Are good patient and embryo characteristics protective against the negative effect of elevated progesterone level on the day of oocyte maturation

Elevated P level on the day of human chorionic gonadotropin administration negatively affects live-birth rate, regardless of embryo stage, embryo quality, patient age, or ovarian response.

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Authors

Micah J. Hill, D.O., Greene Donald Royster IV, M.D., Mae Wu Healy, D.O., Kevin S. Richter, Ph.D., Gary Levy, M.D., Alan H. DeCherney, M.D., Eric D. Levens, M.D., Geeta Suthar, B.S.M.T., C.L.C.P., Eric Widra, M.D., Michael J. Levy, M.D.

Volume 103, Issue 6, Pages 1477-1484

Abstract

Objective:

To evaluate if an elevated progesterone (P) level on the day of human chorionic gonadotropin (hCG) administration is associated with a decrease in live-birth rate in patients with a good prognosis.

Design:

Retrospective cohort study.

Setting:

Large, private, assisted reproductive technology (ART) practice.

Patient(s):

One thousand six hundred twenty fresh autologous ART cycles.

Intervention(s):

None.

Main Outcome Measure(s):

Live-birth rate.

Result(s):

A total of 934 blastocyst and 686 cleavage-stage embryo transfer (ET) cycles were evaluated. Serum P levels were not associated with markers of oocyte or embryo quality, including fertilization, embryo stage at transfer, and embryos available for cryopreservation. Patient age, stage of ET, embryo quality, the number of embryos transferred, and P level on the day of hCG administration were all significantly associated with live birth. Higher P levels were associated with decreased odds of live birth for cleavage- and blastocyst-stage embryos, poor-fair and good-quality embryos, and poor- and high-responder patients. The nonsignificance of interaction tests of P levels with embryo stage, embryo quality, patient age, and ovarian response indicated that the relationship between P level and live birth was similar regardless of these factors.

Conclusion(s):

An elevated serum P level on the day of hCG administration was negatively associated with live birth, even in ETs with a good prognosis.

Read the full text at: http://www.fertstert.org/article/S0015-0282(15)00168-5/fulltext


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.

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