Lack of placental protein 14 production in pregnancy after frozen embryo transfer, down-regulation of anterior pituitary and administration of exogenous oestradiol and progesterone.
The circulating levels of placental protein 14 (PP14) and progesterone were measured in three pregnancies resulting from the transfer of cryopreserved embryos. Two of these women had suppressed ovarian activity as a result of pituitary down-regulation with the luteinizing hormone-releasing hormone agonist (buserelin) prior to treatment with exogenous oestradiol and progesterone. After 14 days of oral oestradiol treatment and if the endometrial thickness was greater than 7 mm, progesterone was given intramuscularly for a further 14 days with embryo transfer on the third day of this treatment. On confirmation of pregnancy by human chorionic gonadotrophin analysis, progesterone administration was altered to transvaginal pessaries for maintenance of adequate progesterone levels and endometrial support. In the two women with ovarian suppression, PP14 levels remained below the 2.5th centile of the normal range for pregnancy. In the third pregnancy, embryo transfer was performed 3 days after a spontaneous luteinizing hormone surge in a normal menstrual cycle. In this pregnancy, PP14 levels were within the normal range. Ultrasonic examination confirmed three normal ongoing singleton pregnancies. These results suggest that the majority of PP14 production in normal pregnancy is under ovarian or anterior pituitary control and that the influence of progesterone is of a secondary nature.
Department of Human Reproduction and Obstetrics, Princess Anne Hospital, Southampton, Hants, UK.
F W
FW
Anthony
D W
DW
Davies
S C
SC
Gadd
J M
JM
Jenkins
G M
GM
Masson
T
T
Chard
L A
LA
Perry
D002064:Buserelin / Q000494:pharmacology; D004624:Embryo Transfer; D004958:Estradiol / Q000494:pharmacology; D005260:Female; D005307:Fertilization in Vitro; D000071816:Glycodelin; D006023:Glycoproteins; D006801:Humans; D010920:Placenta / Q000187:drug effects* / Q000378:metabolism; D011247:Pregnancy; D011257:Pregnancy Proteins / Q000096:biosynthesis* / Q000187:drug effects; D011374:Progesterone / Q000494:pharmacology
D000071816:Glycodelin; D006023:Glycoproteins; C045246:PAEP protein, human; D011257:Pregnancy Proteins; D011374:Progesterone; D004958:Estradiol; D002064:Buserelin