Serum LH levels before progesterone administration significantly affect pregnancy outcomes in hormone replacement therapy-frozen-thawed embryo transfer cycles

Abstract Background In hormone replacement therapy-frozen-thawed embryo transfer (HRT-FET) cycles, endogenous LH levels may still rise, and the relationship between this and pregnancy outcomes is unclear. The purpose of this study was to investigate the correlation between the serum LH levels before...

Full description

Saved in:
Bibliographic Details
Main Authors: Xu Han, Chang Liu, Jie Wang, Ye Zheng, Huidan Wang, Mei Sun, Xiufang Li
Format: Article
Language:English
Published: BMC 2025-07-01
Series:Journal of Ovarian Research
Subjects:
Online Access:https://doi.org/10.1186/s13048-025-01743-x
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849234701209829376
author Xu Han
Chang Liu
Jie Wang
Ye Zheng
Huidan Wang
Mei Sun
Xiufang Li
author_facet Xu Han
Chang Liu
Jie Wang
Ye Zheng
Huidan Wang
Mei Sun
Xiufang Li
author_sort Xu Han
collection DOAJ
description Abstract Background In hormone replacement therapy-frozen-thawed embryo transfer (HRT-FET) cycles, endogenous LH levels may still rise, and the relationship between this and pregnancy outcomes is unclear. The purpose of this study was to investigate the correlation between the serum LH levels before progesterone administration in HRT-FET cycles and the live birth rate (LBR). Methods A total of 13 720 HRT-FET cycles were divided into four groups based on serum LH levels according to the quartiles. Meanwhile, subgroup analyses were performed based on the use of pituitary down-regulation to evaluate the independent effects of serum LH levels on pregnancy outcomes. We used multivariate logistic regression analysis to adjust for potential confounding factors. Results In the overall, the 51-75th percentile group showed significant differences in LBR and miscarriage rate compared to the reference group (P = 0.010; P = 0.004), and the > 75th percentile group showed significant difference in biochemical pregnancy rate compared to the reference group (P = 0.022). In the non-pituitary down-regulation group, the 51-75th percentile group and the reference group exhibited significant differences in LBR and miscarriage rate (P = 0.004), and the 26–50th percentile group showed significant difference in miscarriage rate compared to the reference group (P = 0.026). In the pituitary down-regulation group, the > 75th percentile group showed significant difference in biochemical pregnancy rate compared to the reference group (P = 0.045). Conclusion In HRT-FET cycles, low serum LH levels prior to progesterone administration may be associated with poor pregnancy outcomes. For patients presenting with low LH levels, we may recommend deferring the FET cycle to reduce poor pregnancy outcomes.
format Article
id doaj-art-964a3125d7fd4473884716445480ca4f
institution Kabale University
issn 1757-2215
language English
publishDate 2025-07-01
publisher BMC
record_format Article
series Journal of Ovarian Research
spelling doaj-art-964a3125d7fd4473884716445480ca4f2025-08-20T04:03:02ZengBMCJournal of Ovarian Research1757-22152025-07-0118111010.1186/s13048-025-01743-xSerum LH levels before progesterone administration significantly affect pregnancy outcomes in hormone replacement therapy-frozen-thawed embryo transfer cyclesXu Han0Chang Liu1Jie Wang2Ye Zheng3Huidan Wang4Mei Sun5Xiufang Li6State Key Laboratory of Reproductive Medicine and Offspring Health, Center for Reproductive Medicine, Institute of Women, Children and Reproductive Health, Shandong UniversityState Key Laboratory of Reproductive Medicine and Offspring Health, Center for Reproductive Medicine, Institute of Women, Children and Reproductive Health, Shandong UniversityShandong Provincial Hospital Affiliated to Shandong First Medical UniversityState Key Laboratory of Reproductive Medicine and Offspring Health, Center for Reproductive Medicine, Institute of Women, Children and Reproductive Health, Shandong UniversityState Key Laboratory of Reproductive Medicine and Offspring Health, Center for Reproductive Medicine, Institute of Women, Children and Reproductive Health, Shandong UniversityState Key Laboratory of Reproductive Medicine and Offspring Health, Center for Reproductive Medicine, Institute of Women, Children and Reproductive Health, Shandong UniversityState Key Laboratory of Reproductive Medicine and Offspring Health, Center for Reproductive Medicine, Institute of Women, Children and Reproductive Health, Shandong UniversityAbstract Background In