Serum progesterone level effects on the outcome of in vitro fertilization in patients with different ovarian response: an analysis of more than 10,000 cycles

Elevated serum P levels are associated with reduced ongoing pregnancy rates regardless of different ovarian responses. Increased P threshold concentration is associated with better ovarian responses.

0
0

Authors

Bei Xu, Ph.D., Zhou Li, Ph.D., Hanwang Zhang, Ph.D., Lei Jin, Ph.D., Yufeng Li, Ph.D., Jihui Ai, Ph.D., Guijin Zhu, M.D.

Vol 97, Issue 6 , Pages 1321-1327.e4

Abstract

Objective:

To investigate the relationship between serum P levels on the day of hCG administration and pregnancy outcomes in different responders undergoing IVF.

Design:

Retrospective study.

Setting:

Teaching hospital.

Patient(s):

A total of 11,055 women who underwent their first IVF/intracytoplasmic sperm injection cycles and a subgroup of 4,021 women undergoing frozen-embryo transfer (FET) cycles.

Intervention(s):

Patients underwent IVF-ET with the long GnRH agonist protocol. The ovarian response was classified as high (≥20 oocytes; n = 2,023), poor (≤4 oocytes; n = 827), or intermediate (remaining cases; n = 8,205) according to the number of oocytes retrieved. Clinical outcomes of IVF-ET and FET cycles were analyzed according to plasma P levels.

Main Outcome Measure(s):

Ongoing pregnancy rates (PRs).

Result(s):

Ongoing PRs in fresh cycle were inversely associated with serum P levels on the day of hCG administration for all patients. Different P threshold concentrations were determined according to different ovarian response: We proposed a serum P level of 1.5 ng/mL as the threshold for poor responders, 1.75 ng/mL for intermediate responders, and 2.25 ng/mL for high responders. Our study does not show negative results for elevated P levels on oocyte performance in terms of fertilization, cleavage rate, or PR of FET cycles within different ovarian responses, offering no evidence for a detrimental effect of high P on oocyte quality.

Conclusion(s):

Elevated P levels on the day of hCG administration negatively influence PR regardless of different ovarian responses, although increased P threshold concentration is associated with better ovarian responses. The detrimental effect of P elevation on PR seems to be unrelated to oocyte quality in all responders.

Read the full text at: http://www.fertstert.org/article/S0015-0282(12)00328-7/fulltext


Go to the profile of Fertility and Sterility

Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

No comments yet.