ORIGINAL RESEARCH article
Front. Reprod. Health
Sec. Assisted Reproduction
Volume 7 - 2025 | doi: 10.3389/frph.2025.1547939
Effect of Progesterone Luteal Phase Rescue on Live Birth Rates in Frozen Embryo Transfer Cycles
Provisionally accepted
Chadi YAZBECK1,2*
François Olivennes1Nadia Kazdar1,3Claire Pietin-Vialle1,2Solenne Gricourt2,4The Ambroise Paré Cherest ART group1- 1Ambroise Paré-Hartmann-Cherest Private Clinics, NEUILLY SUR SEINE, France
- 2Reprogynes Medical Institute, Paris, France
- 3Laboratoire Unilabs d'Eylau (France), Neuilly-sur-Seine, Île-de-France, France
- 4Service de Gynécologie Obstétrique, Hôpital Bichat-Claude-Bernard, Paris, France
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Introduction Frozen embryo transfer (FET) is a standard procedure that improves live birth rates and reduces ovarian hyperstimulation risks. Optimizing luteal phase support with hormone replacement therapy (HRT), particularly by progesterone supplementation, enhances endometrial receptivity and embryo implantation success. Despite advances in cryopreservation techniques, optimal protocols for progesterone supplementation in HRT-FET cycles remain uncertain. This study aims to evaluate the effects of an individualized luteal phase protocol using subcutaneous progesterone on live birth rates in HRT-FET cycles. Methods In this retrospective cohort study, we analyzed data from 433 autologous FET cycles prepared with HRT. Serum progesterone levels were measured the day before FET. Two groups were compared according to serum progesterone measurement the day before FET. The control group (≥ 11 ng/mL) received standard luteal support (800 mg vaginal progesterone daily); and the rescue group (<11ng/ml) received an additional 25 mg subcutaneous progesterone daily. Pregnancy outcomes, including biochemical pregnancy, clinical pregnancy, miscarriage, and live birth rates, were assessed across both groups. Results Despite overall similar pregnancy rates, the rescue group, receiving combined subcutaneous and vaginal progesterone, demonstrated a higher live birth rate compared to the control group (36.9% vs. 24.7%, p = 0.006). By Day 12 after FET, progesterone levels in the rescue group were comparable to those in the control group. Conclusion Subcutaneous progesterone supplementation in HRT-FET cycles improves reproductive outcomes in patients with low serum progesterone levels before transfer. These results support tailoring progesterone supplementation to optimize luteal phase support. Further controlled trials are needed to establish standardized protocols for HRT-FET cycles.
Keywords: luteal phase support, Frozen embryo transfer, Progesterone, Hormone Replacement Therapy, Endometrial receptivity, live birth rate
Received: 19 Dec 2024; Accepted: 12 Sep 2025.
Copyright: © 2025 YAZBECK, Olivennes, Kazdar, Pietin-Vialle, Gricourt and ART group. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Chadi YAZBECK, dryazbeck@yahoo.fr
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