17 July 2019

The latest research on the importance of progesterone levels during pregnancy

By the Editorial Comitee IVI Blog

A lot of us have a general idea of how important progesterone is during pregnancy, knowing that the progesterone-oestrogen balance is important for the menstrual cycle and a healthy hormone balance. For most of the non-medical community, that’s probably the extent of the awareness. Now, new research, unveiled at the 35th European Society of Human Reproduction and Embryology (ESHRE) reveals just how crucial progesterone levels are. It shines a light on the importance of the right progesterone levels during pregnancy, with particular reference to the very early stages when implantation takes place as well as the successful continuation of a healthy pregnancy.

This discovery could have a major impact on success rates of the well-established in vitro fertilisation (IVF) technique as part of an assisted reproduction treatment. The new knowledge of progesterone effects will potentially allow medical practitioners in the field to fine-tune levels, leading to more successful outcomes.


The ESHRE Congress: fertile ground for growing new ideas

ESHRE is the foremost conference organised for professionals in the field of Assisted Reproduction in the whole of Europe. It gathers together leading researchers and medical practitioners from all over the world. This gives them the opportunity to share and discuss new ideas and present research findings and in doing so, to arrive at far-reaching resolutions for the future of practices and techniques in the field of reproductive medicine. This year’s event took place in Vienna in June 2019. Just one of the highlights was a presentation by Dr. Elena Labarta, a gynaecologist with IVI, about her work in IVF. It investigated the impact of progesterone levels in the blood on the actual day that embryo transfer takes place.


Findings: the connection between progesterone levels and successful IVF outcomes

What if there is a causal relationship between the levels of progesterone and subsequent rates of success in reproductive treatments? This question was the starting point for Dr. Labarta’s research team. She had already led a research group in 2017 which published a preliminary study aiming to analyse this problem. This pioneering work demonstrated that there are indeed levels of serum progesterone on embryo transfer day, below which the rate of continuing pregnancy decreases quite dramatically.
Progesterone research: the background
Dr. Labarta explained that previously, it had been assumed that the amounts of progesterone routinely administered during the IVF process were sufficient to meet all needs, and that measuring progesterone levels was ineffective since it could not reflect the action of the hormone on a local uterine level. The research questioned this received wisdom, ultimately proving it wrong.
Progesterone research: the detailed results
They carried out two prospective studies on this issue, which included a total of 1,400 patients. The result confirmed that there is an exact level of progesterone which is essential for successful treatments and ongoing pregnancy rates. A cut-off value was identified, showing that patients with serum progesterone levels below 8.8 ng/ml on the day of embryo transfer had an ongoing pregnancy rate 18% lower than those with adequate levels.
In medical terms the results suggest that, despite standard amounts of medication being administered, absorption rates may vary from patient to patient affecting the results. Identifying the exact amount a patient needs on a case by case basis will ensure the right levels of progesterone and therefore improve success rates, making a huge impact within the world of fertility.


What impact will progesterone research have on IVF outcomes?

How will these new findings affect our already high IVF success rates? Dr. Labarta is clear that we are finding out how to remedy the cases where low progesterone levels are likely to cause problems. The fact that the position can be reversed if detected in time is an important finding which will make a major contribution to improve reproductive outcomes.


Our latest audited clinical results: seeing is believing

The current position is already a success story, and this can only become more promising with the incremental improvements that our painstaking research makes possible. Our records show that already, with one of the best success rates per patient, 9 out of 10 couples who put their trust in us achieve their goal of becoming parents. Proof of this shows in the best possible way: in the form of more than 160,000 babies born.

On the statistical side, the headline figure is that overall, our various treatments result in a pregnancy rate of almost 97% over three attempts. You can check our independently audited clinical results here, and browse our website for the latest details of every type of treatment we offer. If your particular interest is in the IVF process, you can watch the video about IVI and ICSI on our IVF YouTube channel for a summary of how it all works.


The future of assisted reproduction: what’s next on the horizon?

Of course it’s impossible to predict the impact of the research into progesterone levels with 100% certainty. We can only feel confident that the newly pinpointed knowledge will help in cases where previously, a failure of the embryo to implant during an IVF cycle may have remained unexplained. In the future, we can expect these cases to become fewer and fewer and our success rates to continue to climb. These improvements are all thanks to the dedicated and meticulous research of people like Dr. Labarta and her colleagues.
We will have to wait for a future ESHRE Congress for a report on results, and on who knows what other future innovations. Watch this space!

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