title: Recurrent IVF failure is associated with elevated progesterone on the day of hCG administration.
abstract: OBJECTIVE
  During in vitro fertilization (IVF) treatment, elevated progesterone on the day of human chorionic gonadotrophin (hCG) administration has been reported to be associated with a reduced chance of live birth. It is not known, however, if the relationship is casual or causal. In the latter situation, one would expect the incidence of elevated progesterone on the day of hCG administration to increase with the number of IVF/embryo transfer (ET) failures. The aim of this study was to investigate if the frequency of elevated progesterone on the day of hCG administration is related to the number of IVF failures.
  
  
  METHODS
  This retrospective, observational, cohort study included a consecutive series of 6673 IVF cycles. Subjects were categorized into one of three groups: Group I, no previous IVF/ET treatment; Group II, one previous IVF/ET treatment failure; or Group III, two or more previous IVF/ET treatment failures. The main outcome measure was the proportion of cycles with elevated progesterone (>6 nmol/l) on the day of hCG administration.
  
  
  RESULTS
  After adjusting for age, oestradiol level on the day of hCG administration and number of oocytes retrieved, the proportion of women with elevated progesterone on the day of hCG administration remained significantly different between the three groups: Group I, 16.8%; Group II, 31.7%; and Group III, 39.7% (p < 0.001).
  
  
  CONCLUSIONS
  Elevated progesterone on the day of hCG administration is more likely in women with recurrent IVF failure. Women with two or more IVF failures are twice as likely to have elevated progesterone on the day of hCG administration as women undergoing their first IVF cycle.
authors.affiliation: Centre of Reproductive Medicine, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, PR China; Department of Reproductive Medicine, Royal Hallamshire Hospital, University of Sheffield, Sheffield, UK.
authors.forename: Liu
authors.initials: L
authors.lastname: Liu
authors.forename: Feng
authors.initials: F
authors.lastname: Zhou
authors.forename: Xiaona
authors.initials: X
authors.lastname: Lin
authors.forename: Tinchiu
authors.initials: T
authors.lastname: Li
authors.forename: Xiaomei
authors.initials: X
authors.lastname: Tong
authors.forename: Haiyan
authors.initials: H
authors.lastname: Zhu
authors.forename: Songying
authors.initials: S
authors.lastname: Zhang
mesh_terms: D000328:Adult; D006063:Chorionic Gonadotropin / Q000627:therapeutic use*; D015331:Cohort Studies; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro / Q000009:adverse effects*; D043373:Follicle Stimulating Hormone, Human / Q000627:therapeutic use; D006801:Humans; D011247:Pregnancy; D018873:Pregnancy Rate; D011374:Progesterone / Q000097:blood; D011994:Recombinant Proteins / Q000627:therapeutic use; D012189:Retrospective Studies
chemical_list: D006063:Chorionic Gonadotropin; D043373:Follicle Stimulating Hormone, Human; D011994:Recombinant Proteins; C571801:follitropin alfa; D011374:Progesterone
keywords: Embryo transfer; IVF; Progesterone; Recurrent IVF failure