Serum progesterone levels on the day of hCG trigger and ICSI outcome: a retrospective observational cohort study

Background: Whether serum progesterone (P4) level on the day of human chorionic gonadotropin (hCG) trigger is related to the outcome of artificial reproductive technology (ART) is still a debatable issue. The objective of this study was to evaluate relationship between serum Progesterone levels on the day of hCG trigger and ICSI outcome.Method: This was a retrospective, non-interventional, observational, cohort study of patients undergoing ICSI at 21st Century Group of Hospitals, Killa Pardi and Surat, Gujarat during the period of January 2018 to March 2018. Patients with age group of 20-40 years who underwent ICSI-ET using GnRH antagonist flexible protocol during this period, had obtained 2 or more MII oocytes during retrieval and had at least one grade I embryo transferred were included in this study. Women using donor oocytes were excluded. Serum progesterone levels were analysed on day of hCG trigger. Total 165 patients were included in the study. They were divided into two groups, those with β-hCG less than or equal to 1.5 ng/ml and those with β-hCG more than 1.5 ng/ml. Student's t test and Chi square test were used to compare the clinical pregnancy rates between two groups.Results: Clinical pregnancy rate decreases with increase in serum progesterone levels on the day of hCG trigger. Patients with serum progesterone levels ≤1.5 ng/ml had significantly higher clinical pregnancy rates than those with progesterone levels >1.5 ng/ml (45% vs 6%; p :<0.001).Conclusion: Pre-hCG rise in serum Progesterone concentration does not affect the oocyte quality. But, it significantly decreases the chances of implantation and the clinical pregnancy rates.

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Embryo transfer factors that may alter clinical pregnancy rates: an observational, cohort study

Fertility and Sterility ◽

10.1016/j.fertnstert.2013.07.368 ◽

2013 ◽

Vol 100 (3) ◽

pp. S498

Author(s):

D.A. Forstein ◽

L.E. Eller ◽

H.L. Higdon ◽

W.R. Boone

Keyword(s):

Cohort Study ◽

Embryo Transfer ◽

Observational Cohort Study ◽

Pregnancy Rates ◽

Clinical Pregnancy ◽

Transfer Factors ◽

Observational Cohort ◽

Clinical Pregnancy Rates

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Correlation between Serum Levels of Progesterone on HCG Administration Day and Clinical Pregnancy Rate in ICSI cycles

QJM ◽

10.1093/qjmed/hcaa056.009 ◽

2020 ◽

Vol 113 (Supplement_1) ◽

Author(s):

T A Raafat ◽

H F Mohammad ◽

E I Hassan

Keyword(s):

Pregnancy Rate ◽

Serum Levels ◽

Fertilization Rate ◽

Pregnancy Rates ◽

Clinical Pregnancy ◽

Implantation Failure ◽

Serum Progesterone ◽

Clinical Pregnancy Rates ◽

Hcg Trigger

Abstract Background Infertility is an illness clinically defined as failure to achieve a clinical conception after 12 months of regular and unprotected normal sexual intercourse. It affects around 8 -12% of child bearing-aged couples globally. Premature progesterone elevation is considered for a long time a cornerstone factor to endometrial implantation failure. Although the extensive usage of GnRH analogues for down-regulation of pituitary, rise in progesterone serum levels, still occur at various levels on the day of administration of hCG for ultimate oocyte maturity in fresh IVF management cycles. Aim to investigate and evaluate the correlation between serum progesterone level on the day of HCG administration and the clinical pregnancy rate as a primary outcome, quality of embryo, quality of oocyte, fertilization rate and chemical pregnancy assessed by B-HCG level 2 weeks after embryo transfer as secondary outcomes. Methodology This prospective non interventional study was conducted at Assisted Reproduction Unit, Ain Shams University Maternity Hospital, Cairo, Egypt, starting from December 2015 till March 2017. The study included 240 women scheduled for ICSI presented with primary or secondary infertility, the causes of infertility in this study were male factor, tubal factor and unexplained infertility. Results the current research study displayed that there was unfavorable statistical correlation between serum progesterone elevation at the day of HCG trigger and the clinical pregnancy rates which was 34.2%, the cut off value of serum progesterone was 1.09 ng/ml; above this value the serum pregnancy rates were negatively influenced. Additionally premature rise of serum progesterone levels reduced the embryonic quality, oocyte quality and fertilization rate. Conclusion serum progesterone level equal to or above 1.09 ng/ml at the day of HCG trigger unfavorably influences on the clinical pregnancy rates in ICSI cycles. Recommendations All embryos should be cryopreserved when serum progesterone on the day of HCG trigger equals to or above 1.09 ng/ml during ICSI cycle to be transferred in subsequent cycle to avoid implantation failure.

