الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Assisted reproductive technology (ART) has provided great hope for millions of infertile couples worldwide. Since the world’s first in vitro fertilization (IVF) baby Louise Brown was born in 1978, more than 6 million babies have been born following ART treatment.
Progesterone plays a vital role in both conception and the maintenance of pregnancy; as such, it has been a central focus of investigation aimed at optimizing hormonal replacement therapy.
Each route of Progesterone administration is associated with a distinct serum and endometrial tissue response. While serum progesterone levels following intramuscular administration are greater than following intra vaginally administration, it has been demonstrated that intravaginal administration produces greater endometrial concentrations of progesterone than intramuscular
Ideally, progesterone (p4) monitoring would be tailored to the administration method; however, given the significant practical difficulties in obtaining endometrial progesterone levels, serum P4 concentrations continue to be the mainstay marker for P4 monitoring.
In accordance with physiological P4 fluctuations, the optimal serum P4 range correlated with improved pregnancy outcomes varies throughout the ART cycle stages. In the late follicular phase of ART cycles, elevated serum P4 levels have been associated with significantly poorer pregnancy rates.
However, in the mid-luteal stage, higher P4 concentrations are preferable for improved pregnancy outcomes. It is between these two well-studied stages, the day of embryo transfer, that the literature on whether there is an optimal serum P4 range becomes more scant. While poorer pregnancy outcomes have been previously associated with lower P4 levels on the day of FET, all the studies supporting this contain small sample sizes.
The aim of this work was to investigate whether progesterone (P4) levels on the day of frozen embryo transfer to a hormonally prepared endometrium correlate with pregnancy outcomes.
This was prospective cohort study carried out on 80 infertile women attending Alexandria IVF centers.
All the patients went through controlled stimulation protocols either luteal long agonist or antagonist protocol. In all cycles, COH, oocyte retrieval, denudation, intracytoplasmic sperm injection (ICSI), embryo culture, verification.
The study included 80 patients divided into two groups:
group (1): Pregnant group were 52 patients.
group (2): Non-pregnant group were 28 patients.
The results of our study showed that the pregnancy rate was 56.3%, on comparing the pregnant and nonpregnant group regarding age and BMI, it was found that there was no significant difference between the two group. The duration and cause of infertility showed insignificant difference between the pregnant and non pregnant group, while the type of infertility show a high percent of secondary infertility in pregnancy rate.
The AMH and prolactin showed insignificant difference between pregnant and non pregnant group, also the day of embryo transfer and endometrial thickness showed insignificant difference between the two groups.
The progesterone level less than 10 and 10-30 ng/ml show a significant increase in pregnancy rate, while the level more than 30 ng/ml showed a inverse effect on pregnancy rate and decrease pregnancy rate.