Akademik Veri Yönetim Sistemi
ASRM-2022 Genes, Gametes, and Genetics, California, Amerika Birleşik Devletleri, 22 - 26 Ekim 2022, cilt.118, sa.4, ss.216
OBJECTIVE: In order to detect the ovulatory disorders, ovulation physiology is needed to be fully understood, and the cut-off values related to the changes in hormone levels are to be defined. This study aimed to define the cut-off values showing the ovulation with serial evaluation of serum hormone levels of progesterone (P), estradiol (E2), and luteinizing hormone (LH), besides ultrasonographic assessments of the subfertile women having regular menstrual cycle.
MATERIALS AND METHODS: In this prospective observational study, 50 subfertile women aged between 18-40, having regular menstruation with a cycle length between 24-38 days, and women accepting blood tests with full attendance to the follow-up visits are included. All participants are provided informed consent. Patients who are fully attended the follow-ups with no ovulation are excluded. Participants are invited for transvaginal ultrasonographic examination (TVUE) and peripheral blood test on the second day of the menstruation and two days prior to the estimated ovulation day, and after the ovulation in order to detect the corpus luteum. During the evaluation, and the analysis of the data, follicle size, E2, LH, P, and endometrial thickness are taken into account.
RESULTS: 50 participants with mean age 31.3±4.2 years underwent serial TVUE, and serial analysis of hormone levels in blood. Mean cycle length was 28.8±1.6 days, and the mean follicle size on the ovulation day was measured as 18.6±1.5 mm in size. The effect of P levels on determining the ovulation day was investigated. It was observed that the data shows an exponential trend, hence an exponential regression was carried out to construct the mathematical model which relates days until and after ovulation with the P levels. The fit was performed on the average of the daily P levels of each patient. The R2, the sum of squared estimate of errors (SSE), and root-mean-square error (RMSE) values of the constructed model was evaluated as 0.99, 0.61, and 0.35, respectively, which show that the model is highly sufficient in estimating the P levels. P levels were measured as 0.57±0.19 ug/L two days prior to the ovulation, 0.79±0.20 ug/L one day prior to the ovulation, 1.31±0.31ug/L on the ovulation day, 2.10±0.48 the day after the ovulation, 4.45±2.36 ug/L two days after the ovulation, and 12.91±6.01 ug/L on the 5th day after the ovulation which can be scheduled for the blastocyst transfer for the natural frozen thaw cycles.
CONCLUSIONS: Progesterone has a particular increasing pattern in menstrual cycle which enables the prediction of the ovulation day in order to schedule the embryo transfer day in natural frozen thaw cycles.
IMPACT STATEMENT: This model may be utilized to determine the ovulation day of patient directly from the P levels, which would assist the physicians in assigning appointments accordingly and avoid unnecessary appointments.