Can the pregnancy outcome be improved by incrementing progesterone supplementation on the day of embryo transfer in women undergoing fresh and frozen embryo transfer cycles?

Abstract

Context: Luteal phase defect has been identified in all assisted reproductive technology cycles, necessitating optimal progesterone levels during the window of implantation (WOI) to improve reproductive outcomes. Aims: The aim of this study was to determine if incrementing progesterone supplementation based on the levels of serum progesterone(P) measured on the day of embryo transfer (ET) has an impact on the pregnancy outcome in fresh and frozen ET cycles. Settings and Design: A total of 220 women undergoing fresh and frozen ET were prospectively enrolled and received standard luteal phase support, an increment in P supplementation made if serum P levels were less than 15 ng/mL. Materials and Methods: Serum progesterone levels were assessed for all the patients on the day of ET. Patients undergoing fresh and frozen ETs were divided into two groups based on serum progesterone levels on the day of ET. If serum progesterone levels were found to be less than 15 ng/mL on the day of ET, the dose of progesterone supplementation was incremented. A correlation between the groups with serum progesterone less than and more than 15 ng/mL on the day of ET with the pregnancy outcome was then made. Results: No statistically significant difference was observed in the clinical pregnancy rate and biochemical pregnancies in the groups with serum progesterone levels less than or more than 15 ng/mL on the day of ET when an increment in the progesterone supplementation was performed (both fresh, P = 0.35 and frozen cycles, P = 0.056). Statistical Analysis Used: Chi-square test was used for qualitative analysis, and the Student’s t test was used for comparison of means. Conclusions: Measuring serum progesterone levels on the day of ET and incrementing P supplementation if serum levels of progesterone are less than 15 ng/mL to obtain optimal progesterone levels during the WOI in both fresh and frozen ET cycles might help in improving our pregnancy outcomes.