The role of hormonal monitoring versus ultrasound only in predicting pregnancy in patients programmed thawed embryo transfer cycles
Role of hormonal monitoring versus ultrasound only in predicting pregnancy in patients programmed thawed embryo transfer cycles
Background: Hormonal monitoring impact on overall pregnancy rate in FET cycles and hence progesterone supplement adjustments remain debatable in current literature.
Objective: In this study we investigated the effect of monitoring and follow-up of serumprogesterone, estradiol & luteinizing hormone levels and progesterone supplement adjustments on pregnancy outcomes for FET in programmed HRT cycles in comparison with ultrasound only in control group.
Methods: Six Hundred FETs were performed in a prospective manner in an infertility center in Alexandria starting from 2019 till 2021 These were further subdivided based on computer randomization into 2 groups.Group I (Control) including300 patients with only ultrasound monitoring &Group II (Cases) including 300 patients with monitoring of serum level of progesterone, estrogen & luteinizing hormone as well as progesterone supplement adjustments which are further subdivided into three groups depending on progesterone level in patient’s serum early in the morning prior to embryo transfer. Group II A: P4 levels < 5ng/dl, Group II B: P4 levels 5-10ng/dl, Group II C: P4 levels >10ng. The primary outcomes were clinical and ongoing pregnancy rate.
Results: Live birth and overall pregnancy rate showed no significant difference among group monitored with ultrasound only compared to the hormonal monitored group. However,on the day of embryo transfer, serum P4 > 11.83 ng/ml represented a cut-off value above which there is marked increase in OPR/LBR and a sensitivity of 53.7% & specificity of 51.2% in predicting pregnancy. Also, serum E2 value more than 292 pg/ml at day 18 demonstrated an increase in OPR/LBR
Conclusion: Monitoring and follow-up of different hormones in patient’s serum in programmed frozen embryo transfer cycles didn’t have an impact on live birth, overall pregnancy & abortion rate when compared to ultrasound only in control group.