title: Subtle rise in serum progesterone during the follicular phase as a predictor of the outcome of in vitro fertilization.
abstract: OBJECTIVE
  To investigate the effects of subtle rises in serum progesterone (P) during the follicular phase on the outcome of in vitro fertilization and embryo transfer (IVF-ET).
  
  
  METHODS
  One hundred one patients underwent IVF-ET for 170 cycles and were stimulated with a combination of clomiphene citrate and human menopausal gonadotropin. Based on their hormonal data, we divided the patients into two groups: those who had a cycle with an increase in serum P concentration (1.0 to 2.0 ng/mL) that was not associated with a pituitary LH release (subtle P rise) and those who had a cycle without any increase in serum P concentration (no P rise).
  
  
  METHODS
  The daily serum estradiol (E2) concentration and the results of IVF-ET (number of developed and collected oocytes, rates of mature oocytes, fertilization, and pregnancy) were compared between the two groups.
  
  
  RESULTS
  Subtle P rises were observed in 31.7% (32/101) of the patients and 20.5% (36/170) of the cycles evaluated during the IVF-ET programs. A significantly higher serum E2 concentration (P less than 0.001) and a greater number of developed and collected oocytes (P less than 0.001 and P less than 0.05, respectively) also were observed in those cycles with a subtle P rise. The rates of mature oocyte formation and fertilization were significantly lower in cycles with a subtle P rise (P less than 0.001 and P less than 0.05, respectively). A lower pregnancy rate was observed in cycles with a subtle P rise, and all 12 ongoing pregnancies occurred only in cycles with a no P rise.
  
  
  CONCLUSIONS
  These results suggest that the development of an increased number of follicles may not necessarily improve the outcome of IVF-ET and that the measurement of serum P may be a better predictor for successful pregnancy.
authors.affiliation: Department of Obstetrics and Gynecology, Tottori University School of Medicine, Yonago, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Mio
authors.forename: A
authors.initials: A
authors.lastname: Sekijima
authors.forename: T
authors.initials: T
authors.lastname: Iwabe
authors.forename: Y
authors.initials: Y
authors.lastname: Onohara
authors.forename: T
authors.initials: T
authors.lastname: Harada
authors.forename: N
authors.initials: N
authors.lastname: Terakawa
mesh_terms: D000328:Adult; D002996:Clomiphene / Q000494:pharmacology; D004624:Embryo Transfer; D004958:Estradiol / Q000097:blood; D005260:Female; D005307:Fertilization in Vitro; D005498:Follicular Phase / Q000502:physiology*; D006801:Humans; D008596:Menotropins / Q000494:pharmacology; D010060:Ovulation / Q000187:drug effects / Q000502:physiology; D011237:Predictive Value of Tests; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D011374:Progesterone / Q000097:blood*
chemical_list: D002996:Clomiphene; D011374:Progesterone; D004958:Estradiol; D008596:Menotropins