 25: 139-45.
  • 11.Tomás C, Alsbjerg B, Martikainen H, Humaidan P. Pregnancy loss after frozen-embryo transfer—a comparison of three protocols. Fertil Steril 2012; 98: 1165-9.
  • 12.Salehpour S, Tamimi M, Saharkhiz N. Comparison of oral dydrogesterone with suppository vaginal progesterone for lutealphase support in in vitro fertilization (IVF): A randomized clinical trial. Iranian J Reprod Med 2013; 11: 913.
  • 13.Child T, Leonard SA, Evans JS, Lass A. Systematic review of the clinical efficacy of vaginal progesterone for luteal phase support in assisted reproductive technology cycles. Reprod. Biomed. Online 2018; 36: 630-45.
  • 14.Sator M, Radicioni M, Cometti B, et al. Pharmacokinetics and safety profile of a novel progesterone aqueous formulation administered by the s.c. route. Gynecol Endocrinol 2013; 29: 205- 8.
  • 15.Griesinger G, Blockeel C, Tournaye H. Oral dydrogesterone for luteal phase support in fresh in vitro fertilization cycles: a new standard? Fertil Steril 2018 May; 109: 756-62.
  • 16.Zarei A, Sohail P, Parsanezhad ME, Alborzi S, Samsami A, Azizi M. Comparison of four protocols for luteal phase support in frozen-thawed Embryo transfer cycles: a randomized clinical trial. Arch Gynecol Obstet 2017; 295:239–46.
  • 17.Guo W, Chen X, Ye D, et al. Effects of oral dydrogesterone on clinical outcomes of frozen-thawed embryo transfer cycles. Nan fang yi ke da xue xue bao=J Southern Medical Univ 2013; 33: 861- 5.
  • 18.Rashidi BH, Ghazizadeh M, Tehrani Nejad ES, Bagheri M, Gorginzadeh M. Oral dydrogesterone for luteal support in frozenthawed embryo transfer artificial cycles: a pilot randomized controlled trial. Asian Pac J Reprod 2016; 5: 490–4.
  • 19.Devine K, Richter KS, Widra EA, McKeeby JL. Vitrified blastocyst transfer cycles with the use of only vaginal progesterone replacement with Endometrin have inferior ongoing pregnancy rates: results from the planned interim analysis of a three-arm randomized controlled noninferiority trial. Fertil Steril 2018; 109: 266–75.

TÜBİTAK ULAKBİM Ulusal Akademik Ağ ve Bilgi Merkezi Cahit Arf Bilgi Merkezi © 2019 Tüm Hakları Saklıdır.