International Clinical and Medical Case Reports Journal (ISSN: 2832-5788) | Volume 4, Issue 6 | Research Article | Open Access DOI
Neha Joshi*
Neha Joshi, Daniel Barnett
Deputy Clinical lead, London Womens Clinic Darlington, United kingdom
*Correspondence to: Neha Joshi
Fulltext PDFProgesterone (P4) is a crucial hormone for implantation and pregnancy maintenance, particularly in frozen embryo transfer (FET) cycles. While previous research has identified a correlation between low progesterone levels and reduced pregnancy success, the optimal serum P4 threshold remains unclear. Additionally, the impact of additional progesterone in patients who had a previous failed FET cycle, is unclear. This study aims to assess the pregnancy outcomes of 2 different strategies for luteal phase support; adding additional subcutaneous progesterone (SP, Lubion, 25mg, qd) in patients below a P4 threshold of 30nmol/L on the day of embryo transfer (ET), and in patients with a previous failed FET cycle, regardless of progesterone level.
This observational study was conducted at the London Women’s Clinic, Infertility Centre in Darlington, UK, between January 2023 and December 2023. A total of 288 patients underwent FET with artificial endometrial preparation, using progesterone pessaries alone or in combination with injectable progesterone. Serum progesterone levels were measured on the day of embryo transfer, and additional supplementation was provided if levels were below 30 nmol/L. Patients who had a previous failed FET received additional SP commencing from 5 days prior to embryo transfer (ET). Patient characteristics, hormone levels, and pregnancy outcomes were analysed using multivariate logistic regression.
The findings indicate no significant association between progesterone blood levels at embryo transfer and pregnancy outcomes. Additionally, patients receiving supplemental SP had similar pregnancy rates to patients with P4>30nmol/L and patients who received SP due to a previous failed FET cycle. Additionally, though non-significant, there was an association between higher pregnancy rates and the use of Utrogestan pessaries compared to Cyclogest. These results signal that additional SP could be beneficial for patients with a previous failed FET cycle, however, further large-scale studies are warranted to investigate this.
Overall, this study contributes to the ongoing debate regarding luteal phase support strategies in FET cycles, highlighting the need for individualized hormone monitoring and supplementation strategies.
Neha Joshi, Daniel Barnett. Individualized Luteal Phase Support Strategies and their Effectiveness on Clinical Pregnancy Rate for Women Undergoing Frozen Embryo Transfer (FET) Cycle. Int Clinc Med Case Rep Jour. 2025;4(6):1-12.