The current medical literature does not present high-quality evidence of the superiority of one form of progesterone administration over the other for FET. The researchers know that in fresh embryo transfer cycles, where natural follicles continue to function and produce progesterone in the form of corpus luteum, no difference in pregnancy rates was reported when vaginal luteal P4 was compared to IM P4 support, but the researchers do not have the same certainty regarding frozen embryo transfers. The objective of this study is to compare the vaginal and IM route of administration of P4 for the FET cycle in a well-designed study. Since many outcome variables are possible, the researchers chose to focus on which one could shed light on a possible biological difference between the two modes of progesterone administration; Uterine contractions. Uterine contractions have already been recognized as a possible factor affecting success rates in patients undergoing IVF treatment. Progesterone is considered a uterine relaxant and its levels in the blood compared to levels in the uterus differ in its method of administration: blood levels are higher when administered IM, while P4 concentrations in the uterus are higher when administered vaginally. Researchers are interested in seeing if IM progesterone in frozen embryo transfers has a different pattern of uterine contraction than vaginal administration. However, little progress has been made in terms of uterine factor. If a uterus has a seemingly normal anatomy, it seems to develop normally, and we also have embryos with optimal ability to implant, why don`t they implant? Why don`t they lead to a successful pregnancy? Obviously, personalization is very important in these cases, but we know that a more complete analysis of the uterus could bring us closer to the key to the subject. The frequency of uterine contraction measured shortly after embryo transfer was significantly associated with pregnancy outcome, including the rate of live births.
Not only do the results have prognostic value, but they can also help identify women who might benefit from using muscle relaxant therapy to improve results. Dr. Chung is a professional clinical consultant in the Department of Obstetrics and Gynecology at the Chinese University of Hong Kong. She continues to specialise in the field of reproductive medicine and is currently training abroad in the UK. His research interests are assisted reproduction technology and implantation defects. The frequency of uterine contraction measured shortly after embryo transfer was significantly associated with pregnancy outcome, including the rate of live births. Not only do the results have prognostic value, but they can also help identify women who might benefit from using muscle relaxant therapy to improve results. The FET protocol of the medical cycle includes ten days of estraque (17b micronized estradiol), starting from day 3 of the cycle at a dose of 4 mg per day for 5 days, followed by 8 mg per day for 5 days. Routine monitoring takes place after 10 years. Treatment day – cycle day 13 – and includes a longitudinal section of the uterine cavity for the thickness and pattern of the endometrium.
This is not a study visit, but a routine visit that is part of the investigators` standard care. The follow-up of the patients of the study includes additional measures (frequency of uterine contraction, counted by the number of contractions per minute). After obtaining sufficient proliferation of the endometrium (≥7 mm thick with a three-layer pattern) with exposure to estrogen, the patient begins to use progesterone. Uterine contractions are physiological. That is, there must be uterine contractions (movement in the muscle) during the implantation process so that it progresses accordingly. Uterine contractions work in the same way as the heart when it contracts with each heartbeat. If contractions in the heart are irregular, they can lead to heart problems. The same could be true for the uterus.
Too many irregular contractions or contractions that don`t go in the right direction can hinder proper implantation. “By thinking about these biomechanical processes during IVF treatment, we can help doctors and expectant parents achieve better results,” he says. The chances of finding an optimal uterine position could be improved by Professor Elad`s recommendations. Progesterone is essential for embryo implantation. Among its many functions is also the control of the contractility of the uterus. It decreases them after they have been increased during a natural cycle due to the action of estradiol. .