Luteal Faz Desteğinde Günlük Intramuskuler Progesteron İlavesi Donma-Çözme Embriyo Transferi Sikluslarında Canlı Doğum Oranlarını Artırmaz

Abstract

Bu retrospektif kohort çalışması, programlanmış dondurulmuş-çözünmüş embriyo transfer (FET) döngülerinde luteal faz desteğinde intramuskuler progesteron eklenmesinin canlı doğum oranlarını arttırıp arttırmadığını araştırmayı amaçlar. Çalışma, Ocak 2014 ile Ocak 2021 arasında üçüncü basamak bir üniversite hastanesinde yardımcı üreme teknolojisi (ART) merkezinde yapıldı. Çalışmaya, teki 5.-6. gün dondurulmuş-çözünmüş blastokist embriyo transferi yapılan 604 infertil hasta dahil edildi. Tüm hastalara luteal faz desteği için ya %8 mikronize vajinal jel ya da vajinal progesteron kapsülleri verildi. İntramusküler progesteron, tüp bebek uzmanının tercihine bağlı olarak vajinal progesterona eklendi. Luteal faz desteği (LPS), dondurulmuş-çözünmüş döngülerde transferden 6 gün önce başlatıldı ve birinci trimesterin sonuna kadar devam etti. Sikluslar, vajinal progesteron tiplerine (8% jel vs. kapsül) ve intramusküler progesteronun varlığına bağlı olarak karşılaştırıldı. Birincil sonuç canlı doğum oranıydı. %8 mikronize progesteron veya progesteron kapsülleri kullanımı canlı doğum oranlarını değiştirmedi (sırasıyla %24 ve %25,9). Ana sonuç olarak, sadece vajinal progesteron yerine vajinal progesteronla birlikte intramusküler progesteron desteği, canlı doğum sonuçlarını iyileştirmedi (%22'ye karşılık %24). Sonuç olarak, bu çalışma rutin olarak verilen intra musküler progesteronun, vajinal progesteronla birlikte verilmesinin ART sonuçlarını iyileştirmediğini göstermektedir. Bu kombinasyon, luteal fazı monitorize edilmiş olan seçili bir popülasyonda faydalı olabilir. Herhangi bir vajinal progesteron formunun tek başına LPS için yeterli olduğu sonucuna varılmıştır.

Keywords

• Luteal Faz Desteği
• İnfertilite
• İntramuskuler Progesteron
• Vajinal Progesteron
• İntrasitoplazmik sperm injeksiyonu

Additional Daily Intramuscular Progesterone for Luteal Phase Support does not Improve Live Birth Rates of Programmed Frozen-Thawed Embryo Transfer Cycles

Abstract

This retrospective cohort study aims to investigate whether additional daily intramuscular progesterone (IMP) for luteal phase support improves live birth rates of programmed frozen-thawed embryo transfer (FET) cycles. The study was conducted at a tertiary level university hospital assisted reproductive technology (ART) center between January 2014 and Jan 2021. Six hundred four infertile patients with single-day 5-6 frozen-thawed blastocyst embryo transfer were enrolled in the study. All patients received either 8% micronized vaginal gel or vaginal progesterone capsules for luteal phase support. Intramuscular progesterone was added to vaginal progesterone depending on the in vitro fertilization (IVF) specialist’s choice. Luteal phase support (LPS) was started 6 days before transfer in frozen-thawed cycles and continued until the end of the first trimester. Cycles were compared depending on vaginal progesterone types (8% gel vs. capsule) and the presence of intramuscular progesterone. The primary outcome was the live birth rate. A total of 604 FET cycles were enrolled. Using 8% micronized progesterone or progesterone capsules did not change the live birth rates (24% vs. 25.9%). As the main result, intramuscular progesterone support with vaginal progesterone compared with only vaginal progesterone did not improve the live birth results (22% vs. 24%). In conclusion, this study demonstrated that routine IMP progesterone given in combination with vaginal progesterone does not improve ART outcomes. This combination may be beneficial in a selective population with a monitored luteal phase. Using any form of vaginal progesterone alone is adequate for LPS.

Keywords

• Luteal Phase Support
• intramuscular progesterone
• infertility
• vaginal progesterone
• intra-cytoplasmic sperm injection

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