Relationship of progesterone/estradiol ratio on day of hCG administration and pregnancy outcomes in high responders undergoing in vitro fertilization.
OBJECTIVE
To evaluate the predictive value of a serum P/E(2) ratio measured on the day of hCG administration regarding pregnancy outcomes in high responders undergoing IVF.


METHODS
Retrospective study.


METHODS
Teaching hospital.


METHODS
Two hundred twenty-three infertile women classified as high responders in IVF-ET cycles.


METHODS
Eligible infertile women undergoing IVF were assigned to four groups according to serum P levels on the day of hCG administration: group 1, P</=0.9 ng/mL; group 2, 0.9 < P<or=1.4 ng/mL; group 3, 1.4 < P<or=2.0 ng/mL; group 4, P>2.0 ng/mL. The relationship of E(2) level and P/E(2) ratio on the day of hCG administration and pregnancy outcomes was analyzed.


METHODS
Implantation and pregnancy rate.


RESULTS
Patients in group 4 had highest E(2) level and P/E(2) ratio, as well as lowest implantation and pregnancy rates. Using P for grouping, the sensitivity/positive predictive values (%/%) of P/E(2) ratio in the four groups were 15/66, 30/65, 30/60, and 25/41, respectively.


CONCLUSIONS
Using the level of a single sex hormone on hCG day to predict pregnancy outcome in high responders undergoing IVF is confounding, whereas using a P/E(2) ratio on hCG day is theoretically reasonable. However, the low sensitivity and positive predictive value make the use of P/E(2) clinically unfeasible.
Lee
Fa-Kung
FK
Department of Obstetrics and Gynecology, Cathay General Hospital, HsinChu Branch, HsinChu, Taiwan; Department of Medical Laboratory Science and Biotechnology, Yuanpei University, Hsin Chu, Taiwan.
Lai
Tsung-Hsuan
TH
Fu Jen Catholic University School of Medicine, Taipei, Taiwan; Department of Obstetrics and Gynecology, Cathay General Hospital, Taipei, Taiwan.
Lin
Tseng-Kai
TK
Department of Obstetrics and Gynecology, Cathay General Hospital, HsinChu Branch, HsinChu, Taiwan; Department of Medical Laboratory Science and Biotechnology, Yuanpei University, Hsin Chu, Taiwan.
Horng
Shang-Gwo
SG
Department of Obstetrics and Gynecology, Cathay General Hospital, HsinChu Branch, HsinChu, Taiwan. Electronic address: hsg@cgh.org.tw.
Chen
Su-Chee
SC
Fu Jen Catholic University School of Medicine, Taipei, Taiwan; Department of Obstetrics and Gynecology, Cathay General Hospital, Taipei, Taiwan.
D000328:Adult; D006063:Chorionic Gonadotropin / Q000008:administration & dosage / Q000627:therapeutic use*; D004958:Estradiol / Q000032:analysis / Q000097:blood*; D005260:Female; D005300:Fertility Agents, Female / Q000008:administration & dosage / Q000627:therapeutic use; D005307:Fertilization in Vitro / Q000379:methods*; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D007247:Infertility, Female / Q000097:blood / Q000175:diagnosis / Q000628:therapy; D007986:Luteinizing Hormone / Q000097:blood; D010062:Ovulation Induction / Q000379:methods*; D011237:Predictive Value of Tests; D011247:Pregnancy; D011256:Pregnancy Outcome; D011374:Progesterone / Q000032:analysis / Q000097:blood*; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome
D006063:Chorionic Gonadotropin; D005300:Fertility Agents, Female; D011374:Progesterone; D004958:Estradiol; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone