{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T01:36:26Z","timestamp":1747186586753,"version":"3.40.5"},"reference-count":21,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2023,10,9]],"date-time":"2023-10-09T00:00:00Z","timestamp":1696809600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Obstet and Gynaecol"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>To develop a model that predicts low progesterone (P) levels on the day of embryo transfer (ET) based on patient and cycle characteristics, including serum estradiol (E<jats:sub>2<\/jats:sub>) concentration after vaginal administration of micronized E<jats:sub>2<\/jats:sub> for endometrial preparation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A prospective cohort of 193 patients scheduled for cryopreserved blastocyst transfer during an artificial endometrial preparation cycle, using micronized E<jats:sub>2<\/jats:sub> vaginally for first 4\u2009days (4\u2009mg\/day), followed by oral administration (6\u2009mg\/day). Blood sampling for E<jats:sub>2<\/jats:sub> was performed prospectively on day\u20105 of vaginal administration and analysis was performed retrospectively. On sixth day of P treatment (daily 300\u2009mg of vaginal micronized P tablets), P levels were measured on ET day. Primary outcome measure was serum P levels after vaginal E<jats:sub>2<\/jats:sub> administration.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Patients with low P levels on the day of ET (&lt;7.8\u2009ng\/mL, 25th percentile) were heavier (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and exhibited lower day 5 serum E<jats:sub>2<\/jats:sub> levels (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) compared with patients with adequate P levels. Multivariate linear regression analysis revealed that weight (<jats:italic>p<\/jats:italic>\u2009=\u20090.003) and day 5 E<jats:sub>2<\/jats:sub> levels (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) were independently associated with the P levels. The sensitivity, specificity, and positive and negative predictive values (%) were 71.4, 55.6, 35.4, and 85.1 for weight\u2009\u2265\u200965\u2009kg; 71.4, 61.8, 38.9, and 86.4 for day 5 E<jats:sub>2<\/jats:sub>\u2009\u2264\u20091615\u2009pg\/mL; 59.2, 83.3, 54.7, and 85.7 for the combination of these two variables; and 82.9, 62.5, 54.7, and 87.0 for the sequential inclusion of these variables, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Low day 5 E<jats:sub>2<\/jats:sub> levels following vaginal administration and high weight are independently associated with low P levels on the day of ET. Predictive performance is enhanced when these variables are considered sequentially or in combination.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jog.15807","type":"journal-article","created":{"date-parts":[[2023,10,12]],"date-time":"2023-10-12T02:40:14Z","timestamp":1697078414000},"page":"2962-2968","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A model for predicting low progesterone levels on the day of embryo transfer in hormonally prepared vitrified\u2010warmed embryo transfer cycles: A secondary analysis of a prospective cohort study"],"prefix":"10.1111","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1934-7106","authenticated-orcid":false,"given":"Safak","family":"Olgan","sequence":"first","affiliation":[{"name":"Fertility Clinic, Memorial Hospital  Antalya Turkey"},{"name":"Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology Akdeniz University School of Medicine  Antalya Turkey"},{"name":"Department of Obstetrics and Gynecology Akdeniz University School of Medicine  Antalya Turkey"},{"name":"Department of Obstetrics and Gynecology Uskudar University School of Medicine  Istanbul Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6230-1229","authenticated-orcid":false,"given":"Enver Kerem","family":"Dirican","sequence":"additional","affiliation":[{"name":"Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology Akdeniz University School of Medicine  Antalya Turkey"},{"name":"Department of Obstetrics and Gynecology Akdeniz University School of Medicine  Antalya Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arif Can","family":"Ozsipahi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Akdeniz University School of Medicine  Antalya Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mehmet","family":"Sakinci","sequence":"additional","affiliation":[{"name":"Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology Akdeniz University School of Medicine  Antalya Turkey"},{"name":"Department of Obstetrics and Gynecology Akdeniz University School of Medicine  Antalya Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Humaidan","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine Aarhus University  Aarhus Denmark"},{"name":"The Fertility Clinic, Skive Regional Hospital  Resenvej Skive 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