Hormonal Induction of Endometrial Receptivity for Fresh or Frozen Embryo Transfer
Hormonal Induction of Endometrial Receptivity for Fresh or Frozen Embryo Transfer Part I & II: An Overview by Richard J. Paulson, MD
Date: February 19, 2025
Author: ASRM
Dive into the history, current practices, and ongoing debates surrounding progesterone administration in assisted reproductive technology (ART) with Dr. Richard Paulson, a seasoned expert in IVF and reproductive medicine from the University of Southern California.
In a two-part ASRMed Talk, Dr. Paulson traces the origins of hormonal induction back to the beginning, with the start of egg donation. The world's first pregnancy in an agonadal recipient took place in 1983. The patient took 50 milligrams twice a day of both oral estrogen and vaginal progesterone, and one two-cell embryo was transferred on the second day of progesterone, meaning the progesterone started when that embryo was at the pre-nuclear stage. After this first procedure, the preparation of the endometrium was extended to surrogacy, and, as embryo cryopreservation became more efficient, it was used for preparation of the endometrium prior to frozen embryo transfer. Today, this use is the most common.
He also delves into current practices for preparing the endometrium using hormonal induction, stating that “estrogen and progesterone are all that have ever been shown to be necessary and nothing added to it has actually been shown to make a difference.” There are two common estrogen induction methods: oral and transdermal. Progesterone is present at much higher levels in the body, requiring higher doses and making intramuscular and vaginal methods the only viable options.
In Part II, he addresses the ongoing debate regarding vaginal versus intramuscular progesterone, recounting his own research that revealed that vaginal administration yielded higher endometrial tissue levels despite lower serum levels. He acknowledges recent studies that challenged the equivalence of these methods, but maintains his belief that vaginal progesterone is equally effective.
Furthermore, Dr. Paulson addresses the crucial aspect of progesterone timing, advocating for administration on the evening of the day of ovulation or the following morning. He also discusses the limitations of endometrial receptivity tests like the ERA, emphasizing the lack of proven clinical superiority. In conclusion, Dr. Paulson underscores the simplicity of endometrial preparation, reaffirming that the established protocols remain effective. He expresses optimism for the future, particularly the potential for subcutaneous progesterone administration, and reiterates the enduring importance of estrogen and progesterone in achieving successful outcomes in ART.
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Journal Club Global en Español: Proyecto SOP 2025
Fertility and Sterility presents Journal Club Global at the 2nd International Congress of "Proyecto SOP"
ASRM Member Spotlight: Navid Esfandiari, PhD, ELD, HCLD
Meet Navid Esfandiari, PhD, ELD, HCLD, Clinical Professor and the IVF and Andrology Laboratories Director at the University of Vermont Medical Center.
William "Bud" R. Keye Jr., MD
Dr. William "Bud" Keye Jr., IVF pioneer and advocate for women's health, passed at 81. He inspired many through teaching, care, and public outreach.
SIG Spotlight: CIMSIG
CIMSIG promotes learning and idea exchange on complementary and integrative therapies in reproductive medicine. Join this dynamic and growing community!
ASRM Today Season Three
ASRM Today returns for season 3! Join host Jeffrey Hayes to explore genetics in science, medicine, ethics, and pop culture. Subscribe so you don't miss out!
Fertility and Sterility Publishes Joint Opinion Piece on Addressing the Endometriosis Gap
Fertility and Sterility highlights racial disparities in endometriosis care and urges equitable treatment, research, and policy changes for Black women.
Philip I. McNamee, MD
Honoring Dr. Philip I. McNamee, pioneering reproductive endocrinologist, a veteran & arts advocate whose legacy of love, innovation and community inspires hope.
Fertility and Sterility On Air - TOC: April 2025
Explore new findings on Turner Syndrome, testosterone therapy, embryo assessment, and ART outcomes in this April 2025 episode of Fertility & Sterility On Air.
ASRM Today: Genetics - Episode One
Explore how Gregor Mendel's pea plant experiments in a monastery garden laid the foundation for modern genetics and reproductive medicine.
