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Dondurulmuş Çözülmüş Embriyo Transferi Öncesi Günü Progesteron Seviyesinin İn-Vitro Fertilizasyon Başarısına Etkisinin İncelenmesi

Yıl 2021, Cilt: 6 Sayı: 2, 282 - 290, 05.06.2021
https://doi.org/10.26453/otjhs.896726

Öz

Amaç: Dondurulmuş çözülmüş embriyo transfer (DÇET) sikluslarında transfer öncesi gün ölçülen serum progesteron konsantrasyonlarının gebelik, düşük ve canlı doğum oranları üzerine etkilerini gözlemlemek.
Materyal ve Metot: Bu retrospektif çalışmada, tek bir merkezde 01.01.2019 ile 01.09.2019 tarihleri arasında gerçekleştirilen 67 DÇET siklus sonuçları incelendi. Progesteron düzeyleri 10,64 ng/ml eşik değerinin altındaki ve üstündeki DÇET sikluslarındaki gebelik, düşük ve canlı doğum sonuçları karşılaştırıldı.
Bulgular: Progesteron konsantrasyonlarına göre DÇET gruplarındaki hastaların yaşı, infertilite nedenleri, sitimülasyon gün sayıları, beden kitle indeks (BKİ) değerleri, endometriyum kalınlıkları ve transfer edilen ortalama embriyo sayıları benzerdi. Gebelik oranları karşılaştırıldığında progesteronun>10,65 ng/ml grubunda gebelik oranları anlamlı derecede yüksekti (p=0,023). Toplam gebeliklerin %50 (21)’sinin canlı doğum ile sonuçlandığı, canlı doğumla sonuçlanan gebeliklerin %90,5 (19)’nin progesteron düzeylerinin >10,64 ng/ml olan gebelerden oluştuğu bulundu. Progesteron düzeyleri <10,64 ng/ml olanların pozitif gebelerin %28,6 (12)’sını oluşturduğu, bu gebeliklerin %83,3 (10)’ünün düşük ile, %16,7 (2)’sinin de canlı doğum ile sonuçlandığı bulundu.
Sonuç: Progesteron düzeylerinin >10,64 ng/ml olduğu sikluslarda gebelik sonuçlarının daha yüksek olduğu ve oluşan gebeliklerin büyük çoğunluğunun canlı doğumla sonuçlandığı görülmektedir.

