An increased serum progesterone-to-estradiol ratio on the day of human chorionic gonadotropin administration does not have a negative impact on clinical pregnancy rate in women with normal ovarian reserve treated with a long gonadotropin releasing hormone agonist protocol.
OBJECTIVE
To evaluate the relationship between serum P:E(2) ratio on the day of hCG administration and the clinical outcomes in infertile women with normal ovarian reserve treated with a long GnRH agonist (GnRH-a) protocol.


METHODS
Retrospective analysis of IVF-embryo transfer data.


METHODS
University teaching hospital.


METHODS
One hundred thirty-nine infertile women with normal ovarian reserve, who received IVF-embryo transfer with a long GnRH-a protocol.


METHODS
Cycles were grouped according to whether premature luteinization (PL) appeared on the day of hCG administration. Premature luteinization was defined as a P:E(2) ratio >or=1.2 by using receiver operator characteristic analysis.


METHODS
Treatment cycle hormonal characteristics and clinical outcomes.


RESULTS
The P:E(2) ratio on the day of hCG administration was significantly higher in the PL (n = 41) compared with the non-PL (n = 98) group (2.4 +/- 1.5 and 0.6 +/- 0.3, respectively). The mean number of oocytes retrieved in the PL and non-PL groups were 4.2 +/- 2.8 and 12.7 +/- 6.6, respectively. However, the difference between the clinical pregnancy rates (PR) in the PL and non-PL groups was not statistically significant (29.3% vs. 34.5%). In a logistic regression analysis, the P:E(2) ratio showed no statistically significant correlation with pregnancy outcome.


CONCLUSIONS
The increased serum P:E(2) ratio on the day of hCG administration, as an indicator of PL, has a poor predictive value on IVF outcomes in infertile women with normal ovarian reserve treated with a long GnRH-a protocol.
Lai
Tsung-Hsuan
TH
Department of Obstetrics and Gynecology, Cathay General Hospital, Taipei, Taiwan. Joseph@cgh.org.tw
Lee
Fa-Kung
FK
Lin
Tseng-Kai
TK
Horng
Shang-Gwo
SG
Chen
Su-Chee
SC
Chen
Ya-Hui
YH
Wang
Pa-Chun
PC
D004305:Dose-Response Relationship, Drug; D004958:Estradiol / Q000097:blood*; D005260:Female; D005300:Fertility Agents, Female / Q000008:administration & dosage*; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists*; D006801:Humans; D007247:Infertility, Female / Q000097:blood* / Q000453:epidemiology / Q000628:therapy*; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D018873:Pregnancy Rate; D015995:Prevalence; D011374:Progesterone / Q000097:blood*; D011379:Prognosis; D012189:Retrospective Studies; D013624:Taiwan / Q000453:epidemiology; D016896:Treatment Outcome
D005300:Fertility Agents, Female; D007987:Gonadotropin-Releasing Hormone; D011374:Progesterone; D004958:Estradiol