Endometrial compaction and serum progesterone measurements at the day of embryo transfer cannot predict pregnancy outcomes in frozen-thaw embryo transfer cycles

Dalal M. Al Jarrah (1) , Manal Taha Al Obaidi (2) , Itlal J. AL Asadi (3)
(1) Department of Obstetrics and Gynaecology, Alzahraa Teaching Hospital, Najaf Ashraf-Iraq, Iraq ,
(2) High Institutes for Infertility Diagnosis and Assisted Reproduction Techniques, Baghdad-Iraq, Iraq ,
(3) Department of Invitro-Fertilization, Al Sadder Medical City, Najaf Ashraf- Iraq, Iraq

Abstract

Endometrial receptivity plays a basic role in successful embryo implantation and pregnancy outcomes and can be assessed by many of non-invasive markers. Our study evaluated the impact of two of these markers specifically serum progesterone and endometrial thickness at embryo transfer day in prediction pregnancy outcomes on (60) patients attempting medicated frozen embryo transfer (FET) cycles. All patients were received sequential estrogen & progesterone medications for endometrial preparation then submitted to measurements of endometrial thickness (EMT) by transvaginal-ultrasound (TV- US) & serums progesterone (P) analysis at the embryo transfer day, thereafter day 3 verified-thawed embryos grades (A ± B) were transferred. Compacted (decreased) EMT was seen in 48.3% of patients with higher pregnancy rate (PR) of 58.6%t than non-compacted EMT (no change or increased) which was seen in 51.7% of patients with (PR) of 29.0%, (P value=0.021). However ongoing pregnancy rate (Ong PR) not differed significantly between both groups (44.8% in compacted vs 25.8% in non-compacted, P value=0.053), also the means of serum P not differed between pregnant and non-pregnant patients (P value=0.374). ROC curves for Ong PR prediction in relations to endometrial compaction & serum progesterone at embryo transfer day were poor (AUC= 0.630, & AUC=0.576, respectively). This study suggested that endometrial compaction or serum P levels measurements at embryo transfer day were poor predictors for ongoing pregnancy where any kind of EMT changes (decreased or not) seen after P administration not significantly affect pregnancy outcomes in frozen-thaw cycles of cleavage stage embryos transfer.

Full text article

Generated from XML file

References

Balaban, B., Brison, D., Calderon, G., Catt, J., Conaghan, J., Cowan, L., Lundin, K. 2011. Alpha scientists in reproductive medicine and ESHRE special interest group of embryology. The Istanbul consensus workshop on embryo assessment: proceedings of an expert meeting. Hum Reprod, 26:1270–83.

Basirat, Z., Rad, H. A., Esmailzadeh, S., Jorsaraei, S. G. A., Hajian-Tilaki, K., Pasha, H., Ghofrani, F. 2016. Comparison of pregnancy rate between fresh embryo transfers and frozen-thawed embryo transfers following ICSI treatment. International Journal of Reproductive BioMedicine, 14(1):39–39.

Bosch, E., Vos, M. D., Humaidan, P. 2020. The Future of Cryopreservation in Assisted Reproductive Technologies. Frontiers in Endocrinology, 11.

Boynukalin, F. K., Gultomruk, M., Turgut, E., Demir, B., Findikli, N., Serdarogullari, M., Coban, O., Yarkiner, Z., Bahceci, M. 2019. Measuring the serum progesterone level on the day of transfer can be an additional tool to maximize ongoing pregnancies in single euploid frozen blastocyst transfers. Reproductive Biology and Endocrinology, 17(1):102–102.

Bu, Z., Yang, X., Song, L., Kang, B., Sun, Y. 2019. The impact of endometrial thickness change after progesterone administration on pregnancy outcome in patients transferred with single frozen-thawed blastocyst. Reproductive Biology and Endocrinology, 17(1):99–99.

Casper, R. F. 2020. Frozen embryo transfer: evidence-based markers for successful endometrial preparation. Fertility and Sterility, 113(2):248–251.

Coroleu, B., Gaggiotti-Marre, S. 2019. Serum progesterone screening for frozen embryo transfer: present and future perspectives. JBRA Assisted Reproduction, 23(2).

Diedrich, K., Fauser, B. C. J. M., Devroey, P., Griesinger, G. 2007. The role of the endometrium and embryo in human implantation. Human Reproduction Update, 13(4):365–377.

El-Toukhy, T., Coomarasamy, A., Khairy, M., Sunkara, K., Seed, P., Khalaf, Y., Braude, P. 2008. The relationship between endometrial thickness and outcome of medicated frozen embryo replacement cycles. Fertility and Sterility, 89(4):832–839.

Forman, E. J. 2019. The receptive endometrium: the thinner the better? Fertility and Sterility, 112(3):469–470.

Gill, P., Kim, J. G., Bergh, P. A., Scott, R. T. 2020. Ultrasound imaging predicts endometrial receptivity-a decrease in endometrial thickness (compaction) prior to embryo transfer is associated with an increase in clinical pregnancy rate in synthetic frozen euploid IVF cycles. Fertility and Sterility, 114(3).

Haas, J., Smith, R., Zilberberg, E., Nayot, D., Meriano, J., Barzilay, E., Casper, R. F. 2019. Endometrial compaction (decreased thickness) in response to progesterone results in optimal pregnancy outcome in frozen-thawed embryo transfers. Fertility and Sterility, 112(3):503–509.e1.

Jabbour, H. N., Kelly, R. W., Fraser, H. M., Critchley, H. O. D. 2006. Endocrine Regulation of Menstruation. Endocrine Reviews, 27(1):17–46.