hormone replacement therapy-frozen-thawed embryo transfer (HRT-FET) cycles, endogenous LH levels may still rise, and the relationship between this and pregnancy outcomes is unclear. The purpose of this study was to investigate the correlation between the serum LH levels before progesterone administration in HRT-FET cycles and the live birth rate (LBR). Methods A total of 13 720 HRT-FET cycles were divided into four groups based on serum LH levels according to the quartiles. Meanwhile, subgroup analyses were performed based on the use of pituitary down-regulation to evaluate the independent effects of serum LH levels on pregnancy outcomes. We used multivariate logistic regression analysis to adjust for potential confounding factors. Results In the overall, the 51-75th percentile group showed significant differences in LBR and miscarriage rate compared to the reference group (P = 0.010; P = 0.004), and the > 75th percentile group showed significant difference in biochemical pregnancy rate compared to the reference group (P = 0.022). In the non-pituitary down-regulation group, the 51-75th percentile group and the reference group exhibited significant differences in LBR and miscarriage rate (P = 0.004), and the 26–50th percentile group showed significant difference in miscarriage rate compared to the reference group (P = 0.026). In the pituitary down-regulation group, the > 75th percentile group showed significant difference in biochemical pregnancy rate compared to the reference group (P = 0.045). Conclusion In HRT-FET cycles, low serum LH levels prior to progesterone administration may be associated with poor pregnancy outcomes. For patients presenting with low LH levels, we may recommend deferring the FET cycle to reduce poor pregnancy outcomes.https://doi.org/10.1186/s13048-025-01743-xHormone replacement therapyFrozen-thawed embryo transferLive birth ratePregnancy outcomeLuteinizing hormone
spellingShingle Xu Han
Chang Liu
Jie Wang
Ye Zheng
Huidan Wang
Mei Sun
Xiufang Li
Serum LH levels before progesterone administration significantly affect pregnancy outcomes in hormone replacement therapy-frozen-thawed embryo transfer cycles
Journal of Ovarian Research
Hormone replacement therapy
Frozen-thawed embryo transfer
Live birth rate
Pregnancy outcome
Luteinizing hormone
title Serum LH levels before progesterone administration significantly affect pregnancy outcomes in hormone replacement therapy-frozen-thawed embryo transfer cycles
title_full Serum LH levels before progesterone administration significantly affect pregnancy outcomes in hormone replacement therapy-frozen-thawed embryo transfer cycles
title_fullStr Serum LH levels before progesterone administration significantly affect pregnancy outcomes in hormone replacement therapy-frozen-thawed embryo transfer cycles
title_full_unstemmed Serum LH levels before progesterone administration significantly affect pregnancy outcomes in hormone replacement therapy-frozen-thawed embryo transfer cycles
title_short Serum LH levels before progesterone administration significantly affect pregnancy outcomes in hormone replacement therapy-frozen-thawed embryo transfer cycles
title_sort serum lh levels before progesterone administration significantly affect pregnancy outcomes in hormone replacement therapy frozen thawed embryo transfer cycles
topic Hormone replacement therapy
Frozen-thawed embryo transfer
Live birth rate
Pregnancy outcome
Luteinizing hormone
url https://doi.org/10.1186/s13048-025-01743-x
work_keys_str_mv AT xuhan serumlhlevelsbeforeprogesteroneadministrationsignificantlyaffectpregnancyoutcomesinhormonereplacementtherapyfrozenthawedembryotransfercycles
AT changliu serumlhlevelsbeforeprogesteroneadministrationsignificantlyaffectpregnancyoutcomesinhormonereplacementtherapyfrozenthawedembryotransfercycles
AT jiewang serumlhlevelsbeforeprogesteroneadministrationsignificantlyaffectpregnancyoutcomesinhormonereplacementtherapyfrozenthawedembryotransfercycles
AT yezheng serumlhlevelsbeforeprogesteroneadministrationsignificantlyaffectpregnancyoutcomesinhormonereplacementtherapyfrozenthawedembryotransfercycles
AT huidanwang serumlhlevelsbeforeprogesteroneadministrationsignificantlyaffectpregnancyoutcomesinhormonereplacementtherapyfrozenthawedembryotransfercycles
AT meisun serumlhlevelsbeforeprogesteroneadministrationsignificantlyaffectpregnancyoutcomesinhormonereplacementtherapyfrozenthawedembryotransfercycles
AT xiufangli serumlhlevelsbeforeprogesteroneadministrationsignificantlyaffectpregnancyoutcomesinhormonereplacementtherapyfrozenthawedembryotransfercycles