title: Are good patient and embryo characteristics protective against the negative effect of elevated progesterone level on the day of oocyte maturation?
abstract: OBJECTIVE
  To evaluate if an elevated progesterone (P) level on the day of human chorionic gonadotropin (hCG) administration is associated with a decrease in live-birth rate in patients with a good prognosis.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Large, private, assisted reproductive technology (ART) practice.
  
  
  METHODS
  One thousand six hundred twenty fresh autologous ART cycles.
  
  
  METHODS
  None.
  
  
  METHODS
  Live-birth rate.
  
  
  RESULTS
  A total of 934 blastocyst and 686 cleavage-stage embryo transfer (ET) cycles were evaluated. Serum P levels were not associated with markers of oocyte or embryo quality, including fertilization, embryo stage at transfer, and embryos available for cryopreservation. Patient age, stage of ET, embryo quality, the number of embryos transferred, and P level on the day of hCG administration were all significantly associated with live birth. Higher P levels were associated with decreased odds of live birth for cleavage- and blastocyst-stage embryos, poor-fair and good-quality embryos, and poor- and high-responder patients. The nonsignificance of interaction tests of P levels with embryo stage, embryo quality, patient age, and ovarian response indicated that the relationship between P level and live birth was similar regardless of these factors.
  
  
  CONCLUSIONS
  An elevated serum P level on the day of hCG administration was negatively associated with live birth, even in ETs with a good prognosis.
authors.affiliation: Shady Grove Fertility Reproductive Science Center, Rockville, Maryland; Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland. Electronic address: hillmicah@mail.nih.gov.
authors.forename: Micah J
authors.initials: MJ
authors.lastname: Hill
authors.affiliation: Shady Grove Fertility Reproductive Science Center, Rockville, Maryland; Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland.
authors.forename: Greene Donald
authors.initials: GD
authors.lastname: Royster
authors.affiliation: Shady Grove Fertility Reproductive Science Center, Rockville, Maryland; Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland.
authors.forename: Mae Wu
authors.initials: MW
authors.lastname: Healy
authors.affiliation: Shady Grove Fertility Reproductive Science Center, Rockville, Maryland.
authors.forename: Kevin S
authors.initials: KS
authors.lastname: Richter
authors.affiliation: Shady Grove Fertility Reproductive Science Center, Rockville, Maryland; Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland.
authors.forename: Gary
authors.initials: G
authors.lastname: Levy
authors.affiliation: Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland.
authors.forename: Alan H
authors.initials: AH
authors.lastname: DeCherney
authors.affiliation: Shady Grove Fertility Reproductive Science Center, Rockville, Maryland.
authors.forename: Eric D
authors.initials: ED
authors.lastname: Levens
authors.affiliation: Shady Grove Fertility Reproductive Science Center, Rockville, Maryland.
authors.forename: Geeta
authors.initials: G
authors.lastname: Suthar
authors.affiliation: Shady Grove Fertility Reproductive Science Center, Rockville, Maryland.
authors.forename: Eric
authors.initials: E
authors.lastname: Widra
authors.affiliation: Shady Grove Fertility Reproductive Science Center, Rockville, Maryland.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Levy
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D006063:Chorionic Gonadotropin / Q000008:administration & dosage*; D015331:Cohort Studies; D004624:Embryo Transfer / Q000706:statistics & numerical data*; D005260:Female; D005300:Fertility Agents, Female / Q000008:administration & dosage; D006801:Humans; D007247:Infertility, Female / Q000097:blood* / Q000453:epidemiology / Q000628:therapy*; D008396:Maryland / Q000453:epidemiology; D008875:Middle Aged; D009865:Oocytes / Q000187:drug effects; D009866:Oogenesis / Q000187:drug effects*; D010062:Ovulation Induction / Q000706:statistics & numerical data; D011247:Pregnancy; D018873:Pregnancy Rate; D011374:Progesterone / Q000097:blood*; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D016896:Treatment Outcome; D015854:Up-Regulation / Q000187:drug effects; D055815:Young Adult
chemical_list: D015415:Biomarkers; D006063:Chorionic Gonadotropin; D005300:Fertility Agents, Female; D011374:Progesterone
keywords: Elevated progesterone; IVF; implantation; premature luteinization