Predicted luteal phase length has no influence on success of vitrified-warmed blastocyst transfer in natural cycle

M Reljič,J Knez

doi:10.1186/s13048-018-0436-6

Abstract

BackgroundThis study evaluated the influence of menstrual cycle length, menstrual cycle variability and predicted luteal phase length on the success of vitrified-warmed blastocyst transfer in natural menstrual cycle using progesterone for luteal phase supplementation.MethodsConsecutive women undergoing vitrified-warmed blastocyst transfer in natural menstrual cycle between January 2013 and December 2015 were included in this retrospective study. Patients’ characteristics, clinical data and data about menstrual cycle length in the last year were collected from our database. Predicted luteal phase length (LPL) was defined as the period starting at ovulation (one day after positive urinary LH test) and ending on the last day before predicted menses, based on women’s usual, minimal and maximal menstrual cycle length data. Logistic regression was used to identify the predictors significantly associated with live-birth.ResultsA total of 1195 FETs (frozen-thawed embryo transfers) resulted in 457 (38.24%) clinical pregnancies, 82 (17.94%), miscarriages and 371 live births (31.04%). There were no statistically significant differences in menstrual cycle length, menstrual cycle variability, day of LH surge, day of FET and predicted LPL between FET cycles resulting in live birth and those not resulting in live birth. In the multivariate logistic regression model, only women’s age (OR 0.93, 95% CI: 0.90–0.96), transfer of morphologically optimal blastocysts (OR 2.17, 95% CI: 1.59–2.94) and endometrium thickness (OR 1.10, 95% CI: 1.03–1.17) were important independent prognostic factors for live birth.ConclusionMenstrual cycle length, menstrual cycle variability and predicted LPL do not seem to be an important factor influencing live birth after FET in natural cycles with progesterone supplementation. Results of our study suggest that FET should not be cancelled if LH surge is detected before or after the predicted period in natural cycle with progesterone supplementation.

Highlights

This study evaluated the influence of menstrual cycle length, menstrual cycle variability and predicted luteal phase length on the success of vitrified-warmed blastocyst transfer in natural menstrual cycle using progesterone for luteal phase supplementation
All women undergoing vitrified-warmed blastocyst transfer performed in natural cycle between 2013 and 2015 at the Department for Reproductive medicine and Gynecological Endocrinology, University Medical Centre Maribor were included in this retrospective study
Women in cycles resulting in live birth were statistically significantly younger (33.20 ± 3.97 vs 34.46 ± 4.14 years, p < 0.001), had less previous unsuccessful IVF/ICSI attempts (1.68 ± 1.35 vs 1.87 ± 1.43, p = 0.03), thicker endometrium on the day of frozen-thawed embryos (FET) (10.38 ± 2.34 vs 9.95 ± 2.17 mm, p = 0.004), higher proportion of transferred blastocysts vitrified on day 5 (71.70% vs 64.56%, p = 0.015) and higher proportion of FET of optimal blastocysts (38.27% vs 20.14% p < 0.001) compared to women in cycles not resulting in live birth

Summary

Introduction

This study evaluated the influence of menstrual cycle length, menstrual cycle variability and predicted luteal phase length on the success of vitrified-warmed blastocyst transfer in natural menstrual cycle using progesterone for luteal phase supplementation. The transfer of frozen-thawed embryos (FET) has become an integral part of successful in vitro fertilization programs. With advances in cryopreservation techniques, this approach offers several important benefits to the patients, which include improved safety of the treatment and higher cumulative success rates. A receptive endometrium is a prerequisite for successful implantation and several protocols for endometrium. There is currently no data available showing a possible role of luteal phase length on the success of FET.

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