{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T05:11:51Z","timestamp":1789621911161,"version":"build-2803163510"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2020,12,19]],"date-time":"2020-12-19T00:00:00Z","timestamp":1608336000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,2,18]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>STUDY QUESTION<\/jats:title>\n                  <jats:p>Is there a serum progesterone (P) threshold on the day of embryo transfer (ET) in artificial endometrium preparation cycles below which the chances of ongoing pregnancy are reduced?<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>SUMMARY ANSWER<\/jats:title>\n                  <jats:p>Serum P levels &amp;lt;8.8\u2009ng\/ml on the day of ET lower ongoing pregnancy rate (OPR) in both own or donated oocyte cycles.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>WHAT IS KNOWN ALREADY<\/jats:title>\n                  <jats:p>We previously found that serum P levels &amp;lt;9.2\u2009ng\/ml on the day of ET significantly decrease OPR in a sample of 211 oocyte donation recipients. Here, we assessed whether these results are applicable to all infertile patients under an artificial endometrial preparation cycle, regardless of the oocyte origin.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>STUDY DESIGN, SIZE, DURATION<\/jats:title>\n                  <jats:p>This prospective cohort study was performed between September 2017 and November 2018 and enrolled 1205 patients scheduled for ET after an artificial endometrial preparation cycle with estradiol valerate and micronized vaginal P (MVP, 400\u2009mg twice daily).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>PARTICIPANTS\/MATERIALS, SETTING, METHODS<\/jats:title>\n                  <jats:p>Patients \u226450\u2009years old with a triple-layer endometrium \u22656.5\u2009mm underwent transfer of one or two blastocysts. A total of 1150 patients treated with own oocytes without preimplantation genetic testing for aneuploidies (PGT-A) (n\u2009=\u2009184), own oocytes with PGT-A (n\u2009=\u2009308) or donated oocytes (n\u2009=\u2009658) were analyzed. The primary endpoint was the OPR beyond pregnancy week 12 based on serum P levels measured immediately before ET.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>MAIN RESULTS AND THE ROLE OF CHANCE<\/jats:title>\n                  <jats:p>Women with serum P levels &amp;lt;8.8\u2009ng\/ml (30th percentile) had a significantly lower OPR (36.6% vs 54.4%) and live birth rate (35.5% vs 52.0%) than the rest of the patients. Multivariate logistic regression showed that serum P\u2009&amp;lt;\u20098.8\u2009ng\/ml was an independent factor influencing OPR in the overall population and in the three treatment groups. A significant negative correlation was observed between serum P levels and BMI, weight and time between the last P dose and blood tests and a positive correlation was found with age, height and number of days on HRT. Multivariate logistic regression showed that only body weight was an independent factor for presenting serum P levels &amp;lt;8.8\u2009ng\/ml. Obstetrical and perinatal outcomes did not differ in patients with ongoing pregnancy regardless of serum P levels being above\/below 8.8\u2009ng\/ml.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>LIMITATIONS, REASONS FOR CAUTION<\/jats:title>\n                  <jats:p>Only women with MVP were included. Extrapolation to other P administration forms needs to be validated.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>WIDER IMPLICATIONS OF THE FINDINGS<\/jats:title>\n                  <jats:p>This study identified the threshold of serum P as 8.8\u2009ng\/ml on the day of ET for artificial endometrial preparation cycles necessary to optimize outcomes, in cycles with own or donated oocytes. One-third of patients receiving MVP show inadequate levels of serum P that, in turn, impact the success of the ART cycle. Monitoring P levels in the mid-luteal phase is recommended when using MVP to adjust the doses according to the needs of the patient.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>STUDY FUNDING\/COMPETING INTEREST(S)<\/jats:title>\n                  <jats:p>None.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>TRIAL REGISTRATION NUMBER<\/jats:title>\n                  <jats:p>NCT03272412.