Serum Progesterone Level on the Day of Embryo Transfer and Clinical Pregnancy Rate in Patients Undergoing Down-Regulated Frozen Embryo Transfer Cycles; Prospective Observational Study

Abstract Background Serum Progesterone concentration <5 ng/ml on the day of frozen embryo transfer (FET) is associated with significantly decreased pregnancy and live birth rates. Aim of the Work This study aims at finding the critical cutoff value of serum progesterone on day of FET that significantly affects pregnancy rates. Patients and Methods The current study was conducted at Ain Shams University Maternity Hospital- IVF Unit during the period between April 2022 and December 2022. It included a total number of 108 patients who either were assessed for eligibility of the study, of which, 14 were excluded due to non-matching inclusion criteria or had exclusion criteria. 4 patients did not consent to participate in the study and 86 patients matched. They were preaped for frozen emberyo transfer according to IVF unit protocol at Ain Shams university and serum progesterone level on day of emberyo transfer was assessed and matched to clinical pregnancy rate. Results Progesterone on day of embryo transfer was significantly lower in cases with positive chemical pregnancy with a cut off value ≤39.2 ng/mL. Conclusion Progesterone is essential for establishing and maintaining embryo implantation and pregnancy; also, P4 is used for luteal phase deficiency in infertility treatment. Yet, progesterone therapy’s optimal timing and dose can influence the impact of P4 on pregnancy. Also, low or elevated P4 level can negatively impact embryo transfer timing and pregnancy rate. This study demonstrated that age, BMI and progesterone on day of embryo transfer had significant low diagnostic performance in predicting positive chemical pregnancy This study illustrated that no statistical significant difference according to chemical pregnancy regarding hormonal profile Before the start of estradiol valerate. Progesterone on day of embryo transfer was significantly lower in cases with positive chemical pregnancy.