Relationship between serum progesterone levels at the day before progesterone suppository administration and pregnancy rate in embryo transfer cycles

Document Type : Original Article

Authors

1 Associate professor, Department of Obstetrics and Gynecology, Infectious and Tropical Diseases Research Center, Faculty of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran.

2 Medical Student, Faculty of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran.

3 Assistant Professor, Department of Community Medicine, Faculty of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran.

Abstract

Introduction: Given the importance of assisted reproductive therapies and achieving a pregnancy leading to live birth, as well as the importance of the used treatments and the various studies which have been performed so far, this study was performed with aim to evaluate the relationship between endometrial pattern and serum progesterone levels at the day before the onset of progesterone suppository in embryo transfer cycles in women referred to Infertility Center of Zahedan.
Methods: This cross-sectional study was performed on 50 women who had undergone IVF for any reason and their embryos were frozen in infertility center of Zahedan University of Medical Sciences in 2019. The patients were treated with progesterone suppository 400 mg at morning and 400 mg at evening intra rectally. Demographic data, endometrial pattern and thickness ultrasound, serum progesterone level at the day before the onset of progesterone suppository and serum BHCG levels 14 days after embryo transfer were recorded. Data were analyzed by SPSS statistical software (version 24) and Chi-square and Mann-Whitney tests. P<0.05 was considered statistically significant.
Results: IVF outcome was positive in 13 cases (26%). 23 patients (46%) had homogenous endometrial pattern and 27 (54%) had three-line pattern. Serum progesterone level were significantly lower in patients who had positive BHCG than patients who had negative BHCG (p <0.001).
Conclusion: Among women undergoing IVF, serum progesterone levels and also endometrial pattern (homogenous or three-line) was different. Serum progesterone level before the onset of treatment was related to the pregnancy outcome (positive or negative), as well as in women with lower progesterone levels   in day before the start of progesterone suppositories, treatment with progesterone suppository could lead to better pregnancy outcomes following IVF, which is a novel and important finding.

Keywords


  1. Behnoud N, Rezaei R, Estorm E, Farzaneh F. The relationship between endometrial thickness and endometrial pattern with pregnancy rate based on positive serum beta-human chorionic gonadotropin. International Journal of Womens Health and Reproduction Sciences 2019; 7(3):400-3.
  2. Farzaneh F, Afshar F. Comparison of ovulation induction with letrozole plus dexamethasone and letrozole alone in infertile women with polycystic ovarian disease: An RCT. International Journal of Reproductive BioMedicine 2020; 18(4):307.
  3. Teimoori B, Esmaeilpoor M, Ashkezari AK, Farzaneh F. Comparison of induction abortion in the first trimester using misoprostol alone and misoprostol with estrogen priming Int J Women’s Health Reprod Sci 2019; 7(3):404-407.
  4. Allersma T, Farquhar C, Cantineau AE. Natural cycle in vitro fertilisation (IVF) for subfertile couples. Cochrane Database of Systematic Reviews 2013(8).
  5. Samsami A, Chitsazi Z, Namazi G. Frozen thawed embryo transfer cycles; A comparison of pregnancy outcomes with and without prior pituitary suppression by GnRH agonists: An RCT. International Journal of Reproductive BioMedicine 2018; 16(9):587.
  6. Di Renzo GC, Mattei A, Gojnic M, Gerli S. Progesterone and pregnancy. Current Opinion in Obstetrics and Gynecology 2005; 17(6):598-600.
  7. Behnoud N, Bahrami R, Kordafshari G, Farzaneh F, Kenari HM. Management of early menopause using traditional Persian medicine: a case report. International Journal of Womens Health and Reproduction Sciences 2019; 7(2):231-6.
  8. Brady PC, Kaser DJ, Ginsburg ES, Ashby RK, Missmer SA, Correia KF, et al. Serum progesterone concentration on day of embryo transfer in donor oocyte cycles. Journal of assisted reproduction and genetics 2014; 31(5):569-75.
  9. Vikas S, Swati G. The impact of progesterone level on day of hCG injection in IVF Cycles on clinical pregnancy rate. Journal of Human Reproductive Sciences 2017; 10(4):265.
  10. Rezaee Z, Ghaseminejad A, Forootan M, Hosseinipoor T, Forghani F. Assessment of serum progesterone level on the day of HCG injection in infertile polycystic ovarian syndrome patients referred to women’s hospital, Tehran, 2009. International journal of fertility & sterility 2012; 5(4):231.
  11. Zahiri SZ, Sharami SH, Atrkar RZ. The relation between endometrial thickness and pattern with pregnancy rate in infertile patients 2007.
  12. Shahin AY. Endometrial sonographic characters predicting pregnancy following recurrent clomiphene induction in unexplained infertility. Reproductive biomedicine online 2008; 17(6):795-802.
  13. Alborzi S, Momtahan M, Zolghadri J, Parsanezhad ME. The effect of endometrial pattern and thickness on pregnancy rate in controlled ovarian hyperstimulation-Intrauterine Insemination. Medical Journal of The Islamic Republic of Iran (MJIRI) 2005; 19(3):189-93.
  14. Nezamdoust S, Farzaneh F. Comparison of the effect of trigger of ovulation with HCG and HCG plus oxytocin on the biochemical pregnancy. Iran J Obstet Gynecol Infertil 2020; 22(12):19-23.
  15. Farzaneh F, Khalili M, Kazemi A. Prevalence of Celiac in Fertile Women Due to Unexplained Infertility. Prensa Med Argent 2019; 105:4.
  16. Farzaneh F, Keikha R. Evaluation of Prevalence of Changes in Thyroid Functional Tests in Mole Hydatiforme. Prensa Med Argent 2019; 105(2):2.