title: Serum progesterone level effects on the outcome of in vitro fertilization in patients with different ovarian response: an analysis of more than 10,000 cycles.
abstract: OBJECTIVE
  To investigate the relationship between serum P levels on the day of hCG administration and pregnancy outcomes in different responders undergoing IVF.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  Teaching hospital.
  
  
  METHODS
  A total of 11,055 women who underwent their first IVF/intracytoplasmic sperm injection cycles and a subgroup of 4,021 women undergoing frozen-embryo transfer (FET) cycles.
  
  
  METHODS
  Patients underwent IVF-ET with the long GnRH agonist protocol. The ovarian response was classified as high (≥ 20 oocytes; n = 2,023), poor (≤ 4 oocytes; n = 827), or intermediate (remaining cases; n = 8,205) according to the number of oocytes retrieved. Clinical outcomes of IVF-ET and FET cycles were analyzed according to plasma P levels.
  
  
  METHODS
  Ongoing pregnancy rates (PRs).
  
  
  RESULTS
  Ongoing PRs in fresh cycle were inversely associated with serum P levels on the day of hCG administration for all patients. Different P threshold concentrations were determined according to different ovarian response: We proposed a serum P level of 1.5 ng/mL as the threshold for poor responders, 1.75 ng/mL for intermediate responders, and 2.25 ng/mL for high responders. Our study does not show negative results for elevated P levels on oocyte performance in terms of fertilization, cleavage rate, or PR of FET cycles within different ovarian responses, offering no evidence for a detrimental effect of high P on oocyte quality.
  
  
  CONCLUSIONS
  Elevated P levels on the day of hCG administration negatively influence PR regardless of different ovarian responses, although increased P threshold concentration is associated with better ovarian responses. The detrimental effect of P elevation on PR seems to be unrelated to oocyte quality in all responders.
authors.affiliation: Reproductive Medicine Center, Tongji Hospital, Tongji Medicine College, Huazhong University of Science and Technology, Wuhan, People's Republic of China.
authors.forename: Bei
authors.initials: B
authors.lastname: Xu
authors.forename: Zhou
authors.initials: Z
authors.lastname: Li
authors.forename: Hanwang
authors.initials: H
authors.lastname: Zhang
authors.forename: Lei
authors.initials: L
authors.lastname: Jin
authors.forename: Yufeng
authors.initials: Y
authors.lastname: Li
authors.forename: Jihui
authors.initials: J
authors.lastname: Ai
authors.forename: Guijin
authors.initials: G
authors.lastname: Zhu
mesh_terms: D000328:Adult; D006063:Chorionic Gonadotropin / Q000008:administration & dosage*; D004624:Embryo Transfer / Q000379:methods; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists; D006801:Humans; D007247:Infertility, Female / Q000628:therapy*; D008875:Middle Aged; D009865:Oocytes / Q000166:cytology; D010062:Ovulation Induction / Q000379:methods*; D011247:Pregnancy; D018873:Pregnancy Rate; D011374:Progesterone / Q000097:blood*; D012102:Reproductive Control Agents / Q000008:administration & dosage; D012189:Retrospective Studies; D020554:Sperm Injections, Intracytoplasmic / Q000379:methods; D055815:Young Adult
chemical_list: D006063:Chorionic Gonadotropin; D012102:Reproductive Control Agents; D007987:Gonadotropin-Releasing Hormone; D011374:Progesterone