Serum progesterone level as a predictor of pregnancy in frozen embryo transfer

Background: Aim of the study was to know the effect of serum progesterone (P4) level on pregnancy rate in frozen embryo transfer. The retrospective observational study was conducted in Institute of Reproductive Medicine, Madras Medical Mission Hospital, Chennai. Methods: 126 patients underwent frozen embryo transfer with hormone replacement treatment using oral estradiol valerate and intramuscular progesterone beyond 7 mm of endometrial thickness were started on IM micronized progesterone 100 mg once a day till p+4. Morula transfer was done with at least one good-quality embryo. Serum progesterone level was measured one day before embryo transfer at our institute by chemiluminescence immunoassay. Adequate luteal support was given. Results: The receiver operating curve (ROC) cut off showed serum progesterone level of 20.6 ng/ml had a sensitivity of 71.7% and specificity of 56.5%. Overall pregnancy rate was 50.7%. Live birth rate was significantly more in P4 >20.6 ng/ml. Conclusions: In conclusion, the results of our study conclude that Progesterone level before embryo transfer day is an important prognostic factor for pregnancy outcome. According to this study, serum progesterone level >20.6 ng/ml one day before embryo transfer can be a good predictor of pregnancy in morula transfer. Further studies on a large scale on morula transfer are needed to modulate individualized treatment for patients for a successful pregnancy outcome.