| BackgroundIn vitro fertilization-embryo transfer(IVF-ET)technology has become one of the main methods for infertile patients to get a successful pregnancy.With the rapid development of vitrification and embryo culture technology,infertile patients who are not suitable for fresh embryo transfer have a better option.Frozen embryo transfer(FET)is an important derivative technology of IVF-ET,which is widely used in clinic for its advantages of increasing cumulative pregnancy rate and avoiding ovarian hyperstimulation.Endometrial preparation is required for FET pregnancy aid treatment,which can be divided into natural cycle,replacement cycle and ovulation induction cycle transplantation according to different methods.There is no significant difference in clinical pregnancy effect.In the natural cycle endometrial preparation scheme transplantation,patients have the support of various endogenous hormones provided by the luteum formed by themselves,and the endometrial situation and blood hormone levels are more close to the female physiological state,which is suitable for infertile women with regular menstruation and ovulation indicated by previous monitoring.The basis of embryo implantation and development requires appropriate endometrial receptivity,and the sustained role of appropriate levels of progesterone in endometrial implantation preparation and regulation of trophoblast invasion and migration is crucial.It is not clear whether the level of serum Progesterone(P)during ovulation can affect pregnancy outcome.Therefore,this study adopted a retrospective analysis to explore the influence of serum P level on pregnancy outcome in patients with natural cycle FET on ovulation day.ObjectiveTo investigate the relationship between the levels of progesterone on ovulation day and pregnancy outcomes of natural cycle FET.MethodsClinical data of 417 patients with natural cycle FET from April 2017 to October 2021 in The Affiliated Reproductive Hospital of Shandong University were retrospectively analyzed.According to the serum P level on ovulation day,the patients were divided into group A(low P group,P<1.2ng/mL)and group B(high P group,P≥1.2ng/mL),and the general situation and pregnancy outcomes of the two groups were compared.Taking pregnancy outcome as the dependent variable,logistic regression model was used to analyze the related factors.ResultsBMI and E2/P on ovulation day in group A were significantly higher than those in group B(all P<0.05),but there were no significant differences in age,endometrial thickness on ovulation day,number of frozen embryos in fresh embryo cycle and E2 on ovulation day between the two groups(P>0.05).The biochemical pregnancy rate of group A was significantly lower than that of group B(53.51%vs 66.95%,P=0.012),and the clinical pregnancy rate was significantly lower than that of group B(45.15%vs55.93%,P=0.047),with statistical significance.The abortion rate of group A was higher than that of group B(22.96%vs 21.21%,P=0.780),and the early abortion rate was higher than that of group B(18.52%vsl5.15%,P=0.554),but the differences were not statistically significant.The late abortion rate in group A was lower than that in group B(4.44%vs 6.06%,P=0.621),the live birth rate was lower than that in group B(34.78%vs44.07%,P=0.078),and the premature birth rate was lower than that in group B(5.19%vs7.58%,P=0.502),but the differences were not statistically significant.Logistic regression showed high P level on ovulation day(aOR=1.627,95%CI:1.040-2.546;P=0.033),female age(aOR=0.933,95%CI:0.890-0.977;P=0.003),intrauterine thickness on ovulation day(aOR=14.417,95%CI:4.080-50.946;P<0.001)were independent influencing factors of clinical pregnancy.ConclusionThe serum P level on ovulation day in natural cycle FET can predict clinical pregnancy outcomes.The serum P level on ovulation day,the female age and endometrial thickness on ovulation day are independent factors affecting the clinical pregnancy,so paying attention to P level is beneficial to improve the pregnancy rate of natural cycle FET. |
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