Ratio of progesterone-to-number of follicles as a prognostic tool for in vitro fertilization cycles.
OBJECTIVE
To establish a ratio of the P level to the number of follicles (P/F ratio) on the day of human chorionic gonadotropin (hCG) administration and to evaluate whether this ratio is associated with in vitro fertilization (IVF) outcome.


METHODS
This study was conducted between January 2012 and June 2013. A total of 337 patients with cleavage-stage day-3 fresh embryo transfer with P levels ≤1.5 ng/mL on the day of hCG administration were included in the study. The main outcome was ongoing pregnancy rate.


RESULTS
The P/F ratio was calculated according to the equation (P[ng/mL]/number of follicles) on the day of final oocyte maturation. Using ROC, we established a cut-off level of 0.075 for the P/F ratio. The area under the curve (AUC) (0.756; 95 % confidence interval [CI]: 0.704-0.807) indicated that it was a good prognostic test. In group 1 (patients under 36 years old), the ongoing pregnancy rates were 57 and 30 % for patients with P/F ratios ≤ .075 and > .075, respectively, (p = 0.003). In group 2 (patients between 36 and 39 years old), the ongoing pregnancy rates were 58 % and 17 % (p = 0.001) for patients with P/F ratios ≤ .075 and > .075, respectively. In group 3 (patients ≥ 40 years old), the ongoing pregnancy rates were 41.7 and 10.9 % (p = 0.001) for patients with P/F ratios ≤ .075 and > .075, respectively.


CONCLUSIONS
The P/F ratio is a good prognostic test for predicting IVF outcome that can correlate the P level with ovarian response.
ORIGEN-Center for Reproductive Medicine, Avenida Rodolfo de Amoedo, 140, Barra da Tijuca, Rio de Janeiro, Brazil, matheusroque@hotmail.com.
Matheus
M
Roque
Marcello
M
Valle
Marcos
M
Sampaio
Selmo
S
Geber
Miguel Angel
MA
Checa
D019540:Area Under Curve; D006063:Chorionic Gonadotropin / Q000494:pharmacology*; D016001:Confidence Intervals; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D006080:Ovarian Follicle; D065851:Ovarian Reserve; D011237:Predictive Value of Tests; D011247:Pregnancy; D018873:Pregnancy Rate; D011374:Progesterone / Q000097:blood*; D012102:Reproductive Control Agents / Q000494:pharmacology*; D016896:Treatment Outcome
D006063:Chorionic Gonadotropin; D012102:Reproductive Control Agents; D011374:Progesterone