Elevated serum progesterone level on the day of human chorionic gonadotropin administration does not adversely affect implantation rates after intracytoplasmic sperm injection and embryo transfer.
OBJECTIVE
To evaluate the association between serum P levels on the day of hCG administration and the outcome of intracytoplasmic sperm injection (ICSI).


METHODS
Retrospective case study.


METHODS
Assisted reproduction unit of a tertiary care private hospital.


METHODS
Nine hundred eleven ICSI cycles that proceeded to ET were studied.


METHODS
The decision to administer hCG was based on serum E2 levels and follicle size. Serum P was measured from frozen sera obtained on the day of hCG administration. Cycles were stratified according to serum P levels of <0.9 ng/mL (n = 298) or > or =0.9 ng/mL (n = 613). This cutoff level was selected because it yielded the highest sensitivity and specificity according to a receiver operator characteristic curve.


METHODS
Implantation and clinical pregnancy rates.


RESULTS
In cycles with high serum P levels, more oocytes were retrieved and more embryos were available for transfer. Clinical pregnancy rates per ET in the low and high P groups were 36.9% and 45.4%, respectively (P<.05). The implantation rate per embryo was similar in the two groups (14.9% and 16.4%, respectively, in cycles with P levels <0.9 vs > or =0.9 ng/mL). Abortion rates were 22.7 and 25.8%, respectively (P>.05).


CONCLUSIONS
Our data showed no adverse effect of high serum P levels on the day of hCG administration on implantation rates after ICSI and ET.
Urman
B
B
Assisted Reproduction Unit, American Hospital of Istanbul, Turkey. burman@superonline.com
Alatas
C
C
Aksoy
S
S
Mercan
R
R
Isiklar
A
A
Balaban
B
B
D000328:Adult; D006063:Chorionic Gonadotropin / Q000627:therapeutic use*; D010064:Embryo Implantation; D004624:Embryo Transfer; D005260:Female; D006801:Humans; D008423:Maternal Age; D011247:Pregnancy; D018873:Pregnancy Rate; D018566:Pregnancy, High-Risk; D011374:Progesterone / Q000097:blood*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D020554:Sperm Injections, Intracytoplasmic; D013997:Time Factors; D016896:Treatment Outcome
D006063:Chorionic Gonadotropin; D011374:Progesterone