Frozen-warmed blastocyst transfer after 6 or 7 days of progesterone administration: impact on live birth rate in hormone replacement therapy cycles
Caroline Roelens, Samuel Santos-Ribeiro, Lauren Becu, Shari Mackens, Lisbet Van Landuyt, Annalisa Racca, Michel De Vos, Arne van de Vijver, Herman Tournaye, Christophe Blockeel, Caroline Roelens, Samuel Santos-Ribeiro, Lauren Becu, Shari Mackens, Lisbet Van Landuyt, Annalisa Racca, Michel De Vos, Arne van de Vijver, Herman Tournaye, Christophe Blockeel
Abstract
Objective: To study the difference in live birth rate (LBR) between frozen-warmed blastocyst transfer (FET) on the 6th or the 7th day of progesterone administration in artificially prepared cycles.
Design: Retrospective cohort study.
Setting: Tertiary university-based referral hospital.
Patient(s): Patients who underwent FET between December 2015 and December 2017 in a hormone replacement therapy cycle (HRT).
Intervention(s): Group A included all eligible patients who underwent transfer of a vitrified-warmed blastocyst on the 6th day of progesterone administration; group B included patients who underwent blastocyst transfer on the 7th day of progesterone. The artificial HRT protocol in this study consisted of estrogen administration at a dose of 2 mg twice daily for 7 days followed by 2 mg three times daily for 6 days and micronized vaginal progesterone 200 mg three times daily from an adequately considered endometrial thickness onward.
Main outcome measure(s): Live birth rate.
Results: The study included 619 patients, 346 in group A and 273 in group B. The LBRs were comparable between both groups (36.6% for group A and group B), even after adjustment for confounding factors (adjusted odds ratio 1.073, 95% confidence interval 0.740-1.556). Subgroup analysis revealed significantly higher miscarriage rates for day 6 blastocysts transferred on the 6th day of progesterone supplementation compared with transfer on the 7th day of progesterone supplementation (50.0% versus 21.4%, respectively). Additionally, there was a tendency toward a higher LBR when the 7-day progesterone supplementation protocol was used for transfer of a day 6 blastocyst (21.5% and 35.5% for group A and group B, respectively).
Conclusion: Warmed blastocyst transfer on the 6th compared with the 7th day of progesterone administration in an HRT cycle results in similar LBR. Subgroup analysis of day 6 blastocysts showed significantly higher miscarriage rates when FET was performed on the 6th day of progesterone administration.
Keywords: Frozen embryo transfer; hormone replacement therapy cycles; live birth rate; progesterone supplementation.
Copyright © 2020 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.
Source: PubMed