Is There Clinical Value in the Mid-Luteal Progesterone Check in Same-Sex Female Couples Undergoing Donor Sperm Intrauterine Insemination?

Purpose: The objective was to evaluate whether the mid-luteal progesterone (MLP) assessment in same-sex female couples benefits clinical outcomes in natural cycles using donor sperm intrauterine insemination (IUI). Methods: This retrospective cohort study included same-sex female couples undergoing...

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Main Authors: Isabelle C. Band, Samantha L. Estevez, Joseph A. Lee, Morgan Baird, Noah Copperman, Daniel Stein, Tanmoy Mukherjee, Alan B. Copperman, Jenna Friedenthal
Format: Article
Language:English
Published: Mary Ann Liebert 2024-04-01
Series:Women's Health Reports
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Online Access:https://www.liebertpub.com/doi/10.1089/whr.2024.0056
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author Isabelle C. Band
Samantha L. Estevez
Joseph A. Lee
Morgan Baird
Noah Copperman
Daniel Stein
Tanmoy Mukherjee
Alan B. Copperman
Jenna Friedenthal
author_facet Isabelle C. Band
Samantha L. Estevez
Joseph A. Lee
Morgan Baird
Noah Copperman
Daniel Stein
Tanmoy Mukherjee
Alan B. Copperman
Jenna Friedenthal
author_sort Isabelle C. Band
collection DOAJ
description Purpose: The objective was to evaluate whether the mid-luteal progesterone (MLP) assessment in same-sex female couples benefits clinical outcomes in natural cycles using donor sperm intrauterine insemination (IUI). Methods: This retrospective cohort study included same-sex female couples undergoing donor sperm IUI from January 2004 to April 2022. Cases included patients with MLP evaluation; controls included those without. MLP was obtained ∼7 days after ovulation. Only natural cycles with human chorionic gonadotropin trigger for timing were included. Primary outcome was clinical pregnancy rate; secondary outcomes were ongoing pregnancy (OP) and spontaneous abortion rates. Results: The study included 912 cycles, in 56 of which MLP was assessed. There were no demographic differences between groups. Among those assessed, the mean MLP was 10.96 ng/mL and 19/56 (33.9%) subsequently received supplemental progesterone. In an unadjusted analysis, there were no significant differences in clinical outcomes between groups. After adjusting for age, body mass index, day 3 follicle-stimulating hormone, and endometrial thickness at the time of ovulation, having MLP evaluated did not predict clinical (odds ratio [OR]: 3.34, confidence interval [CI]: 0.194–57.510, p = 0.406) or OP rate (OR 5.056, CI 0.24–106.62, p = 0.298). A subanalysis found no difference in clinical and OP rates when comparing patients who had received supplemental progesterone versus those who had not. Conclusion: Clinicians may reconsider the MLP assessment within same-sex female couples who use donor sperm IUI, as it does not appear to enhance treatment outcome. Prospective studies may delineate the cost–benefit analysis of the MLP assessment in this cohort.
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spelling doaj-art-c745e68318fd413bbe6a6269cbb559222025-08-20T02:30:55ZengMary Ann LiebertWomen's Health Reports2688-48442024-04-015196597210.1089/whr.2024.0056Is There Clinical Value in the Mid-Luteal Progesterone Check in Same-Sex Female Couples Undergoing Donor Sperm Intrauterine Insemination?Isabelle C. Band0Samantha L. Estevez1Joseph A. Lee2Morgan Baird3Noah Copperman4Daniel Stein5Tanmoy Mukherjee6Alan B. Copperman7Jenna Friedenthal8Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York, USA.Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York, USA.Reproductive Medicine Associates of New York, New York, New York, USA.Reproductive Medicine Associates of New York, New York, New York, USA.Reproductive Medicine Associates of New York, New York, New York, USA.Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York, USA.Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York, USA.Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York, USA.Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York, USA.Purpose: The objective was to evaluate whether the mid-luteal progesterone (MLP) assessment in same-sex female couples benefits clinical outcomes in natural cycles using donor sperm intrauterine insemination (IUI). Methods: This retrospective cohort study included same-sex female couples undergoing donor sperm IUI from January 2004 to April 2022. Cases included patients with MLP evaluation; controls included those without. MLP was obtained ∼7 days after ovulation. Only natural cycles with human chorionic gonadotropin trigger for timing were included. Primary outcome was clinical pregnancy rate; secondary outcomes were ongoing pregnancy (OP) and spontaneous abortion rates. Results: The study included 912 cycles, in 56 of which MLP was assessed. There were no demographic differences between groups. Among those assessed, the mean MLP was 10.96 ng/mL and 19/56 (33.9%) subsequently received supplemental progesterone. In an unadjusted analysis, there were no significant differences in clinical outcomes between groups. After adjusting for age, body mass index, day 3 follicle-stimulating hormone, and endometrial thickness at the time of ovulation, having MLP evaluated did not predict clinical (odds ratio [OR]: 3.34, confidence interval [CI]: 0.194–57.510, p = 0.406) or OP rate (OR 5.056, CI 0.24–106.62, p = 0.298). A subanalysis found no difference in clinical and OP rates when comparing patients who had received supplemental progesterone versus those who had not. Conclusion: Clinicians may reconsider the MLP assessment within same-sex female couples who use donor sperm IUI, as it does not appear to enhance treatment outcome. Prospective studies may delineate the cost–benefit analysis of the MLP assessment in this cohort.https://www.liebertpub.com/doi/10.1089/whr.2024.0056mid-luteal progesteronesame-sex female couplesintrauterine inseminationmedicalizationlesbian
spellingShingle Isabelle C. Band
Samantha L. Estevez
Joseph A. Lee
Morgan Baird
Noah Copperman
Daniel Stein
Tanmoy Mukherjee
Alan B. Copperman
Jenna Friedenthal
Is There Clinical Value in the Mid-Luteal Progesterone Check in Same-Sex Female Couples Undergoing Donor Sperm Intrauterine Insemination?
Women's Health Reports
mid-luteal progesterone
same-sex female couples
intrauterine insemination
medicalization
lesbian
title Is There Clinical Value in the Mid-Luteal Progesterone Check in Same-Sex Female Couples Undergoing Donor Sperm Intrauterine Insemination?
title_full Is There Clinical Value in the Mid-Luteal Progesterone Check in Same-Sex Female Couples Undergoing Donor Sperm Intrauterine Insemination?
title_fullStr Is There Clinical Value in the Mid-Luteal Progesterone Check in Same-Sex Female Couples Undergoing Donor Sperm Intrauterine Insemination?
title_full_unstemmed Is There Clinical Value in the Mid-Luteal Progesterone Check in Same-Sex Female Couples Undergoing Donor Sperm Intrauterine Insemination?
title_short Is There Clinical Value in the Mid-Luteal Progesterone Check in Same-Sex Female Couples Undergoing Donor Sperm Intrauterine Insemination?
title_sort is there clinical value in the mid luteal progesterone check in same sex female couples undergoing donor sperm intrauterine insemination
topic mid-luteal progesterone
same-sex female couples
intrauterine insemination
medicalization
lesbian
url https://www.liebertpub.com/doi/10.1089/whr.2024.0056
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