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    Mid-luteal serum progesterone concentrations govern implantation rates for cryopreserved embryo transfers conducted under hormone replacement

    Access Status
    Fulltext not available
    Authors
    Yovich, John
    Conceicao, J.
    Stanger, J.
    Hinchliffe, P.
    Keane, Kevin
    Date
    2015
    Type
    Journal Article
    
    Metadata
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    Citation
    Yovich, J. and Conceicao, J. and Stanger, J. and Hinchliffe, P. and Keane, K. 2015. Mid-luteal serum progesterone concentrations govern implantation rates for cryopreserved embryo transfers conducted under hormone replacement. Reproductive BioMedicine Online. 31 (2): pp. 180-191.
    Source Title
    Reproductive BioMedicine Online
    DOI
    10.1016/j.rbmo.2015.05.005
    ISSN
    1472-6483
    School
    School of Biomedical Sciences
    URI
    http://hdl.handle.net/20.500.11937/14590
    Collection
    • Curtin Research Publications
    Abstract

    This study explores the relevance of mid-luteal serum hormonal concentrations in cryopreserved embryo transfer cycles conducted under hormone replacement therapy (HRT) control and which involved single-embryo transfer (SET) of 529 vitrified blastocysts. Widely ranging mid-luteal oestradiol and progesterone concentrations ensued from the unique HRT regimen. Oestradiol had no influence on clinical pregnancy or live birth rates, but an optimal progesterone range between 70 and 99nmol/l (P < 0.005) was identified in this study. Concentrations of progesterone below 50nmol/l and above 99nmol/l were associated with decreased implantation rates. There was no clear interaction between oestradiol and progesterone concentrations but embryo quality grading did show a significant influence on outcomes (P < 0.001 and P = 0.002 for clinical pregnancy and live birth rates, respectively). Multiple comparison analysis showed that the progesterone effect was influential regardless of embryo grading, body mass index or the woman's age, either at vitrification or at cryopreserved embryo transfer. The results support the argument that careful monitoring of serum progesterone concentrations in HRT-cryopreserved embryo transfer is warranted and that further studies should explore pessary adjustments to optimize concentrations for individual women to enhance implantation rates.

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