Women utilizing oocyte donation have a decreased live birth rate if they displayed a low progesterone level in a previous hormonal replacement mock cycle

Abstract

Purpose

Is serum progesterone(P) level on day 2 of vaginal P administration in a hormonally substituted mock cycle predictive of live birth in oocyte donation(OD)?

Methods

Retrospective analysis of 110 mock cycles from 2008 to 2016 of OD recipients having at least one subsequent embryo transfer (ET). Endometrial preparation consisted of sequential administration of vaginal estradiol, followed by transdermal estradiol and 600 mg/day vaginal micronized P. In mock cycles, serum P was measured 2 days after vaginal P introduction. OD was performed 1 to 3 years later, without P measurement.

Results

In mock cycles, mean serum P level on day 2 was 12.8 ± 4.5 ng/mL (range: 4–28 ng/mL). A total of 32% patients had P < 10 ng/mL. At the time of first OD, age of recipients and donors, number of retrieved and attributed oocytes, and number of transferred embryos were comparable between patients with P < 10 ng/mL in their mock cycles compared with P ≥ 10 ng/mL. Pregnancy and live birth rate after first ET were significantly lower for patients with P < 10ng/mL (9% vs. 35 %; P = 0.002 and 9% vs. 32%; P = 0.008, respectively). Considering both fresh and subsequent frozen-thawed ET, cumulative live birth rate per-patient and per-transfer were significantly lower in patients with P < 10 ng/mL in their mock cycle (14% vs. 35%; P = 0.02 and 11% vs. 27%; P = 0.03).

Conclusion

A low P level in hormonally substituted cycles several years before ET performed with the same endometrial preparation is associated with a significantly lower chance of live birth. This suggests that altered vaginal P absorption is a permanent phenomenon. Monitoring serum P in hormonally substituted cycles appears mandatory to adjust luteal P substitution.

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Data availability

All data are available on reasonable request.

Abbreviations

0D:

oocyte donation

LBR:

live birth rate

HRT:

hormonal replacement therapy

E2:

estogen

P:

progesterone

OPR:

ongoing pregnancy rate

FET:

frozen embryo transfer

ICSI:

intracytoplasmic sperm injection

SD:

standard deviation

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Correspondence to Isabelle Cedrin-Durnerin.

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Labrosse, J., Peigné, M., Eustache, F. et al. Women utilizing oocyte donation have a decreased live birth rate if they displayed a low progesterone level in a previous hormonal replacement mock cycle. J Assist Reprod Genet 38, 605–612 (2021). https://doi.org/10.1007/s10815-020-02059-z

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Keywords

  • Serum progesterone level
  • Vaginal progesterone administration
  • Mock cycle
  • Hormone replacement therapy
  • Oocyte donation
  • Live birth