title: The relationship between the changes in the level of progesterone and the outcome of in vitro fertilization-embryo transfer.
abstract: We observed the effects of changes in progesterone (P) during late follicular phases on the treatment outcome of in vitro fertilization-embryo transfer (IVF-ET) and intracytoplasmic sperm injection (ICSI) in patients with different ovarian responses. The data of 8,575 cycles of patients receiving gonadotropin-releasing hormone (GnRH) agonist using the long protocol were retrospectively analyzed. According to the number of oocytes retrieved, the cycles were divided into poor ovarian response group (oocyte retrieval <5), intermediate ovarian response group (5≤ oocyte retrieval ≤15), and high ovarian response group (oocyte retrieval ≥16). We found that in the poor ovarian response group, the clinical pregnancy rate was not significantly associated with both the level of P or the day of human chorionic gonadotrophin (hCG) and the duration of pre-hCG P elevation (p = 0.66 and p = 0.1874). In intermediate and high ovarian response groups, the clinical pregnancy rate was inversely related to both the level of P on the day of hCG administration and the duration of pre-hCG P elevation (all p < 0.0001). The cut-off values of serum P level on the day of hCG administration were 1 ng/ml and 1.75 ng/ml in intermediate and high ovarian response groups, respectively. The cut-off values of pre-hCG P elevation duration were obtained on day 1 in the intermediate ovarian response group, and days 1 or 3 in the high ovarian response group. After correcting for other confounding factors, multivariate logistic regression analysis indicated that P level on the day of hCG administration was not associated with clinical pregnancy rates, but pre-hCG P elevation duration was negatively associated with clinical pregnancy rate in the intermediate and high ovarian response groups. P level is associated with clinical pregnancy rate only in the patients with intermediate or high ovarian response. The longer the duration of pre-hCG P 1 ng/ml, the lower the clinical pregnancy rate.
authors.affiliation: a Reproductive Medical Center, First Affiliated Hospital of Zhengzhou University , Zhengzhou , China.
authors.forename: Wei
authors.initials: W
authors.lastname: Dai
authors.affiliation: a Reproductive Medical Center, First Affiliated Hospital of Zhengzhou University , Zhengzhou , China.
authors.forename: Zhi-qin
authors.initials: ZQ
authors.lastname: Bu
authors.affiliation: a Reproductive Medical Center, First Affiliated Hospital of Zhengzhou University , Zhengzhou , China.
authors.forename: Lin-lin
authors.initials: LL
authors.lastname: Wang
authors.affiliation: a Reproductive Medical Center, First Affiliated Hospital of Zhengzhou University , Zhengzhou , China.
authors.forename: Ying-pu
authors.initials: YP
authors.lastname: Sun
mesh_terms: D000328:Adult; D006063:Chorionic Gonadotropin; D004624:Embryo Transfer / Q000706:statistics & numerical data*; D005260:Female; D005307:Fertilization in Vitro / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D011247:Pregnancy; D018873:Pregnancy Rate; D011374:Progesterone / Q000097:blood*; D055815:Young Adult
chemical_list: D006063:Chorionic Gonadotropin; D011374:Progesterone
keywords: Assisted reproductive technology; duration of progesterone elevation; long protocol; ovarian response; progesterone level