Evidence map›Paper›PMID 40229881›Full record

Observational studyJournal of ovarian research2025

Defining the LH surge in natural cycle frozen-thawed embryo transfer: the role of LH, estradiol, and progesterone.

Raoul Orvieto, Nira Morag, Elena Rubin, Ravit Nahum

Abstract readObservational Study
In one paragraph

Observational study in Journal of ovarian research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Raoul OrvietoDepartment of Obstetrics and Gynecology, Chaim Sheba Medical Center (Tel Hashomer), Ramat Gan, 52621, Israel. raoul.orvieto@sheba.health.gov.il.
Nira MoragFaculty of Medical and Health Science, Tel Aviv University, Tel Aviv, Israel.
Elena RubinDepartment of Obstetrics and Gynecology, Mayanei Hayeshua Medical Center, Bnei Brak, Israel.
Ravit NahumDepartment of Obstetrics and Gynecology, Chaim Sheba Medical Center (Tel Hashomer), Ramat Gan, 52621, Israel.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveSeveral replacement protocols for frozen-thawed ET (FET) exist, with no advantage of one protocol over the others. In the present retrospective and observational study we aim to evaluate the hormonal changes round the LH surge, for better determination of the LH surge and improving the NC FET outcome. We reviewed the computerized files of all consecutive women admitted to our IVF Institute, between January 1, 2023 and June 30, 2024, who underwent NC FET cycles in our IVF Institute. The elimination of bias in this selection, for the purposes of this study, was achieved by including only patients who had two consecutive hormonal blood tests and transvaginal ultrasound evaluations prior to ovulation, on two days (D- 2) before and one day before ovulation (D- 1). Data on patient demographics and infertility-treatment-related variables were collected from the files. We studied and compared several variable between patients who conceived and those who did not, including the % changes in LH (D- 1 minus D- 2/D- 2), in estradiol (D- 2 minus D- 1/D- 2) and % change in progesterone (D- 1 minus D- 2/D- 2) levels.

resultsSix hundreds and sixty-eight NC FET cycles were performed during the study periods. Pregnancy was achieved in 348 patients (pregnancy rate, 52% per cycle). Figure that is not-significantly higher than our previous reported outcome, when the LH surge was defined only by the rise in LH level (46% per cycle). Patients who conceived were significantly younger, with no in-between group differences in LH, E2 and progesterone levels. Moreover, while no differences were observed in the % changes in E2, nor LH levels, the % change in progesterone levels was significantly higher in those who conceived (1.9 + 1.5 vs 1.6 + 1.4, p < 0.013), as compared to those who did not.

conclusionsPatients undergoing NC FET should be monitored by LH, estradiol and progesterone levels. We suggest that the LH surge should be determined by an increase in LH, concomitant to a drop in estradiol and a threefold increase in progesterone levels between D- 2 to D- 1. Further large prospective studies are needed to elucidate the aforementioned recommendation prior to its routine implementation.

Indexed as

Embryo TransferEstradiolLuteinizing HormoneProgesteroneAdultCryopreservationFemaleFertilization in VitroHumansPregnancyPregnancy RateRetrospective StudiesEstradiolLuteinizing HormoneProgesteroneCryopreservationFrozen-thawed embryo transferLH surgeLuteal supportNatural cycleOutcomePregnancy rate

Identifiers

PMID40229881
PMCPMC11995576

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.