NIVEIS ADEQUADOS DE PROGESTERONA EM CICLOS ARTIFICIAIS PARA TRANSFERENCIA DE EMBRIÕES : REVISÃO SISTEMÁTICA

Abstract

INTRODUCTION: The transfer of frozen embryos to the woman's uterus in assisted reproduction procedures is performed after the preparation of the endometrium. For this, two main methods can be used: preparation with a natural cycle or with an artificial cycle. In the latter, the use of exogenous progesterone is indispensable in the process. OBJECTIVE: To conduct a systematic review of published studies on adequate serum progesterone levels in artificial endometrial preparation cycles for cryopreserved embryo transfer. METHODOLOGY: Systematic literature review, designed according to the PICO strategy and based on the PRISMA protocol, with a search in the PubMed database, based on the MeSH terms, using the following descriptors: "in Vitro Fertilization" AND "Progesterone". The filter of works produced in the last 10 years was applied. RESULTS: A total of 536 articles were found and 23 papers were selected for analysis and final production of this review. DISCUSSION: In the artificial endometrial preparation cycles for embryo transfer, patients with serum progesterone levels greater than 10 ng/mL close to embryo transfer experienced more continuous pregnancies or live births, more clinical pregnancies, and fewer spontaneous abortions than those with serum progesterone levels below this cut-off point. For serum progesterone thresholds ≥ 20ng/mL, however, there was uncertainty as to whether a higher progesterone level was associated with better treatment outcomes. Serum progesterone values < 5ng/ml are certainly associated with lower success rates in these cycles. CONCLUSION: This systematic review suggests that there is a clinically important serum luteal progesterone trough level of approximately 10 ng/mL associated with higher rates of ongoing pregnancy or live births, higher chance of clinical pregnancy, and reduced risk of miscarriage in women undergoing frozen embryo transfer treatment.