Association between serum progesterone concentration on the day before frozen embryo transfer and pregnancy outcomes
Keywords:
dydrogesterone, embryo transfer, hormone replacement therapy, progesteroneAbstract
Introduction: Progesterone is a key hormone linked to in vitro fertilisation outcomes, and serum progesterone is a significant marker before embryo transfer.
Objective: To evaluate the relationship between serum progesterone (P4) concentrations measured one day before frozen blastocyst transfer and pregnancy outcomes.
Methods: The prospective study included 276 frozen blastocyst transfer cycles. Endometrial preparation was performed using hormone replacement therapy (HRT), and luteal support was provided with 800 mg micronized vaginal progesterone and 20 mg oral dydrogesterone daily. Serum P4 was measured one day before embryo transfer. The positive hCG rate, clinical pregnancy rate, and live birth rate were evaluated.
Results: The live birth group had significantly lower mean P4 levels than the non-live birth group (13.1 vs 15.7 ng/mL, p = 0.0008). Clinical pregnancy and live birth rates were lower in the highest P4 tercile (>14.50 ng/mL) compared to lower terciles (<14.50 ng/mL). A receiver operating characteristic analysis showed serum P4 was a significant predictor of live birth, with an optimal cut-off of 14.75 ng/mL (44.8% sensitivity, 81.2% specificity).
Conclusions: In patients using our HRT protocol, higher serum progesterone levels on the day before embryo transfer were associated with reduced pregnancy and live birth rates.
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Copyright (c) 2025 Hang Doan Thi, Thanh Trinh Quoc, Phuong Nguyen Minh, Thien Trinh An, Hanh Pham M., Son Trinh The, Tuan Tran Van , Nhat Nguyen Ngoc
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