title: Elevated serum progesterone-to-estradiol ratio during gonadotropin stimulation for intrauterine insemination or in vitro fertilization is not associated with diminished ovarian reserve.
abstract: 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.
authors.affiliation: Department of Obstetrics and Gynecology, Bethesda Center for Reproductive Health and Fertility, Bethesda Hospital, Cincinnati, Ohio 45206, USA. hofmanng@aol.com
authors.forename: Glen E
authors.initials: GE
authors.lastname: Hofmann
authors.forename: Jane
authors.initials: J
authors.lastname: Khoury
authors.forename: Chad
authors.initials: C
authors.lastname: Michener
mesh_terms: 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
chemical_list: D006063:Chorionic Gonadotropin; D005300:Fertility Agents, Female; D002996:Clomiphene; D011374:Progesterone; D004958:Estradiol; D008596:Menotropins