The dosage of human chorionic gonadotropins influences the relationship between progesterone and cycle outcome during in vitro fertilization-embryo transfer.
OBJECTIVE
To determine if the dose of hCG affects the initial rise in progesterone seen in patients undergoing IVF-ET and therefore affects it usefulness as a predictor of cycle outcome.


METHODS
Comparison of the rise in progesterone with cycle outcomes for IVF patients receiving 5,000 or 10,000 mIU hCG to stimulate oocyte maturation.


METHODS
University-based infertility program. Patients-One hundred six patients undergoing IVF-ET on a long protocol of down-regulation with GnRH, hMG stimulation, and hCG to stimulate oocyte maturation. Stimulation protocol varied only in dose of hCG [5,000 mIU (N = 72) vs. 10,000 mIU (N = 34)].


METHODS
Rise in progesterone from 12 hours before to 12 hours after hCG administration and its relationship with cycle outcome.


RESULTS
All 106 women exhibited a rise in progesterone following the administration of hCG. As seen in earlier studies, there appeared to be a relationship between minimal progesterone increases (<3-fold) and cycle failure in patients receiving 5,000 mIU (P < .02). However, using the criteria of the previous study, there appears to be no relationship between progesterone and cycle outcome in patients receiving 10,000 mIU (P = .30). Further, the higher dose of hCG appeared to induce greater increases in progesterone over the 24-hour period examined (P < .02). After readjustment of the critical value to 3.5-fold, there was an increased tendency toward cycle failure in women exhibiting a minimal progesterone increase. Unlike the relationship associated with 5,000 mIU hCG, though, the relationship between 10,000 mIU hCG and progesterone levels was not statistically different (P = .10).


CONCLUSIONS
Increasing the dose of hCG used to stimulate oocyte maturity shifts the previously described relationship between progesterone and IVF-ET-cycle outcome. However, while it remains unclear if progesterone can be used as a predictor of outcome at the higher hCG dose, it appears clear that a relationship exists between minimal progesterone response to hCG and cycle failure.
Prien
S D
SD
Department of Obstetrics and Gynecology, Texas Tech University Health Sciences Center, Lubbock 79430, USA.
Canez
M S
MS
Messer
R H
RH
D000328:Adult; D006063:Chorionic Gonadotropin / Q000008:administration & dosage / Q000494:pharmacology*; D004305:Dose-Response Relationship, Drug; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D007246:Infertility / Q000097:blood / Q000628:therapy*; D010062:Ovulation Induction; D011247:Pregnancy; D011374:Progesterone / Q000097:blood*; D013997:Time Factors
D006063:Chorionic Gonadotropin; D011374:Progesterone