Serum Progesterone Level on the Day of Embryo Transfer Is Not a Reliable Predictor for Frozen–Thawed Embryo Transfer Outcomes With Euploid Blastocyst Transfer: A Retrospective Cohort Study

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OBJECTIVE: To investigate whether serum progesterone (P4) levels on embryo transfer (ET) day correlate with the likelihood of live birth in artificial frozen-thawed transfer cycles using intramuscular progesterone. DESIGN: Retrospective cohort study. SETTING: University-affiliated hospital. POPULATION: Patients undergoing single euploid blastocyst transfer after preimplantation genetic testing. METHODS: Live birth rate (LBR) was calculated in each percentile of serum P4 to detect a threshold associated with an increased probability of LB. The association between serum P4 and pregnancy outcomes was evaluated using multivariable logistic regression analysis. MAIN OUTCOME MEASURES: LBR was the primary outcome. Secondary outcomes included clinical pregnancy rate (CPR) and early pregnancy loss (EPL) rate. RESULTS: In total, 761 patients were included, and the overall LBR was 55.72%. For LBR, each percentile group of serum P4 did not significantly differ. The distributions of P4 were comparable between the LB and non-LB groups, with an average of 12.62 ± 4.05 and 12.84 ± 4.39 ng/mL, respectively. The multivariate analysis revealed that serum P4 did not affect the LBR, whereas the day of the blastocyst (D5 vs. D6: adjusted odds ratio [aOR] 2.15, 95% confidence interval [CI] 1.52-3.03) and embryo quality (good vs. viable embryo: aOR 1.88, 95% CI 1.37-2.58) were independently associated with LBR. Similarly, serum P4 was not associated with CPR and EPL rates. CONCLUSIONS: Serum P4 levels on ET day do not predict LBR in artificial cycles with intramuscular progesterone.

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