title: The duration of pre-ovulatory serum progesterone elevation before hCG administration affects the outcome of IVF/ICSI cycles.
abstract: OBJECTIVE
  During controlled ovarian stimulation (COS), does the duration of premature serum progesterone (P) elevation before administration of hCG affect the outcomes of IVF/ICSI embryo transfer (-ET) cycles?
  
  
  CONCLUSIONS
  The duration of the premature serum P elevation is inversely related to the clinical pregnancy rate of IVF/ICSI-ET cycles.
  
  
  BACKGROUND
  The majority of the previous studies only considered a single serum P measurement made on the day of hCG administration and the results of attempts to relate this to IVF/ICSI-ET outcomes were controversial. However, the effect of the duration of premature serum P elevation before the hCG administration on the outcomes of IVF/ICSI-ET cycles has not been studied well. Here we demonstrate that the duration of premature serum P elevation has a more significant inverse correlation than the absolute serum P concentration on the day of hCG administration with IVF/ICSI-ET outcomes.
  
  
  METHODS
  It is a retrospective, single-centre cohort study. A total of 1784 IVF and/or ICSI-ET cycles were included from October 2005 to June 2011.
  
  
  METHODS
  A total of 1784 patients underwent their IVF and/or ICSI-ET cycles in a university hospital IVF unit. The inclusion criteria include (i) age between 20 and 42 years and (ii) eligible indications for COS before IVF/ICSI.
  
  
  RESULTS
  The duration of premature serum P elevation to >1 ng/ml is significantly inversely associated with the probability of clinical pregnancy (odds ratio = 0.773, 95% confidence interval: 0.660-0.891, P < 0.001), after adjustment for possible confounders with multivariate logistic regression analysis. However, the significance of inverse correlation between the absolute serum P concentration on the day of hCG administration with clinical pregnancy rate decreased after adjustment.
  
  
  CONCLUSIONS
  The cutoff value we chose to define premature serum P elevation (P > 1.0 ng/ml) might not be able to be applied to different immunoassay kits and study population. The retrospective nature of this study inevitably might be influenced by some selection bias.
  
  
  CONCLUSIONS
  Older patients (>42 years) are excluded from our study.
authors.affiliation: Department of Obstetrics and Gynecology,  National Taiwan University Hospital and College of Medicine, No. 7 Chung-Shan South Road, Taipei,  Taiwan.
authors.forename: Chu-Chun
authors.initials: CC
authors.lastname: Huang
authors.forename: Yih-Ron
authors.initials: YR
authors.lastname: Lien
authors.forename: Hsin-Fu
authors.initials: HF
authors.lastname: Chen
authors.forename: Mei-Jou
authors.initials: MJ
authors.lastname: Chen
authors.forename: Chia-Jen
authors.initials: CJ
authors.lastname: Shieh
authors.forename: Yi-Lin
authors.initials: YL
authors.lastname: Yao
authors.forename: Chin-Hao
authors.initials: CH
authors.lastname: Chang
authors.forename: Shee-Uan
authors.initials: SU
authors.lastname: Chen
authors.forename: Yu-Shih
authors.initials: YS
authors.lastname: Yang
mesh_terms: D000328:Adult; D006063:Chorionic Gonadotropin / Q000378:metabolism*; D015331:Cohort Studies; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists / Q000378:metabolism; D006801:Humans; D009865:Oocytes / Q000166:cytology; D010062:Ovulation Induction / Q000379:methods; D011247:Pregnancy; D011256:Pregnancy Outcome; D018873:Pregnancy Rate; D011374:Progesterone / Q000096:biosynthesis* / Q000097:blood; D012044:Regression Analysis; D012189:Retrospective Studies; D020554:Sperm Injections, Intracytoplasmic / Q000379:methods*
chemical_list: D006063:Chorionic Gonadotropin; D007987:Gonadotropin-Releasing Hormone; D011374:Progesterone