Purpose

Is serum progesterone(P) level on day 2 of vaginal P administration in a hormonally substituted mock cycle predictive of live birth in oocyte donation(OD)?

Methods

Retrospective analysis of 110 mock cycles from 2008 to 2016 of OD recipients having at least one subsequent embryo transfer (ET). Endometrial preparation consisted of sequential administration of vaginal estradiol, followed by transdermal estradiol and 600 mg/day vaginal micronized P. In mock cycles, serum P was measured 2 days after vaginal P introduction. OD was performed 1 to 3 years later, without P measurement.

Results

In mock cycles, mean serum P level on day 2 was 12.8 ± 4.5 ng/mL (range: 4–28 ng/mL). A total of 32% patients had P < 10 ng/mL. At the time of first OD, age of recipients and donors, number of retrieved and attributed oocytes, and number of transferred embryos were comparable between patients with P < 10 ng/mL in their mock cycles compared with P ≥ 10 ng/mL. Pregnancy and live birth rate after first ET were significantly lower for patients with P < 10ng/mL (9% vs. 35 %; P = 0.002 and 9% vs. 32%; P = 0.008, respectively). Considering both fresh and subsequent frozen-thawed ET, cumulative live birth rate per-patient and per-transfer were significantly lower in patients with P < 10 ng/mL in their mock cycle (14% vs. 35%; P = 0.02 and 11% vs. 27%; P = 0.03).

Conclusion

A low P level in hormonally substituted cycles several years before ET performed with the same endometrial preparation is associated with a significantly lower chance of live birth. This suggests that altered vaginal P absorption is a permanent phenomenon. Monitoring serum P in hormonally substituted cycles appears mandatory to adjust luteal P substitution.

中文翻译：

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如果使用卵母细胞捐赠的女性在之前的激素替代模拟周期中显示出低孕酮水平，则她们的活产率会降低

目的

在激素替代模拟周期中阴道 P 给药第 2 天的血清孕酮 (P) 水平是否可以预测卵母细胞捐赠 (OD) 中的活产？

方法

回顾性分析 2008 年至 2016 年 OD 受者的 110 个模拟周期，这些受者至少有一次随后的胚胎移植 (ET)。子宫内膜制备包括连续给药阴道雌二醇，然后是经皮雌二醇和 600 mg/天阴道微粉化 P。在模拟周期中，在阴道 P 引入后 2 天测量血清 P。OD 是在 1 到 3 年后进行的，没有进行 P 测量。

结果

在模拟周期中，第 2 天的平均血清 P 水平为 12.8 ± 4.5 ng/mL（范围：4-28 ng/mL）。共有 32% 的患者 P < 10 ng/mL。在第一次 OD 时，受者和供者的年龄、取回和归属的卵母细胞数量以及移植胚胎的数量在模拟周期中 P < 10 ng/mL 的患者与 P ≥ 10 ng/mL 的患者之间具有可比性。对于 P < 10ng/mL 的患者，第一次 ET 后的妊娠率和活产率显着降低（分别为 9% 对35%；P = 0.002 和 9% 对 32%；P = 0.008）。考虑到新鲜和随后的冻融 ET，在模拟周期中 P < 10 ng/mL 的患者中，每位患者和每次转移的累积活产率显着降低（14% 对 35%；P= 0.02 和 11% 对 27%；P = 0.03）。

结论

在使用相同子宫内膜准备进行 ET 前几年，激素替代周期中的低 P 水平与活产机会显着降低有关。这表明改变的阴道 P 吸收是一种永久性现象。在激素替代周期中监测血清磷似乎是调整黄体磷替代的必要条件。