ASRM, SART Decry “Dangerous and Devastating” Cuts at HHS
ASRM and SART condemn dangerous staffing cuts at FDA, NIH, and CDC, calling for immediate reversal to protect vital public health and reproductive research.
Winners of the 2025 SREI Fellow's Young Investigator Research Award Announced
SREI and ASRM announce winners of the prestigious 2025 Young Investigator Research Award, supporting innovative research in reproductive endocrinology.
Advocacy in Action: March 2025
A summary of federal and state legislation, and highlighting advocacy and outreach efforts of our members.
Reproductive Managers, Nurses, and APPS Take on Nashville for the Annual ARM & NPG National Meeting and the Inaugural APP Conference
Reproductive Managers, Nurses, and APPS Take on Nashville for the Annual ARM & NPG National Meeting and the Inaugural APP Conference.
ASRM Member Spotlight: Sigal Klipstein, MD
Meet Dr. Sigal Klipstein, renowned reproductive endocrinologist at InVia Fertility Specialists, expert in infertility treatment, medical ethics, and patient care.
NEW at the ASRM 2025 President’s Gala
The team is working behind the scenes to spice up the 2025 President’s Gala, Sunday, October 26, in San Antonio.
Honor a Nurse. Support Their Future.
Honor fertility nurses during National Nurses Week by donating to support specialized training, showing gratitude, and investing in their professional growth.
How is a New CPT Code “Created”?
Introducing a New CPT Code for Reimbursement of Pelvic Exams Performed in Clinic
ASRM Staff Spotlight: Madeline Brooks
Meet Madeline Brooks, BS, Practice Guidelines Development Coordinator at ASRM.
ASRM Center for Policy & Leadership Releases Fact Sheet on Safety of IVF for Pregnant People and Babies
ASRM's fact sheet confirms IVF as a safe, effective, regulated medical procedure, emphasizing careful monitoring of pregnancies for optimal health outcomes.
Fertility and Sterility On Air - TOC: March 2025
Explore the latest reproductive medicine research, from embryo retention and fertility preservation to ovulation tests and sleep’s impact on ovarian reserve.
ASRM Center for Policy & Leadership Releases White Paper Detailing Oversight of IVF in the U.S. and Abroad
ASRM's Center for Policy & Leadership releases a white paper on IVF and ART oversight, detailing U.S. and global regulations and their impact on reproductive care.
Journal Club Global: Clinical Evaluation and Management of Chronic Endometritis and Its Impact on Fertility
Experts discuss chronic endometritis, its diagnosis, treatment, and impact on fertility, highlighting key findings, diagnostic methods, and future research needs.
ASRM Center for Policy and Leadership Announces 2025 PRIMED Cohort
ASRM's Center for Policy and Leadership announces the 2025 PRIMED cohort, advancing advocacy in reproductive medicine through expert training and engagement.
SIG Spotlight: FP SIG
The ASRM Fertility Preservation SIG promotes global research, education, and strategies on fertility loss from cancer therapy and other medical treatments.
ASRM Releases Statement on IVF Policy Priorities
ASRM advocates for expanded IVF access, urging policy solutions that prioritize patient care, inclusivity, and medical decision-making free from political interference.
ASRM Staff Spotlight: Lou Ella Watkins
Meet Lou Ella Watkins, the Accounting Services Administrator at ASRM. She has dedicated 36 years to ASRM, working 30 of those years in the Finance Department.
Advocacy in Action: February 2025
A summary of federal and state legislation, and highlighting advocacy and outreach efforts of our members.
February: What's New from the Fertility and Sterility Family of Journals
Here’s a peek at this month’s issues from our family of journals! As an ASRM Member, you can access all of our journals.
Federal Advocacy Day
Join RESOLVE & ASRM on May 20, 2025, for Federal Advocacy Day to support reproductive medicine and ART access. Register now for this virtual advocacy event.
John A. Collins, MD, FRCSC, FRCOG, FACOG, C.M.
An OB/GYN and reproductive medicine specialist, Dr. Collins made significant contributions to women's health, reproductive endocrinology, and evidence-based medicine.
Caring for Black Women Seeking Fertility Treatment: Challenges, Stigma, and Hope
Celebrating Black History Month, we honor Black women facing unique medical, societal, and cultural challenges throughout their personal infertility journeys.