Destekleyen Kurum

HERHAN GİR DESTEKLEYEN KURUM BUUNMAMAKTADIR

Kaynakça

  • Bhattacharya S. Maternal and perinatal outcomes after fresh versus frozen embryo transfer-what is the risk-benefit ratio? Fertility and Sterility. 2016;106(2):241-243.
  • Maheshwari A, Pandey S, Shetty A, Hamilton M, Bhattacharya S. Obstetric and perinatal outcomes in singleton pregnancies resulting from the transfer of frozen thawed versus fresh embryos generated through in vitro fertilization treatment: a systematic review and meta-analysis. Fertility and Sterility. 2012;98(2):368-377.
  • Wennerholm UB, Henningsen AK, Romundstad LB, Bergh C, Pinborg A, Skjaerven R, et al. Perinatal outcomes of children born after frozen-thawed embryo transfer: a Nordic cohort study from the CoNARTaS group. Human Reproduction (Oxford, England). 2013;28(9):2545-2553.
  • Rienzi L, Gracia C, Maggiulli R, et al. Oocyte, embryo and blastocyst cryopreservation in ART: systematic review and meta-analysis comparing slow-freezing versus vitrification to produce evidence for the development of global guidance. Human Reproduction Update. 2017;23(2):139-155.
  • Coates A, Kung A, Mounts E, et al. Optimal euploid embryo transfer strategy, fresh versus frozen, after preimplantation genetic screening with next generation sequencing: a randomized controlled trial. Fertility and Sterility. 2017;107(3):723-730.
  • Mackens S, Santos-Ribeiro S, van de Vijver A, et al. Frozen embryo transfer: a review on the optimal endometrial preparation and timing. Human Reproduction. 2017;32(11):2234-2242.
  • Groenewoud ER, Cohlen BJ, Macklon NS. Programming the endometrium for deferred transfer of cryopreserved embryos: hormone replacement versus modified natural cycles. Fertility and Sterility. 2018;109(5):768-774.
  • Yarali H, Polat M, Mumusoglu S, Yarali I, Bozdag G. Preparation of endometrium for frozen embryo replacement cycles: a systematic review and meta-analysis. Journal of Assisted Reproduction and Genetics. 2016;33(10):1287-1304.
  • Gellersen B, Brosens JJ. Cyclic decidualization of the human endometrium in reproductive health and failure. Endocrine Reviews. 2014;35(6):851-905.
  • Paulson RJ. Hormonal induction of endometrial receptivity. Fertility and Sterility. 2011;96(3):530-535.
  • Gaggiotti-Marre S, Martinez F, Coll L, et al. Low serum progesterone the day prior to frozen embryo transfer of euploid embryos is associated with significant reduction in live birth rates. Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology. 2019;35(5):439-442.
  • Labarta E, Mariani G, Holtmann N, Celada P, Remohí J, Bosch E. Low serum progesterone on the day of embryo transfer is associated with a diminished ongoing pregnancy rate in oocyte donation cycles after artificial endometrial preparation: a prospective study. Human Reproduction. 2017;32(12):2437-2442.
  • Alsbjerg B, Thomsen L, Elbaek HO, et al. Progesterone levels on pregnancy test day after hormone replacement therapy-cryopreserved embryo transfer cycles and related reproductive outcomes. Reproductive Biomedicine Online. 2018;37(5):641-647.
  • De Ziegler D, Bulletti C, De Monstier B, Jääskeläinen AS. The first uterine pass effect. Annals of the New York Academy of Sciences. 1997;828:291-299.
  • Yovich JL, Conceicao JL, Stanger JD, Hinchliffe PM, Keane KN. Mid-luteal serum progesterone concentrations govern implantation rates for cryopreserved embryo transfers conducted under hormone replacement. Reproductive Biomedicine Online. 2015;31(2):180-191.
  • Bjuresten K, Landgren BM, Hovatta O, Stavreus-Evers A. Luteal phase progesterone increases live birth rate after frozen embryo transfer. Fertility and Sterility. 2011;95(2):534-537.
  • Kim CH, Lee YJ, Lee KH, et al. The effect of luteal phase progesterone supplementation on natural frozen-thawed embryo transfer cycles. Obstetrics & Gynecology Science. 2014;57(4):291-296.
  • Brady PC, Kaser DJ, Ginsburg ES, et al. Serum progesterone concentration on day of embryo transfer in donor oocyte cycles. Journal of Assisted Reproduction and Genetics. 2014;31(5):569-575.
  • Buvat J, Marcolin G, Guittard C, Herbaut JC, Louvet AL, Dehaene JL. Luteal support after luteinizing hormone-releasing hormone agonist for in vitro fertilization: superiority of human chorionic gonadotropin over oral progesterone. Fertility and Sterility. 1990;53(3):490-494.
  • Miles RA, Paulson RJ, Lobo RA, Press MF, Dahmoush L, Sauer MV. Pharmacokinetics and endometrial tissue levels of progesterone after administration by intramuscular and vaginal routes: a comparative study. Fertility and Sterility. 1994;62(3):485-490.
  • Khan N, Richter KS, Newsome TL, Blake EJ, Yankov VI. Matched-samples comparison of intramuscular versus vaginal progesterone for luteal phase support after in vitro fertilization and embryo transfer. Fertility and Sterility. 2009;91(6):2445-2450.
  • La Rocca C, Carbone F, Longobardi S, Matarese G. The immunology of pregnancy: regulatory T cells control maternal immune tolerance toward the fetus. Immunology Letters. 2014;162(1 Pt A):41-48.
  • Bhurke AS, Bagchi IC, Bagchi MK. Progesterone-Regulated endometrial factors controlling implantation. American Journal of Reproductive Immunology. 2016;75(3):237-425.
  • Alsbjerg B, Polyzos NP, Elbaek HO, Povlsen BB, Andersen CY, Humaidan P. Increasing vaginal progesterone gel supplementation after frozen-thawed embryo transfer significantly increases the delivery rate. Reproductive Biomedicine Online. 2013;26(2):133-137.
  • Salat-Baroux J, Cornet D, Alvarez S, et al. Pregnancies after replacement of frozen-thawed embryos in a donation program. Fertility and Sterility. 1988;49(5):817-821.

