Related Experiment Video
Updated: Jul 31, 2025
Author Spotlight: Advancing Therapeutic Strategies for Improving Pregnancy Rates by Analyzing Embryo-Endometrium Interactions
Published on: June 21, 2024
Elevated serum progesterone levels before frozen embryo transfer do not negatively impact reproductive outcomes: a
Iñaki González-Foruria1, Sandra García2, Manuel Álvarez2
1Department of Obstetrics Gynecology and Reproductive Medicine, Dexeus University Hospital, Barcelona, Spain; Universitat de Vic - Universitat Central de Catalunya, Vic, Spain.
Objective:
To evaluate whether patients with high-serum progesterone levels before frozen embryo transfer (FET) under hormonal replacement therapy present with worse reproductive outcomes.
Design:
A cohort retrospective study.
Setting:
A university-affiliated fertility center.
Patient(S):
A total of 3,183 FET cycles in patients receiving hormonal replacement therapy between March 2009 and December 2020 were included. The luteal phase was covered with 200 mg per 8 hours of vaginal micronized progesterone either alone or in combination with a daily subcutaneous injection of 25 mg of progesterone. A total of 1,360 cycles corresponded to frozen homologous embryo transfer (ET) (hom-FET), 1,024 were euploid ET (eu-FET) after preimplantation genetic testing for aneuploidies, and 799 cycles were frozen heterologous ET (het-FET). All patients had adequate serum progesterone levels (≥10.6 ng/mL) before the procedure.
Intervention(S):
Frozen embryo transfer cycles.
Main Outcome Measure(S):
Clinical pregnancy, miscarriage, and live birth rates (LBRs).
Results:
Median (P25; P75) serum progesterone level before FET was 14.39 (12.43-17.49) ng/mL. Progesterone levels were significantly higher in the group under vaginal plus subcutaneous progesterone (15.96 [13.74-21.60] vs. 14.09 [12.19-16.95]). No differences in clinical pregnancy, miscarriage, and LBR were observed based on the use of vaginal or vaginal plus subcutaneous progesterone for each of the groups (hom-FET, eu-FET, and het-FET). Live birth rates were comparable among patients in the highest centile of serum progesterone levels (≥p90) (22.33 ng/mL) and the rest of the patients (p<90) (43.9% vs. 41.3%). Patients with progesterone levels ≥p90 presented lower body mass index than those in the lower centiles (
Conclusions:
Elevated serum progesterone levels before FET do not impair reproductive outcomes in patients receiving artificially prepared cycles with vaginal or vaginal plus subcutaneous progesterone.
