title: Evaluation of the reproductive performance of women with elevated day 10 progesterone levels during ovarian reserve screening.
abstract: OBJECTIVE
  To evaluate the relationship of elevated day 10 P levels (> or = 1.1 ng/mL, conversion factor to SI unit, 3.18) during ovarian reserve screening and reproductive performance.
  
  
  METHODS
  Prospective screening with longitudinal follow-up.
  
  
  METHODS
  One hundred seven women underwent ovarian reserve screening with a clomiphene citrate challenge test.
  
  
  METHODS
  Serum FSH, LH, and E2 levels were determined on cycle day 3 and FSH, LH, and P levels were determined on day 10. A fertility evaluation was completed and a treatment plan was instituted.
  
  
  RESULTS
  Twenty-two of 107 (20.6%) women had day 10 P levels > or = 1.1 ng/mL. Women with elevated day 10 P levels were similar in age to women with normal day 10 P levels (< or = 0.9 ng/mL) but had significantly shorter menstrual cycles, higher day 3 and day 10 FSH levels, higher day 3 E2 levels, and higher day 10 LH levels than women with normal day 10 P levels. During ovarian hyperstimulation, women with elevated day 10 P levels required more ampules of hMG, had lower peak E2 levels, and had fewer mature follicles than women with a normal day 10 P level. Sixteen of 85 (18.8%) women with normal day 10 P levels became pregnant, but none of the 22 women with elevated day 10 P levels became pregnant. The incidence of diminished ovarian reserve was higher in women with elevated day 10 P levels (13/22; 59%) when compared with women with a normal day 10 P levels (9/85; 10.6%).
  
  
  CONCLUSIONS
  Elevated day 10 P levels (> or = 1.1 ng/mL) during ovarian reserve screening is associated with diminished ovarian reserve and correlates with menstrual cycle parameters associated with a short follicular phase and poor reproductive performance.
authors.affiliation: Department of Obstetrics and Gynecology, Bethesda Hospital, Cincinnati, Ohio, USA.
authors.forename: G E
authors.initials: GE
authors.lastname: Hofmann
authors.forename: R T
authors.initials: RT
authors.lastname: Scott
authors.forename: G M
authors.initials: GM
authors.lastname: Horowitz
authors.forename: J
authors.initials: J
authors.lastname: Thie
authors.forename: D
authors.initials: D
authors.lastname: Navot
mesh_terms: D000328:Adult; D002996:Clomiphene; D004958:Estradiol / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D005498:Follicular Phase; D006801:Humans; D007986:Luteinizing Hormone / Q000097:blood; D008596:Menotropins / Q000008:administration & dosage; D008597:Menstrual Cycle; D010053:Ovary / Q000502:physiology*; D011247:Pregnancy; D011374:Progesterone / Q000097:blood*; D011446:Prospective Studies; D012098:Reproduction; D013997:Time Factors
chemical_list: D002996:Clomiphene; D011374:Progesterone; D004958:Estradiol; D008596:Menotropins; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone