title: Late follicular progesterone to estradiol ratio is not influenced by protocols or gonadotropins used.
abstract: OBJECTIVE
  Increased progesterone level during follicular phase seemed to be associated with decreased pregnancy rate.
  
  
  METHODS
  A prospective cohort study, 1.1.2012 - 31.8.13. The Progesterone (P) and Progesterone/Estrogen (P/E2) level on ovulation induction day were compared between the protocols and the different gonadotropins used. Roc analysis was calculated to determine the cutoff of P/E2 to predict delivery rates. P/E2 ratio was calculated as PX1000/e2 level.
  
  
  RESULTS
  One hundred thirty-nine patients were enrolled to the study. No difference in the P level at hCG stimulation day between different protocols, however, E2 and P/E2 ratio were significantly lower in the long protocol compare with antagonist protocol 1757.7 ± 923.2 vs. 1342.9 ± 1223; P = 0.003 and 0.48 ± 0.31 vs. 0.83 ± 0.87; P = 0.038). The endometrium was significantly thicker in the long group compare with short and antagonist. Significantly more top-quality embryos (TOP) were achieved in the antagonist group. Comparable results between the types of gonadotropins used in regards with cycle characteristics and pregnancy and delivery rates. The P/E2 ratio which can predict live birth rate was found to be 0.45, AUC = 0.632, p = 0.02 and 95 % CI 0.525-0.738 and a significantly higher pregnancy and delivery rates at a P/E2 bellow 0.45.
  
  
  CONCLUSIONS
  Endometrial receptivity is determined by the complex interactions of E2 and P.
authors.affiliation: Department of Obstetrics and Gynecology, IVF unit, Hillel Yaffe Medical Center, Faculty of Medicine, Technion - Israel Institute of Technology, Hadera, Israel. einatshalompaz@gmail.com.
authors.forename: E
authors.initials: E
authors.lastname: Shalom-Paz
authors.affiliation: Department of Obstetrics and Gynecology, IVF unit, Hillel Yaffe Medical Center, Faculty of Medicine, Technion - Israel Institute of Technology, Hadera, Israel. nardin_aslih@yahoo.com.
authors.forename: N
authors.initials: N
authors.lastname: Aslih
authors.affiliation: Department of Obstetrics and Gynecology, IVF unit, Hillel Yaffe Medical Center, Faculty of Medicine, Technion - Israel Institute of Technology, Hadera, Israel. nivin5ss@yahoo.com.
authors.forename: N
authors.initials: N
authors.lastname: Samara
authors.affiliation: Department of Obstetrics and Gynecology, IVF unit, Hillel Yaffe Medical Center, Faculty of Medicine, Technion - Israel Institute of Technology, Hadera, Israel. medeia_michaeli@yahoo.com.
authors.forename: M
authors.initials: M
authors.lastname: Michaeli
authors.affiliation: Department of Obstetrics and Gynecology, IVF unit, Hillel Yaffe Medical Center, Faculty of Medicine, Technion - Israel Institute of Technology, Hadera, Israel. ellenbogen55@yahoo.com.
authors.forename: A
authors.initials: A
authors.lastname: Ellenbogen
mesh_terms: D000328:Adult; D004359:Drug Therapy, Combination; D004717:Endometrium / Q000187:drug effects; D004958:Estradiol / Q000097:blood*; D005260:Female; D005640:Follicle Stimulating Hormone / Q000494:pharmacology / Q000627:therapeutic use*; D005498:Follicular Phase / Q000097:blood* / Q000187:drug effects*; D006801:Humans; D008596:Menotropins / Q000494:pharmacology / Q000627:therapeutic use*; D010062:Ovulation Induction / Q000379:methods*; D011247:Pregnancy; D018873:Pregnancy Rate; D011374:Progesterone / Q000097:blood*; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D011374:Progesterone; D004958:Estradiol; D008596:Menotropins; D005640:Follicle Stimulating Hormone