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/humrep\/deaa322","type":"journal-article","created":{"date-parts":[[2020,10,30]],"date-time":"2020-10-30T04:22:10Z","timestamp":1604031730000},"page":"683-692","source":"Crossref","is-referenced-by-count":136,"title":["Impact of low serum progesterone levels on the day of embryo transfer on pregnancy outcome: a prospective cohort study in artificial cycles with vaginal progesterone"],"prefix":"10.1093","volume":"36","author":[{"given":"Elena","family":"Labarta","sequence":"first","affiliation":[{"name":"Human Reproduction Department, IVI RMA Valencia, Valencia 46015, Spain"},{"name":"IVI Foundation, Health Research Institute La Fe, Valencia 46026, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Mariani","sequence":"additional","affiliation":[{"name":"Human Reproduction Department, IVI RMA Valencia, Valencia 46015, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefania","family":"Paolelli","sequence":"additional","affiliation":[{"name":"Human Reproduction Department, IVI RMA Valencia, Valencia 46015, Spain"},{"name":"IVI Foundation, Health Research Institute La Fe, Valencia 46026, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Rodriguez-Varela","sequence":"additional","affiliation":[{"name":"IVI Foundation, Health Research Institute La Fe, Valencia 46026, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmina","family":"Vidal","sequence":"additional","affiliation":[{"name":"Human Reproduction Department, IVI RMA Valencia, Valencia 46015, Spain"},{"name":"IVI Foundation, Health Research Institute La Fe, Valencia 46026, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan","family":"Giles","sequence":"additional","affiliation":[{"name":"Human Reproduction Department, IVI RMA Valencia, Valencia 46015, Spain"},{"name":"IVI Foundation, Health Research Institute La Fe, Valencia 46026, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9","family":"Bellver","sequence":"additional","affiliation":[{"name":"Human Reproduction Department, IVI RMA Valencia, Valencia 46015, Spain"},{"name":"IVI Foundation, Health Research Institute La Fe, Valencia 46026, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio","family":"Cruz","sequence":"additional","affiliation":[{"name":"Human Reproduction Department, IVI RMA Valencia, Valencia 46015, Spain"},{"name":"IVI Foundation, Health Research Institute La Fe, Valencia 46026, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alicia","family":"Marzal","sequence":"additional","affiliation":[{"name":"Human Reproduction Department, IVI RMA Valencia, Valencia 46015, Spain"},{"name":"IVI Foundation, Health Research Institute La Fe, Valencia 46026, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula","family":"Celada","sequence":"additional","affiliation":[{"name":"Human Reproduction Department, IVI RMA Valencia, Valencia 46015, Spain"},{"name":"IVI Foundation, Health Research Institute La Fe, Valencia 46026, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ines","family":"Olmo","sequence":"additional","affiliation":[{"name":"Human Reproduction Department, IVI RMA Valencia, Valencia 46015, Spain"},{"name":"IVI Foundation, Health Research Institute La Fe, Valencia 46026, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pilar","family":"Alam\u00e1","sequence":"additional","affiliation":[{"name":"Human Reproduction Department, IVI RMA Valencia, Valencia 46015, Spain"},{"name":"IVI Foundation, Health Research Institute La Fe, Valencia 46026, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9","family":"Remohi","sequence":"additional","affiliation":[{"name":"Human Reproduction Department, IVI RMA Valencia, Valencia 46015, Spain"},{"name":"IVI Foundation, Health Research Institute La Fe, Valencia 46026, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ernesto","family":"Bosch","sequence":"additional","affiliation":[{"name":"Human Reproduction Department, IVI RMA Valencia, Valencia 46015, Spain"},{"name":"IVI Foundation, Health Research Institute La Fe, Valencia 46026, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,12,19]]},"reference":[{"key":"2021021818581536300_deaa322-B1","doi-asserted-by":"crossref","first-page":"2045","DOI":"10.1007\/s10815-020-01851-1","article-title":"Serum progesterone levels on day of embryo transfer in frozen embryo transfer cycles - the truth lies in the detail","volume":"37","author":"Alsbjerg","year":"2020","journal-title":"J Assist Reprod Genet"},{"key":"2021021818581536300_deaa322-B2","doi-asserted-by":"crossref","first-page":"641","DOI":"10.1016\/j.rbmo.2018.08.022","article-title":"Progesterone levels on pregnancy test day after hormone replacement therapy-cryopreserved embryo transfer cycles and related reproductive outcomes","volume":"37","author":"Alsbjerg","year":"2018","journal-title":"Reprod Biomed Online"},{"key":"2021021818581536300_deaa322-B3","doi-asserted-by":"crossref","first-page":"1073","DOI":"10.1093\/humrep\/12.5.1073","article-title":"Targeted drug delivery in gynaecology: