The importance of progesterone during pregnancy – and to aid in implantation in the days before a confirmed pregnancy – is well known, but what if we could establish a causal relationship between progesterone levels and success rates in reproductive treatment? Making that link was the starting point of an IVI study entitled, “A large prospective trial in unselected population confirms that low serum progesterone on the day of embryo transfer impairs pregnancy outcome in artificial cycles,” presented by Dr. Elena Labarta, an IVI gynecologist, during the 35th European Society of Human Reproduction and Embryology (ESHRE) conference taking place in Vienna, Austria.
“During the last 3 years, we have been investigating the impact of progesterone values taken on embryo transfer day on pregnancy rates in artificial endometrial preparation cycles. Until now, based on the studies carried out by other groups, it was believed that taking a progesterone measurement was not useful because it would not reflect the progesterone level in the uterus and that the administered progesterone dose given to patients was more than enough to meet the needs of any patient. However, our discoveries have proven that serum progesterone levels are indeed associated with pregnancy outcomes. We carried out the first two prospective studies on the matter, which in total include 1,400 patients, and found that there is a progesterone level below which ongoing pregnancy rates may drop up to 20%, a drastic decline in reproductive treatment success rates”, said Dr. Labarta.
The data also pointed to a progesterone cut-off value, below which results are significantly worse. Patients with serum progesterone levels lower than 8.8 ng/ml on embryo transfer day display an 18% lower ongoing pregnancy rate. These results suggest that the absorption of vaginal progesterone may vary among patients, influencing the marker in the achieved results.
This study, which collected data from nearly 1,200 patients, has piqued great interest among the scientific community, and has been presented at various forums and conferences around the world due to the impact it has on the future of reproductive medicine.
In 2017, a research group headed by Dr. Labarta published the first prospective study on this topic, carrying out pioneering work to show that there are serum progesterone threshold levels on embryo transfer day, below which ongoing pregnancy rates decreases dramatically.
“Those findings caused us to invest further in this topic. We have seen progesterone levels be predictive of outcomes not only if measured on embryo transfer day, but also over the course of the luteal phase (from the day the embryo gets implanted until the day the pregnancy test is taken). We are also discovering ways to treat patients with sub-optimal progesterone levels, and the results are truly encouraging, as we have seen that the situation can be reversed if detected in time. These are all important findings that help us in our constant search for the best possible reproductive results,” Dr. Labarta said.
In addition to Dr. Labarta, Dr. Ernesto Bosch, medical director of IVI Valencia, and Dr. Nicolás Garrido, IVI Foundation’s director, also presented their research at ESHRE.
Dr. Bosch presented the main lines of research regarding managing Ovarian Hyperstimulation Syndrome (OHSS) in accordance with ESHRE guidelines, and participated as the only Spanish member of a team which has been defining the guideline on ovarian stimulation over the last two years.
Dr. Garrido spoke about sperm selection techniques and criteria as a way to enhance reproductive success, with a special focus on smart sperm selection methods based on molecular features. These procedures would complement or replace the existing ones, which are autonomously done by the sperm cells or subjectively decided by the operator. They would ultimately improve clinical results by selecting and using the most suitable sperm cell among millions.
Finally, Dr. Roberto Matorras of IVI Bilbao addressed ESHRE’s recommendations of good clinical practice for follicular puncture.
ESHRE is Europe’s biggest meeting for the human reproduction industry, serving as a hub for the world’s leading professionals to reach meaningful conclusions that will define the future of the reproductive medicine field.
IVI doctors, scientists and researchers submitted a total of 49 pieces of research to this year’s conference – 14 oral presentations, 31 posters and 4 papers.
About IVI – RMANJ
IVI was set up in 1990 as the first medical institution in Spain to specialize exclusively in human reproduction. Since then it has helped create more than 160,000 babies, thanks to its use of the latest Assisted Reproduction technologies. In 2017, IVI merged with RMANJ to become the largest Assisted Reproduction group in the world. It currently has more than 65 clinics in 11 countries and is a leader in Reproductive Medicine. https://ivi.es/ – http://www.rmanj.com/