Lower pregnancy rate with premature luteinization during pituitary suppression with leuprolide acetate.
The relationship of the circulating level of progesterone (P) on the day of human chorionic gonadotropin (hCG) injection to occurrence of clinical pregnancy was examined in 133 leuprolide acetate human menopausal gonadotropin (hMG) in vitro fertilization cycles in women having at least three embryos transferred. Progesterone concentrations greater than 0.5 ng/mL were associated with a significantly lower rate of pregnancy (12/59, 20%) compared with less than 0.5 ng/mL (40/74, 54%, P less than 0.005). The higher P cycles were associated with greater patient age and hMG dose, although these relationships appeared to be indirect. Luteinizing hormone (LH) concentrations remained suppressed. Ovarian stimulation may cause excessive luteinization and an adverse cycle outcome even in the presence of low LH levels. Prospective use of P levels may be helpful to determine optimal hCG timing.
Schoolcraft
W
W
Swedish Hospital, Denver, Colorado.
Sinton
E
E
Schlenker
T
T
Huynh
D
D
Hamilton
F
F
Meldrum
D R
DR
D000328:Adult; D006063:Chorionic Gonadotropin / Q000008:administration & dosage; D004334:Drug Administration Schedule; D004958:Estradiol / Q000097:blood; D005260:Female; D005307:Fertilization in Vitro; D007987:Gonadotropin-Releasing Hormone / Q000031:analogs & derivatives* / Q000494:pharmacology; D006728:Hormones / Q000494:pharmacology*; D006801:Humans; D016729:Leuprolide; D008183:Luteal Phase / Q000187:drug effects*; D007986:Luteinizing Hormone / Q000097:blood; D008596:Menotropins / Q000627:therapeutic use; D010062:Ovulation Induction; D010902:Pituitary Gland / Q000187:drug effects*; D011374:Progesterone / Q000097:blood
D006063:Chorionic Gonadotropin; D006728:Hormones; D007987:Gonadotropin-Releasing Hormone; D011374:Progesterone; D004958:Estradiol; D008596:Menotropins; D007986:Luteinizing Hormone; D016729:Leuprolide