Elevated serum progesterone-to-estradiol ratio during gonadotropin stimulation for intrauterine insemination or in vitro fertilization is not associated with diminished ovarian reserve.
OBJECTIVE
To determine whether an elevated serum P:E2 ratio on the day of hCG administration during gonadotropin stimulation for intrauterine insemination (IUI) or IVF is associated with diminished ovarian reserve.


METHODS
Retrospective chart review.


METHODS
Tertiary fertility center.


METHODS
Two hundred eighty-six women undergoing a fertility evaluation.


METHODS
Clomiphene citrate challenge test (CCCT).


METHODS
E2 and P concentrations on the day of hCG administration.


RESULTS
For the IUI group (n = 98), 74 women had a normal CCCT, while 24 had an abnormal CCCT. For women undergoing IVF (n = 188), 171 had a normal CCCT and 17 had an abnormal CCCT. For women undergoing IUI with a normal CCCT, 33 (44%) had a [(P/E2) x 1000] ratio <1 on the day of hCG, while 12 (50%) (abnormal CCCT) had a [(P/E2) x 1000] ratio <1. Similarly, for women doing IVF with a normal CCCT, 96 (56%) had a [(P/E2) x 1000] ratio <1 on the day of hCG, and 9 (44%) (abnormal CCCT) had a [(P/E2) x 1000] ratio <1 on the day of hCG. The frequencies were similar for all comparable groups. For both groups, there was no association between serum (P/E2) x 1000 on the day of hCG administration and day 3 or 10 FSH during the CCCT. For women with a normal CCCT, there were no differences in delivery rates based on the (P/E2) x 1000 ratio.


CONCLUSIONS
In women stimulated with hMG for IUI or IVF, the serum P:E2 ratio on the day of hCG administration is not associated with diminished ovarian reserve, as demonstrated by the CCCT, or pregnancy outcome.
Hofmann
Glen E
GE
Department of Obstetrics and Gynecology, Bethesda Center for Reproductive Health and Fertility, Bethesda Hospital, Cincinnati, Ohio 45206, USA. hofmanng@aol.com
Khoury
Jane
J
Michener
Chad
C
D000328:Adult; D006063:Chorionic Gonadotropin / Q000627:therapeutic use*; D002996:Clomiphene; D004958:Estradiol / Q000097:blood*; D005260:Female; D005300:Fertility Agents, Female; D006801:Humans; D007247:Infertility, Female / Q000503:physiopathology / Q000628:therapy; D007315:Insemination, Artificial; D008596:Menotropins / Q000627:therapeutic use; D010053:Ovary / Q000503:physiopathology*; D010062:Ovulation Induction; D011247:Pregnancy; D011256:Pregnancy Outcome; D011374:Progesterone / Q000097:blood*; D012189:Retrospective Studies
D006063:Chorionic Gonadotropin; D005300:Fertility Agents, Female; D002996:Clomiphene; D011374:Progesterone; D004958:Estradiol; D008596:Menotropins