Investigation of the Effect of Progesterone Level on In-Vitro Fertilization Success The Day Before Frozen-Thawed Embryo Transfer

Yıl 2021, Cilt: 6 Sayı: 2, 282 - 290, 05.06.2021
https://doi.org/10.26453/otjhs.896726

Öz

Objective: To observe the effects of serum progesterone concentrations measured on the day before transfer on pregnancy, miscarriage and live birth rates in frozen-thawed embryo transfer (DCE) cycles.
Materials and Methods: In this retrospective study, the results of 67 ICET cycles performed in a single center between 01.01.2019 and 01.09.2019 were analyzed. Pregnancy, abortion and live birth outcomes were compared in DCE cycles below and above the threshold value of 10.64 ng/ml of progesterone.
Results: According to progesterone concentrations, the age, causes of infertility, stimulation days, body mass index (BMI) values, endometrial thicknesse, and mean number of embryos transferred were similar in the groups. When pregnancy rates were compared in terms of progesterone concentrations, pregnancy rates were significantly higher in the progesterone>10.65 ng/ml group p=0.023. We found that 50% (21) of total pregnancies resulted in a live birth, and 90.5% (19) of pregnancies resulting in live birth consisted of pregnant women whose progesterone levels were progesterone>10.64 ng/ml. Those whose progesterone levels were <10.64 ng/ml constituted 28.6% (12) of positive pregnant women, 83.3% (10) of these pregnancies were found to be with miscarriage, and 16.7% (2) of them resulted with live births.
Conclusion: It is observed that pregnancy outcomes are higher in cycles where progesterone levels are progesterone>10.64 ng/ml, and most of the pregnancies that occur result in a live birth.