Kaye, L. A., Rasouli, M. A., Liu, A. H., Raman, A., Bedient, C. E., Garner, F. C., Shapiro, B. S. 2020. Sonographic observation of endometrial compaction as a potential predictor of endometrial receptivity. Fertility and Sterility, 114(3):e249–e249.

Kofinas, J. D., Blakemore, J., McCulloh, D. H., Grifo, J. 2015. Serum progesterone levels greater than 20 ng/dl on day of embryo transfer are associated with lower live birth and higher pregnancy loss rates. Journal of Assisted Reproduction and Genetics, 32(9):1395–1399.

Labarta, E., Mariani, G., Holtmann, N., Celada, P., Remohí, J., Bosch, E. 2017. 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, 32(12):2437–2442.

Lessey, B. A., Young, S. L. 2019. What exactly is endometrial receptivity? Fertility and Sterility, 111(4):611–617.

Mackens, S., Santos-Ribeiro, S., van de Vijver, A., Racca, A., Landuyt, L. V., Tournaye, H., Blockeel, C. 2017. Frozen embryo transfer: a review on the optimal endometrial preparation and timing. Human Reproduction, 32(11):2234–2242.

Malhotra, N., Kumar, P., Malhotra, J. 2014. Jeffcoate’s principles of gynaecology. Jaypee Brothers Medical Publishers, 4:72–81.

Polat, M., Mumusoglu, S., Bozdag, G., Ozbek, I. Y., Humaidan, P., Yarali, H. 2020. Addition of intramuscular progesterone to vaginal progesterone in hormone replacement therapy in vitrified– warmed blastocyst transfer cycles. Reproductive BioMedicine Online, 40(6):812–818.

Punyadeera, C., Verbost, P., Groothuis, P. 2003. Oestrogen and progestin responses in human endometrium. The Journal of Steroid Biochemistry and Molecular Biology, 84(4):393–410.

Riestenberg, C., Quinn, M. M., Akopians, A. L., Danzer, H., Surrey, M., Ghadir, S., Kroener, L. 2020. Endometrial compaction does not predict ongoing pregnancy rate in programmed single euploid embryo transfer cycles. Fertility and Sterility, 114(3):e304–e305.

Shaodi, Z., Qiuyuan, L., Yisha, Y., Cuilian, Z. 2020. The effect of endometrial thickness on pregnancy outcomes of frozen-thawed embryo transfer cycles which underwent hormone replacement therapy. PLOS ONE, 15(9):e0239120–e0239120.

Smith, M. B., Paulson, R. J. 2019. Endometrial preparation for third-party parenting and cryopreserved embryo transfer. Fertility and Sterility, 111(4):641–649.

Torelli, F., Padilla, C., Cavagnoli, M., Bonetti, T., Serafini, P., Motta, E. 2016. Intramuscular progesterone (IM-P4) administration is associated with better pregnancy rates in frozen-thawed blastocyst transfers, regardless of progesterone serum levels. Great clarendon st, oxford ox2 6dp. oxford univ press, 31:426–426.

Usadi, R. S., Groll, J. M., Lessey, B. A., Lininger, R. A., Zaino, R. J., Fritz, M. A., Young, S. L. 2008. Endometrial Development and Function in Experimentally Induced Luteal Phase Deficiency. The Journal of Clinical Endocrinology & Metabolism, 93(10):4058–4064.

Volovsky, M., Pakes, C., Rozen, G., Polyakov, A. 2020. Do serum progesterone levels on day of embryo transfer influence pregnancy outcomes in artificial frozen-thaw cycles? Journal of Assisted Reproduction and Genetics, 37(5):1129–1135.

Ye, J., Zhang, J., Gao, H., Zhu, Y., Wang, Y., Cai, R., Kuang, Y. 2020. Effect of Endometrial Thickness Change in Response to Progesterone Administration on Pregnancy Outcomes in Frozen-Thawed Embryo Transfer: Analysis of 4465 Cycles. Frontiers in Endocrinology, 11.

Young, S. L., Savaris, R. F., Lessey, B. A., Sharkey, A. M., Balthazar, U., Zaino, R. J., Sherwin, R. A., Fritz, M. A. 2017. Effect of randomized serum progesterone concentration on secretory endometrial histologic development and gene expression. Human Reproduction, 32(9):1903–1914.

Zhao, J., Zhang, Q., Li, Y. 2012. The effect of endometrial thickness and pattern measured by ultra- sonography on pregnancy outcomes during IVFET cycles. Reproductive Biology and Endocrinology, 10(1):100–100.

Zilberberg, E., Smith, R., Nayot, D., Haas, J., Meriano, J., Barzilay, E., Casper, R. F. 2020. Endometrial compaction before frozen euploid embryo transfer improves ongoing pregnancy rates. Fertility and Sterility, 113(5):990–995.

Authors

Dalal M. Al Jarrah
Manal Taha Al Obaidi
Itlal J. AL Asadi
Itlal.asadi@gmail.com (Primary Contact)
Dalal M. Al Jarrah, Manal Taha Al Obaidi, & Itlal J. AL Asadi. (2021). Endometrial compaction and serum progesterone measurements at the day of embryo transfer cannot predict pregnancy outcomes in frozen-thaw embryo transfer cycles. International Journal of Research in Pharmaceutical Sciences, 12(1), 407–415. Retrieved from https://ijrps.com/home/article/view/258

Article Details

No Related Submission Found