the first uterine pass effect","volume":"12","author":"Bulletti","year":"1997","journal-title":"Hum Reprod"},{"key":"2021021818581536300_deaa322-B4","doi-asserted-by":"crossref","first-page":"483","DOI":"10.2307\/2530613","article-title":"An improved approximate formula for calculating sample sizes for comparing two binomial distributions","volume":"34","author":"Casagrande","year":"1978","journal-title":"Biometrics"},{"key":"2021021818581536300_deaa322-B5","doi-asserted-by":"crossref","first-page":"472","DOI":"10.1016\/j.rbmo.2018.11.026","article-title":"Serum progesterone concentration and live birth rate in frozen\u2013thawed embryo transfers with hormonally prepared endometrium","volume":"38","author":"C\u00e9drin-Durnerin","year":"2019","journal-title":"Reprod Biomed Online"},{"key":"2021021818581536300_deaa322-B6","doi-asserted-by":"crossref","first-page":"1657","DOI":"10.1016\/j.fertnstert.2007.05.050","article-title":"Comparison of concomitant outcome achieved with fresh and cryopreserved donor oocytes vitrified by the Cryotop method","volume":"89","author":"Cobo","year":"2008","journal-title":"Fertil Steril"},{"key":"2021021818581536300_deaa322-B7","doi-asserted-by":"crossref","first-page":"E677","DOI":"10.1152\/ajpendo.00225.2019","article-title":"Potential influence of the corpus luteum on circulating reproductive and volume regulatory hormones, angiogenic and immunoregulatory factors in pregnant women","volume":"317","author":"Conrad","year":"2019","journal-title":"Am J Physiol Endocrinol Metab"},{"key":"2021021818581536300_deaa322-B8","doi-asserted-by":"crossref","first-page":"2131","DOI":"10.1093\/humrep\/dey288","article-title":"Effect on endometrial histology and pharmacokinetics of different dose regimens of progesterone vaginal pessaries, in comparison with progesterone vaginal gel and placebo","volume":"33","author":"Duijkers","year":"2018","journal-title":"Hum Reprod"},{"key":"2021021818581536300_deaa322-B9","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1080\/09513590.2018.1534952","article-title":"Low serum progesterone the day prior to frozen embryo transfer of euploid embryos is associated with significant reduction in live birth rates","volume":"35","author":"Gaggiotti-Marre","year":"2019","journal-title":"Gynecol Endocrinol"},{"key":"2021021818581536300_deaa322-B10","first-page":"CD003414","article-title":"Cycle regimens for frozen-thawed embryo transfer","volume":"7","author":"Ghobara","year":"2017","journal-title":"Cochrane Database Syst Rev"},{"key":"2021021818581536300_deaa322-B11","doi-asserted-by":"crossref","first-page":"797","DOI":"10.1016\/j.rbmo.2020.03.001","article-title":"Factors associated with serum progesterone concentrations the day before cryopreserved embryo transfer in artificial cycles","volume":"40","author":"Gonz\u00e1lez-Foruria","year":"2020","journal-title":"Reprod Biomed Online"},{"key":"2021021818581536300_deaa322-B12","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1016\/j.rbmo.2018.11.017","article-title":"Dydrogesterone: pharmacological profile and mechanism of action as luteal phase support in assisted reproduction","volume":"38","author":"Griesinger","year":"2019","journal-title":"Reprod Biomed Online"},{"key":"2021021818581536300_deaa322-B13","doi-asserted-by":"crossref","first-page":"768","DOI":"10.1016\/j.fertnstert.2018.02.135","article-title":"Programming the endometrium for deferred transfer of cryopreserved embryos: hormone replacement versus modified natural cycles","volume":"109","author":"Groenewoud","year":"2018","journal-title":"Fertil Steril"},{"key":"2021021818581536300_deaa322-B14","doi-asserted-by":"crossref","first-page":"2047","DOI":"10.1007\/s10815-020-01862-y","article-title":"Relationship between serum progesterone (P) levels and pregnancy outcome. Lessons from artificial cycles when using vaginal natural micronized progesterone","volume":"37","author":"Labarta","year":"2020","journal-title":"J Assist Reprod Genet"},{"key":"2021021818581536300_deaa322-B15","doi-asserted-by":"crossref","first-page":"2437","DOI":"10.1093\/humrep\/dex316","article-title":"Low serum progesterone on the day of embryo transfer is associated with a diminished ongoing pregnancy rate in oocyte donation cycles after artificial endometrial preparation: a prospective study","volume":"32","author":"Labarta","year":"2017","journal-title":"Hum Reprod"},{"key":"2021021818581536300_deaa322-B16","doi-asserted-by":"crossref","first-page":"606","DOI":"10.1093\/humrep\/14.3.606","article-title":"Pharmacokinetics of natural progesterone administered in the form of a vaginal tablet","volume":"14","author":"Levy","year":"1999","journal-title":"Hum