Free Access Articles
Strong variation in progesterone production of the placenta in early pregnancy – what are the clinical implications?
We thank Dr Tesarik (Tesarik, 2020) for his interest in our study on the onset of placental progesterone production in patients receiving dydrogesterone for scheduling endometrial receptivity and for supporting early pregnancy in anovulatory (‘artificial’) frozen-thawed embryo transfer cycles (FET) (Neumann et al., 2020). In his letter, Dr Tesarik suggests that the luteo-placental shift can be delayed and that this delay could be a cause for miscarriage. Indeed, in our study a strong variation in placental progesterone production between individual singleton pregnancies can be observed (Figure 4A, Neumann et al., 2020).Follicular flushing in patients with poor ovarian response: a systematic review and meta-analysis
A systematic literature review and meta-analysis was conducted to evaluate the effect of follicular flushing on clinical outcomes (primary outcome: mean number of cumulus–oocyte–complexes [COC]) in poor-response IVF patients). The bibliographic databases OvidMedline (includes Pubmed), Cochrane Library and Web of Science were searched electronically for randomized controlled trials (RCT) comparing follicular flushing with no flushing. Three RCT with a total of 210 patients could be included. The mean number of COC did not increase with flushing (weighted mean difference: −0.45 COC, 95% CI −1.14 to 0.25, I2 = 70%; P = 0.21; three RCT, n = 210).To pill or not to pill in GnRH-antagonist cycles: the answer is in the data already!
The planning of IVF treatment by scheduling menstruation and hence initiation of ovarian stimulation using sex-steroid pre-treatment is commonly used. Pooling data from six randomized-controlled trials encompassing 1343 patients, with and without combined oral contraceptive pill pre-treatment, suggests that the ongoing pregnancy rate per randomized woman is significantly lower in patients with oral contraceptive pill pre-treatment (relative risk [RR]: 0.80, 95% confidence interval [CI]: 0.66–0.97; rate difference [RD]: −5%, 95% CI: −10% to −1%; fixed effects model).
