Progesterone Hypersensitivity: A Challenge for Luteal Support

Area of Science:

• Reproductive Endocrinology
• Infertility Management

Background:

• Progesterone hypersensitivity is a rare condition impacting fertility treatments.
• Exogenous progesterone is commonly used for endometrial preparation in frozen embryo transfer (FET).

Observation:

• A 27-year-old female with endometriosis and PCOS experienced hypersensitivity to exogenous progesterone during FET preparation.
• Standard artificial cycles for endometrial preparation failed due to the hypersensitivity reaction.

Findings:

• A Modified Natural Cycle (MNC) was successfully employed, utilizing endogenous progesterone from the corpus luteum for endometrial preparation.
• Ovulation induction with tamoxifen and human menopausal gonadotropin, followed by hCG trigger, facilitated natural progesterone production.

Implications:

• Endogenous progesterone offers a viable alternative for endometrial preparation in patients with exogenous progesterone hypersensitivity.
• This approach enables successful FET cycles in challenging infertility cases.
• Highlights the importance of personalized treatment strategies in assisted reproductive technologies.