Reprod"},{"key":"2021021818581536300_deaa322-B17","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1016\/S0015-0282(16)56935-0","article-title":"Pharmacokinetics and endometrial tissue levels of progesterone after administration by intramuscular and vaginal routes: a comparative study","volume":"62","author":"Miles","year":"1994","journal-title":"Fertil Steril"},{"key":"2021021818581536300_deaa322-B18","doi-asserted-by":"crossref","first-page":"4241","DOI":"10.1210\/jc.2013-3937","article-title":"Progesterone pharmacokinetics and pharmacodynamics with 3 dosages and 2 regimens of an effervescent micronized progesterone vaginal insert","volume":"99","author":"Paulson","year":"2014","journal-title":"J Clin Endocrinol Metab"},{"key":"2021021818581536300_deaa322-B19","first-page":"58","volume-title":"Criterios ASEBIR de Valoraci\u00f3n Morfol\u00f3gica de Ovocitos, Embriones Tempranos y Blastocistos Humanos","author":"Pons","year":"2015","edition":"3rd edn."},{"key":"2021021818581536300_deaa322-B20","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1093\/humrep\/dep346","article-title":"Embryo development of fresh \u2018versus\u2019 vitrified metaphase II oocytes after ICSI: a prospective randomized sibling-oocyte study","volume":"25","author":"Rienzi","year":"2010","journal-title":"Hum Reprod"},{"key":"2021021818581536300_deaa322-B21","doi-asserted-by":"crossref","first-page":"1293","DOI":"10.3389\/fimmu.2018.01293","article-title":"Progesterone modulation of pregnancy-related immune responses","volume":"9","author":"Shah","year":"2018","journal-title":"Front Immunol"},{"key":"2021021818581536300_deaa322-B22","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1016\/j.rbmo.2013.10.022","article-title":"Luteal-phase support in assisted reproduction treatment: real-life practices reported worldwide by an updated website-based survey","volume":"28","author":"Vaisbuch","year":"2014","journal-title":"Reprod Biomed Online"},{"key":"2021021818581536300_deaa322-B23","doi-asserted-by":"crossref","first-page":"1097","DOI":"10.1093\/humrep\/dew045","article-title":"What is the optimal duration of progesterone administration before transferring a vitrified-warmed cleavage stage embryo? A randomized controlled trial","volume":"31","author":"van de Vijver","year":"2016","journal-title":"Hum Reprod"},{"key":"2021021818581536300_deaa322-B24","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1016\/j.rbmo.2018.06.026","article-title":"GnRH antagonist for endometrial priming in an oocyte donation programme: a prospective, randomized controlled trial","volume":"37","author":"Vidal","year":"2018","journal-title":"Reprod Biomed Online"},{"key":"2021021818581536300_deaa322-B25","doi-asserted-by":"crossref","first-page":"1129","DOI":"10.1007\/s10815-020-01713-w","article-title":"Do serum progesterone levels on day of embryo transfer influence pregnancy outcomes in artificial frozen-thaw cycles?","volume":"37","author":"Volovsky","year":"2020","journal-title":"J Assist Reprod Genet"},{"key":"2021021818581536300_deaa322-B26","doi-asserted-by":"crossref","first-page":"640","DOI":"10.1161\/HYPERTENSIONAHA.118.12043","article-title":"Increased preeclampsia risk and reduced aortic compliance with in vitro fertilization cycles in the absence of a corpus luteum","volume":"73","author":"von Versen-H\u00f6ynck","year":"2019","journal-title":"Hypertension"},{"key":"2021021818581536300_deaa322-B27","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1016\/j.rbmo.2015.05.005","article-title":"Mid-luteal serum progesterone concentrations govern implantation rates for cryopreserved embryo transfers conducted under hormone replacement","volume":"31","author":"Yovich","year":"2015","journal-title":"Reprod Biomed Online"}],"container-title":["Human Reproduction"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/humrep\/article-pdf\/36\/3\/683\/36317871\/deaa322.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/humrep\/article-pdf\/36\/3\/683\/36317871\/deaa322.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,2,21]],"date-time":"2021-02-21T01:35:41Z","timestamp":1613871341000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/humrep\/article\/36\/3\/683\/6042226"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,12,19]]},"references-count":27,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2020,12,19]]},"published-print":{"date-parts":[[2021,2,18]]}},"URL":"https:\/\/doi.org\/10.1093\/humrep\/deaa322","relation":{},"ISSN":["0268-1161","1460-2350"],"issn-type":[{"value":"0268-1161","type":"print"},{"value":"1460-2350","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,3,1]]},"published":{"date-parts":[[2020,12,19]]}}}