Human Reproduction, Vol 13, 720-723, Copyright © 1998 by Oxford University Press
Y Prapas, N Prapas, EE Jones, AJ Duleba, DL Olive, A Chatziparasidou and G Vlassis
In 192 oocyte donation cycles performed between January 1993 and July 1996,
we examined the width of 'the window for embryo transfer' using standard
hormonal replacement methods. All transfers were performed within 48 h of
insemination. We varied the day of embryo transfer with regard to the
initiation of progesterone therapy and, thus, the duration of endometrial
exposure to progesterone and analysed the resulting pregnancy rates.
Patients were divided into five groups (I-V) and embryo transfers were
performed 2, 3, 4, 5 or 6 days following initiation of progesterone
therapy. The number of pregnancies per transfer cycle achieved in groups
I-V were 0 (0%), 3 (12%), 16 (40%), 29 (48.3%), and 10 (20.4%)
respectively. The increased pregnancy rate in group III in comparison to
group II is statistically significant (P < 0.03). Furthermore, the
pregnancy rate in group IV (5 days of progesterone administration before
embryo transfer) was significantly higher than in group V (6 days of
progesterone administration before embryo transfer; P < 0.005). We also
noted that, when embryos were transferred 4 or 5 days after initiation of
progesterone therapy, the pregnancy rates were not significantly different
between menopausal and cycling recipients (50% vs 43.7%). Our results
indicate that the window for embryo transfer is dependent on duration of
treatment with progesterone; it begins approximately 48 h after starting
progesterone administration and lasts for approximately 4 days. The optimum
period for transferring embryos at the 4- to 8-cell stage corresponds to
cycle days 18 and 19. Transfers performed on the 17th and 20th days of the
cycle can result in successful implantation, although the rates of
implantation are highest when transfers are done on days 18 and 19.
ARTICLES
The window for embryo transfer in oocyte donation cycles depends on the duration of progesterone therapy
Fourth Department of Obstetrics and Gynecology, Aristoteleion University of Thessaloniki, Greece.
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