Progesterone and estrogen levels are associated with live birth rates following artificial cycle frozen embryo transfers

PurposeDoes an association exist between serum progesterone and estradiol levels and live birth rates in artificial cycle frozen embryo transfer (AC-FET)?Methods Retrospective cohort study was based on prospectively collected data at a university-affiliated fertility center. Included were all cycles using an artificial endometrial preparation with estradiol hemihydrate (Estrofem, 2 mg/8 h) and vaginal progesterone (Endometrin 100 mg/8 h), autologous oocytes, and cleavage stage embryo transfers. Serum progesterone and estradiol levels were measured 14 days after FET. A total of 921 cycles in 568 patients from to December 2010 to June 2019 were investigated. Live birth was the primary outcome measure.ResultsSignificant association was found between live birth and progesterone as well as estradiol levels (progesterone 14.65 vs 11.62 ng/ml, p=0.001; estradiol 355.12 vs 287.67 pg/ml, p=0.001). A significant difference in live birth rate was found below and above the median progesterone level (10.9 ng/ml, p=0.007). Lower estradiol level was significantly associated with lower live birth rate (<188.2 pg/ml 8.3%,>263.1 pg/ml 16%, p=0.02).ConclusionsSerum progesterone and estradiol levels impact live birth rate in AC-FET.

Automated summary

This study found a significant association between serum progesterone and estradiol levels and live birth rates in AC-FET. Lower levels of progesterone and estradiol were associated with lower live birth rates. The findings suggest that monitoring and potentially adjusting these hormone levels may improve outcomes in artificial cycle frozen embryo transfer.