Kaynakça

  • Bhattacharya S. Maternal and perinatal outcomes after fresh versus frozen embryo transfer-what is the risk-benefit ratio? Fertility and Sterility. 2016;106(2):241-243.
  • Maheshwari A, Pandey S, Shetty A, Hamilton M, Bhattacharya S. Obstetric and perinatal outcomes in singleton pregnancies resulting from the transfer of frozen thawed versus fresh embryos generated through in vitro fertilization treatment: a systematic review and meta-analysis. Fertility and Sterility. 2012;98(2):368-377.
  • Wennerholm UB, Henningsen AK, Romundstad LB, Bergh C, Pinborg A, Skjaerven R, et al. Perinatal outcomes of children born after frozen-thawed embryo transfer: a Nordic cohort study from the CoNARTaS group. Human Reproduction (Oxford, England). 2013;28(9):2545-2553.
  • Rienzi L, Gracia C, Maggiulli R, et al. Oocyte, embryo and blastocyst cryopreservation in ART: systematic review and meta-analysis comparing slow-freezing versus vitrification to produce evidence for the development of global guidance. Human Reproduction Update. 2017;23(2):139-155.
  • Coates A, Kung A, Mounts E, et al. Optimal euploid embryo transfer strategy, fresh versus frozen, after preimplantation genetic screening with next generation sequencing: a randomized controlled trial. Fertility and Sterility. 2017;107(3):723-730.
  • Mackens S, Santos-Ribeiro S, van de Vijver A, et al. Frozen embryo transfer: a review on the optimal endometrial preparation and timing. Human Reproduction. 2017;32(11):2234-2242.
  • Groenewoud ER, Cohlen BJ, Macklon NS. Programming the endometrium for deferred transfer of cryopreserved embryos: hormone replacement versus modified natural cycles. Fertility and Sterility. 2018;109(5):768-774.
  • Yarali H, Polat M, Mumusoglu S, Yarali I, Bozdag G. Preparation of endometrium for frozen embryo replacement cycles: a systematic review and meta-analysis. Journal of Assisted Reproduction and Genetics. 2016;33(10):1287-1304.
  • Gellersen B, Brosens JJ. Cyclic decidualization of the human endometrium in reproductive health and failure. Endocrine Reviews. 2014;35(6):851-905.
  • Paulson RJ. Hormonal induction of endometrial receptivity. Fertility and Sterility. 2011;96(3):530-535.
  • Gaggiotti-Marre S, Martinez F, Coll L, et al. Low serum progesterone the day prior to frozen embryo transfer of euploid embryos is associated with significant reduction in live birth rates. Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology. 2019;35(5):439-442.
  • Labarta E, Mariani G, Holtmann N, Celada P, Remohí J, Bosch E. Low serum progesterone on the day of embryo transfer is associated with a diminished ongoing pregnancy rate in oocyte donation cycles after artificial endometrial preparation: a prospective study. Human Reproduction. 2017;32(12):2437-2442.
  • Alsbjerg B, Thomsen L, Elbaek HO, et al. Progesterone levels on pregnancy test day after hormone replacement therapy-cryopreserved embryo transfer cycles and related reproductive outcomes. Reproductive Biomedicine Online. 2018;37(5):641-647.
  • De Ziegler D, Bulletti C, De Monstier B, Jääskeläinen AS. The first uterine pass effect. Annals of the New York Academy of Sciences. 1997;828:291-299.
  • Yovich JL, Conceicao JL, Stanger JD, Hinchliffe PM, Keane KN. Mid-luteal serum progesterone concentrations govern implantation rates for cryopreserved embryo transfers conducted under hormone replacement. Reproductive Biomedicine Online. 2015;31(2):180-191.
  • Bjuresten K, Landgren BM, Hovatta O, Stavreus-Evers A. Luteal phase progesterone increases live birth rate after frozen embryo transfer. Fertility and Sterility. 2011;95(2):534-537.
  • Kim CH, Lee YJ, Lee KH, et al. The effect of luteal phase progesterone supplementation on natural frozen-thawed embryo transfer cycles. Obstetrics & Gynecology Science. 2014;57(4):291-296.
  • Brady PC, Kaser DJ, Ginsburg ES, et al. Serum progesterone concentration on day of embryo transfer in donor oocyte cycles. Journal of Assisted Reproduction and Genetics. 2014;31(5):569-575.
  • Buvat J, Marcolin G, Guittard C, Herbaut JC, Louvet AL, Dehaene JL. Luteal support after luteinizing hormone-releasing hormone agonist for in vitro fertilization: superiority of human chorionic gonadotropin over oral progesterone. Fertility and Sterility. 1990;53(3):490-494.
  • Miles RA, Paulson RJ, Lobo RA, Press MF, Dahmoush L, Sauer MV. Pharmacokinetics and endometrial tissue levels of progesterone after administration by intramuscular and vaginal routes: a comparative study. Fertility and Sterility. 1994;62(3):485-490.
  • Khan N, Richter KS, Newsome TL, Blake EJ, Yankov VI. Matched-samples comparison of intramuscular versus vaginal progesterone for luteal phase support after in vitro fertilization and embryo transfer. Fertility and Sterility. 2009;91(6):2445-2450.
  • La Rocca C, Carbone F, Longobardi S, Matarese G. The immunology of pregnancy: regulatory T cells control maternal immune tolerance toward the fetus. Immunology Letters. 2014;162(1 Pt A):41-48.
  • Bhurke AS, Bagchi IC, Bagchi MK. Progesterone-Regulated endometrial factors controlling implantation. American Journal of Reproductive Immunology. 2016;75(3):237-425.
  • Alsbjerg B, Polyzos NP, Elbaek HO, Povlsen BB, Andersen CY, Humaidan P. Increasing vaginal progesterone gel supplementation after frozen-thawed embryo transfer significantly increases the delivery rate. Reproductive Biomedicine Online. 2013;26(2):133-137.
  • Salat-Baroux J, Cornet D, Alvarez S, et al. Pregnancies after replacement of frozen-thawed embryos in a donation program. Fertility and Sterility. 1988;49(5):817-821.
Toplam 25 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm Araştırma Makalesi
Yazarlar

Özcan Budak 0000-0002-2617-3175

Songül Doğanay 0000-0002-1730-1331

Mehmet Sühha Bostancı Bu kişi benim 0000-0002-4776-6244

Nermin Akdemir 0000-0002-9129-2103

Serhan Cevrioğlu 0000-0002-3810-6519

Veysel Toprak 0000-0002-3280-851X

Seda Özküler Bu kişi benim 0000-0001-5585-0289

Yayımlanma Tarihi 5 Haziran 2021
Gönderilme Tarihi 15 Mart 2021
Kabul Tarihi 10 Nisan 2021
Yayımlandığı Sayı Yıl 2021 Cilt: 6 Sayı: 2

Kaynak Göster

AMA Budak Ö, Doğanay S, Bostancı MS, Akdemir N, Cevrioğlu S, Toprak V, Özküler S. Dondurulmuş Çözülmüş Embriyo Transferi Öncesi Günü Progesteron Seviyesinin İn-Vitro Fertilizasyon Başarısına Etkisinin İncelenmesi. OTSBD. Haziran 2021;6(2):282-290. doi:10.26453/otjhs.896726

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