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Elevated serum progesterone values at the time of ovulation induction in luteal leuprolide acetate-down-regulated GIFT cycles are associated with decreased clinical pregnancy rates

Journal of Assisted Reproduction and Genetics ◽

10.1007/bf02066524 ◽

1996 ◽

Vol 13 (6) ◽

pp. 459-463 ◽

Cited By ~ 17

Author(s):

Gary W. Randall ◽

Pickens A. Gantt ◽

Dian Gantt ◽

Michael J. Kirk ◽

Natalie Romines

Keyword(s):

Ovulation Induction ◽

Elevated Serum ◽

Pregnancy Rates ◽

Clinical Pregnancy ◽

Leuprolide Acetate ◽

Serum Progesterone ◽

Clinical Pregnancy Rates

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Effectiveness of highly purified HMG plus r-FSH vs r-FSH alone vs r-FSH plus r-LH in IVF-ET/ ICSI patients：a retrospective cohort study

10.21203/rs.3.rs-81451/v1 ◽

2020 ◽

Author(s):

Zhong-Kai Wang ◽

She-ling Wu ◽

Xiao-Na Yu ◽

Hong-Wu Qiao ◽

Hua Lou ◽

...

Keyword(s):

Cohort Study ◽

Subgroup Analysis ◽

Retrospective Cohort Study ◽

Ovulation Induction ◽

Retrospective Cohort ◽

Pregnancy Rates ◽

Clinical Pregnancy ◽

Current Standard ◽

Significant Difference ◽

Clinical Pregnancy Rates

Abstract Objective: To evaluate the effectiveness of highly purified human menopausal gonadotropins (hp-HMG) plus recombinant follicle stimulating hormone (r-FSH) vs r-FSH vs r-FSH plus recombinant luteinizing hormone （r-LH） in vitro fertilization (IVF) / intracytoplasmic sperm injection (ICSI) patients。Design :Retrospective cohort studyMethods:This was a retrospective study. Among a total number of 3568 patients who had undergone IVF/ICSI applications, 409 eligible patients were included.Total units of follitropin alpha preparations used in ovulation induction, total number of meiois-2 phase oocytes, total number of used oocytes in ICSI cycle, fertilization rate and clinical pregnancy rates of both groups were analyzed. In this retrospective cohort study, women undergoing IVF/ICSI Gonadotropin releasing hormone (GnRH) antagonist cycles downregulation. 409 patients were included in the study. Among them One group followed the current standard protocol of no LH or hp-HMG supplementation given(n=64). The other had LH supplementation in the form of r -LH (Luveris; Merck Serono, Switzerland) (n=221), Another group had hp-HMG supplementation in the form of hp-HMG (Menopur , Ferring,Germany)(n=121).In the Subgroup analysis were decided by AFC ,7 < AFC〈20 or AFC>20 of the three group.Result: Mean duration of stimulation and was longer in the group of patients treated with hp-HMG plus rFSH compared to the group of patients treated with r-FSH and the group of r-LH plus r-FSH (13.24 days and 12.72days and12.21days, respectively; P<0.05). The amount of GN does for patients treated withhp-HMG plus rFSH compared to the group of patients treated with r-FSH plus r-LH and the group of r-FSH alone respectively (P<0.05). Clinical pregnancy rates were 76.6% and 60.9% and 62.9% （P<0.05）in the groups of patients treated with hp-hMG plus rFSH, r-FSH plus r-LH,r-FSHalonerespectively. What’s morea greater live birth rate was noted in the hp-hMG plus r-FSH group, there was statistically significant difference between the three groups (P>0.05).in the subgroup analysis when AFC>20 hp-HMG plus rFSH group have more lower ovarian hyperstimulation syndrome （OHSS） than r-FSH plus r-LH and rFSH alone,respectively.Clonclusion:The higher oocyte yield with r-FSH does not result in higher quality embryos.hp-HMG or r-LH supplementation is an option for improving IVF outcome in patients ovulation induction with r-FSH during GnRH agonist down-regulation. Particularly, hp-HMG is recommended as it may have a beneficial action on implantation in selected group especially AFC more than 20patients.

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