Subtle rise in serum progesterone during the follicular phase as a predictor of the outcome of in vitro fertilization.
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.
Mio
Y
Y
Department of Obstetrics and Gynecology, Tottori University School of Medicine, Yonago, Japan.
Sekijima
A
A
Iwabe
T
T
Onohara
Y
Y
Harada
T
T
Terakawa
N
N
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*
D002996:Clomiphene; D011374:Progesterone; D004958:Estradiol; D008596:Menotropins