THE ASSOCIATION OF ESTROGEN/PROGESTERONE RATIO AND IVF OUTCOMES IN FROZEN EMBRYO CYCLES

BackgroundThe number of frozen Embryo transfers (FET) in invitro fertilization cycles (IVF) is increasing and has already surpassed numbers fresh stimulated IVF cycles. Increasing elective single ETs are also resulting more embryos available for subsequent FET Most commonly, medicated or hormone supplemented (HC) which the endometrium prepared by exogenous estrogen progesterone following pituitary downregulation with gonadotropin releasing agonist (1,2). Estrogen (E2) can be administered form oral tablets, transdermal patches, subcutaneous implants vaginal rings tablets. Recently a retrospective study showed that serum levels less than 10.6 ng/mL had significantly higher miscarriage rate lower live birth those P greater ng/ml. Another finding (P4) 20 ng/dl on day embryo transfer associated pregnancy loss rates(3,4). Progesterone induces limitation growth decrease mitosis DNA synthesis. This mainly due to interfering receptor expression stimulation 17β-hydroxysteroid dehydrogenase sulfotransferase, converts estradiol estrone sulfate(5). Based these findings we believe ratio E2 correlated outcomes during an cycle.ObjectiveTo assess correlation E2/P4 cycle 15, 17, post 11 ratesMaterials MethodsThis chart review; data was collected over period 5 years from January 2014 until October 2019. All patients undergoing were performed at Jones institute. Data included age, BMI, gravida, parity, characteristics such as rate, clinical pregnancy, rate. Patients excluded if their cancelled prior transfer.Result(s)A total 659 frozen-thawed blastocysts included. Patient’s mean age 34.9 ± 4.3 BMI 27.4 6.1 kg/m2. There no statistically significant difference between race, diagnosis, pregnant non-pregnant groups. Out 342 positive pregnancies, 305 pregnancies 203 recorded births. Using χ2 found trend where 15 4595 – 2792 women 57.2% (p= 0.06), 50.1% (p=0.058), 37.2% (p=0.18) . When E2P4 analyzed who 18.55 31.1 40.1 % (p=0.041), non-significant 60% (p=0.34) 54% (p=0.35)Conclusion(s)Tabled 1Table 1. Association Day 17 Cycle outcomesDay E2P4PregnancyClinical IUPLBR<18.5554%45%25%18.55 - 31.0160%45%40%31.01 53.0053%44%30%>5350%45%33% Open table new tab Financial SupportSeifeldin Sadek MD, No disclosureLaura Haworth disclosuresGina Vivino disclosuresMadison Seward disclosuresTamar Matitashvili disclosuresLaurel Stadtmauer MD PhD disclosuresReferences1. Ghobara T, Gelbaya TA, Ayeleke RO. regimens transfer. Cochrane database Syst Rev. 2017 Jul;7:CD003414.2. Mackens S, Santos-Ribeiro van de Vijver A, Racca Van Landuyt L, Tournaye H, et al. Frozen transfer: review optimal endometrial preparation timing. Hum Reprod [Internet]. 2017;32(11):1–9. Available from: http://academic.oup.com/humrep/article/doi/10.1093/humrep/dex285/4107819/Frozen-embryo-transfer-a-review-on-the-optimal3. Martinez F, Coll Garcia Álvarez M, Parriego Barri N, Low euploid reduction rates. Gynecol Endocrinol 2019;35(5):439–42. https://doi.org/10.1080/09513590.2018.15349524. Kofinas JD, Blakemore J, Mcculloh DH, Grifo J. Serum ng / dl 2015;1395–9.5. Taylor HS, Pal Seli E. Speroff’s Clinical Gynecologic Endocrinology Infertility Lippincott Williams & Wilkins; (Clinical Infertility). https://books.google.com/books?id=xB_eoQEACAAJ cycle. The ObjectiveTo rates To Materials Result(s)A (p=0.35) A Conclusion(s)Tabled disclosures Seifeldin disclosure Laura Gina Madison Tamar Laurel References1. Jul;7:CD003414. 2. http://academic.oup.com/humrep/article/doi/10.1093/humrep/dex285/4107819/Frozen-embryo-transfer-a-review-on-the-optimal 3. https://doi.org/10.1080/09513590.2018.1534952 4. 2015;1395–9. 5.