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Detection of early placental hormone production in embryo transfer cycles lacking a corpus luteum

  • Assisted Reproduction Technologies
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Abstract

Purpose

This study sought to identify the initiation of placental hormonal production as defined by the production of endogenous estradiol (E2) and progesterone (P4) in a cohort of patients undergoing programmed endometrial preparation cycles with single embryo transfers resulting in live-born singletons.

Methods

In this retrospective cohort study, patients undergoing either programmed frozen-thawed embryo transfer (FET) with autologous oocytes or donor egg recipient (DER) cycles with fresh embryos were screened for inclusion. Only patients who underwent a single embryo transfer, had a single gestational sac, and a resultant live-born singleton were included. All patients were treated with E2 patches and intramuscular progesterone injections. Main outcome measures were serial E2 and P4, with median values calculated for cycle days 28 (baseline), or 4w0d gestational age (GA), through 60, or 8w4d GA. The baseline cycle day (CD) 28 median value was compared to each daily median cycle day value using the Wilcoxon signed rank test.

Results

A total of 696 patients, 569 using autologous oocytes in programmed FET cycles and 127 using fresh donor oocytes, from 4/2013 to 4/2019 met inclusion criteria. Serum E2 and P4 levels stayed consistent initially and then began to increase daily. Compared to baseline CD 28 E2 (415 pg/mL), the serum E2 was significantly elevated at 542 pg/mL (P < 0.001) beginning on CD 36 (5w1d GA). With respect to baseline CD 28 P4 (28.1 ng/mL), beginning on CD 48 (6w6d GA), the serum P4 was significantly elevated at 31.6 ng/mL (P < 0.001).

Conclusion

These results demonstrate that endogenous placental estradiol and progesterone production may occur by CD 36 and CD 48, respectively, earlier than traditionally thought.

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Data availability

Data is available upon request.

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Authors and Affiliations

  1. The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medical College, 1305 York Avenue 6th Floor, New York, NY, 10021, USA

    Robert Setton, Lilli D. Zimmerman, Zev Rosenwaks & Steven D. Spandorfer

  2. Department of Obstetrics and Gynecology, Weill Cornell Medical College, 1300 York Avenue, New York, NY, 10021, USA

    Kelly McCarter

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  1. Robert Setton
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  2. Kelly McCarter
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  3. Lilli D. Zimmerman
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  4. Zev Rosenwaks
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  5. Steven D. Spandorfer
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Correspondence to Steven D. Spandorfer.

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Poster Presentation at the 2019 Annual Meeting, American Society of Reproductive Medicine, Philadelphia, Pennsylvania, October 12 to 16, 2019

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Setton, R., McCarter, K., Zimmerman, L.D. et al. Detection of early placental hormone production in embryo transfer cycles lacking a corpus luteum. J Assist Reprod Genet 38, 413–419 (2021). https://doi.org/10.1007/s10815-020-02049-1

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  • DOI: https://doi.org/10.1007/s10815-020-02049-1

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