Hormonal Induction of Endometrial Receptivity for Fresh or Frozen Embryo Transfer Part I & II: An Overview by Richard J. Paulson, MD
Explore progesterone use in ART with IVF expert Dr. Richard Paulson of USC—covering history, current practices, and ongoing debates in reproductive medicine.
ASRM responds to Trump Executive Order on IVF
ASRM welcomes Trump’s Executive Order on IVF, urging mandated insurance coverage and federal employee access to fertility care.
Fertility and Sterility On Air - TOC: Feb 2025
Explore the latest research in reproductive medicine, from IVF risks to IVM advancements, POI implications, and REI fellowship insights in this episode of F&S On Air.
ASRM Member Spotlight: Giovanni Jubiz, MD, PhD, FACOG, FCRI
Meet Giovanni Jubiz, MD, PhD, FACOG, FCRI, the current Chairman of the ASRM Reproductive Immunology Special Interest Group, RI SIG.
ASRM Supports Nomination of Lori Chavez-DeRemer to Serve as U.S. Secretary of Labor
ASRM supports Lori Chavez-DeRemer's nomination for Secretary of Labor, citing her bipartisan leadership on fertility care and advocacy for IVF insurance coverage.
STATEMENT: RESOLVE + ASRM: Infertility Patients and Physicians Object to Latest Threats to Medical Research
RESOLVE and ASRM condemn NIH budget cuts, warning of devastating effects on medical research and urging Americans to demand policy reversal.
Fertility and Sterility On Air - TOC: Jan 2025
This episode of Fertility and Sterility On Air covers groundbreaking research on reproductive medicine, including PGTA in donor eggs, BMI effects, and ovarian transplantation.
ASRM Clinical Embryology Learning Laboratory (“CELL”)
Gain comprehensive training in clinical embryology with ASRM's 10-month CELL program. Includes didactic lectures, hands-on simulation, and supervised fellowship.
American Society for Reproductive Medicine Releases Fact Sheet on Biological Sex Differentiation
ASRM releases a new “Just the Facts” paper on biological sex, emphasizing scientific complexity and advocating for informed policymaking in reproductive medicine.
SIG Spotlight: HD SIG
The ASRM HDSIG aims to reduce reproductive health disparities and improve outcomes for diverse racial and ethnic populations.
Welcome New ASRM Members!
It is with great pleasure that the American Society for Reproductive Medicine (ASRM) acknowledges and thanks the following people for their new membership in the Society.
The First Two Weeks of the Second Trump Administration: A Message from the ASRM Office of Public Affairs
ASRM analyzes the Trump administration's early actions, opposing restrictions on public health, research, and reproductive rights while urging members to stay informed and engaged.
Advocacy in Action: January 2025
A summary of federal and state legislation, and highlighting advocacy and outreach efforts of our members.
ASRM Government Affairs Manager Jessie Losch named Director of Government Affairs
Jessie Losch, an experienced advocate for reproductive medicine, has been named ASRM's Director of Government Affairs, starting February 1, 2025.
ASRM Member Spotlight: Emily Harris, PA-C
Meet Emily Harris, PA-C, a Physician Associate Certified (PA-C) at Seattle Reproductive Medicine (SRM) in Seattle, WA.
New Chaperone CPT Code
Introducing a New CPT Code for Reimbursement of Pelvic Exams Performed in Clinic
Welcome to Tech Talk
Welcome to Tech Talk, ASRM’s new blog where cutting-edge tech meets the world of reproductive health.
ASRMed Talks
Check out more ASRMed Talks
Tips and Strategies for Matching Into an REI Fellowship - Residents and Research
Drs. Jiang and Walker share tips on securing research, cold emailing, and strategies for residents in smaller programs with limited or no research opportunities.
Tips and Strategies for Matching Into an REI Fellowship - Fellows Perspective
Drs. Jiang and Walker share tips and strategies on securing research opportunities, cold emailing, and some great strategies from a fellows perspective.More News from ASRM
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An indispensable news digest for reproductive scientists, clinicians and allied health professionals.