Elevated serum progesterone levels on the day of human chorionic gonadotropin administration do not predict outcome in assisted reproduction cycles.
OBJECTIVE
To determine if the level of serum P drawn on the day of hCG administration predicts assisted reproductive technology (ART) outcome in patients undergoing stimulation with hMG under GnRH agonist (GnRH-a) suppression.


METHODS
Retrospective P assay of stored serum.


METHODS
One hundred seventy-one patients (189 cycles) who had undergone GnRH-a suppression (leuprolide acetate or nafarelin) and stimulation with hMG for an ART procedure.


METHODS
Progesterone RIA of serum obtained on the day of hCG administration. Measurement of sequential serum LH values by RIA in those patients with the highest P levels.


RESULTS
Pregnancy rates per oocyte retrieval were not correlated with the P level before hCG administration. There were 18 of 54 (33.3%) clinical pregnancies in those cycles with P < 0.9 ng/mL (conversion factor to SI unit, 3.180) and 42 of 135 (31.1%) clinical pregnancies in cycles with a P > or = 0.9 ng/mL. Significantly higher serum E2 levels and numbers of of follicles and oocytes obtained were observed in the high P cycles. There were no differences in the number of oocytes fertilized, the number of embryos transferred, or the implantation rate. However, a significantly higher percentage of mature oocytes were fertilized in the low P cycles (73%), as compared with the high P cycles (60%).


CONCLUSIONS
Serum P levels before hCG administration do not predict the outcome of ART cycles in patients suppressed with GnRH-a before hMG stimulation. Lower fertilization rates observed in the high P cycles did not have an effect on clinical outcome.
Givens
C R
CR
Department of Obstetrics, Gynecology, and Reproductive Services, University of California at San Francisco 94143-0132.
Schriock
E D
ED
Dandekar
P V
PV
Martin
M C
MC
D006063:Chorionic Gonadotropin / Q000008:administration & dosage* / Q000627:therapeutic use; D004624:Embryo Transfer; D004958:Estradiol / Q000097:blood; D005260:Female; D005307:Fertilization in Vitro; D015181:Gamete Intrafallopian Transfer; D006801:Humans; D016729:Leuprolide / Q000627:therapeutic use; D007986:Luteinizing Hormone / Q000097:blood; D008596:Menotropins / Q000627:therapeutic use; D017274:Nafarelin / Q000627:therapeutic use; D011247:Pregnancy; D011374:Progesterone / Q000097:blood*; D012099:Reproductive Techniques; D012189:Retrospective Studies; D017388:Zygote Intrafallopian Transfer
D006063:Chorionic Gonadotropin; D017274:Nafarelin; D011374:Progesterone; D004958:Estradiol; D008596:Menotropins; D007986:Luteinizing Hormone; D016729:Leuprolide