Premature elevation of plasma progesterone alters pregnancy rates of in vitro fertilization and embryo transfer.
OBJECTIVE
To determine if an increase in plasma P occurring before hCG administration might impair the outcome of IVF-ET.


METHODS
Five hundred eighty-five IVF-ET cycles were prospectively studied for the occurrence of plasma P elevation before hCG administration.


METHODS
Tertiary institution, IVF-ET program, Hôpital A. Béclère.


METHODS
Participating patients included IVF-ET candidates 23 to 42 years of age only, excluding the couples in whom a male factor was a primary or an accessory cause of infertility.


METHODS
To clarify the practical consequences on IVF-ET outcome of pre-hCG increases in plasma P, we studied 585 consecutive IVF-ET cycles. These were divided into two groups according to plasma P levels observed on the day of hCG administration; plasma P of 0.9 ng/mL (2.9 nmol/L) was taken as an arbitrary cutoff value. Group A included 485 IVF cycles in which plasma P was < or = 0.9 ng/mL (2.9 nmol/L); group B included the remaining 100 cycles in which plasma P was > 0.9 ng/mL (2.9 nmol/L).


RESULTS
The number of mature oocytes retrieved, the oocyte cleavage rate, and the number of embryos obtained were similar in groups A and B. In contrast to this apparent similarity in oocyte quality, a decrease in pregnancy rate (PR) and a trend for a decrease in embryo implantation rate were observed in group B in comparison with group A.


CONCLUSIONS
The similar fertilization and cleavage rates obtained in groups A and B suggest that pre-hCG elevation in plasma P does not lead to decreased oocyte quality. Yet the lower PR observed when plasma P rises prematurely suggests that the prolonged but discrete elevation in plasma P occurring in these cases might alter endometrium receptivity to embryo implantation.
Fanchin
R
R
Department of Obstetrics and Gynecology, Hôpital Antoine Béclère, Clamart, France.
de Ziegler
D
D
Taieb
J
J
Hazout
A
A
Frydman
R
R
D000328:Adult; D015415:Biomarkers / Q000097:blood; D006063:Chorionic Gonadotropin / Q000627:therapeutic use; D004624:Embryo Transfer; D004958:Estradiol / Q000097:blood; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D007986:Luteinizing Hormone / Q000097:blood; D008596:Menotropins / Q000627:therapeutic use; D011247:Pregnancy / Q000097:blood*; D011256:Pregnancy Outcome; D011374:Progesterone / Q000097:blood*; D011446:Prospective Studies
D015415:Biomarkers; D006063:Chorionic Gonadotropin; D011374:Progesterone; D004958:Estradiol; D008596:Menotropins; D007986:Luteinizing Hormone