The impact of progesterone level on day of hCG injection in IVF Cycles on clinical pregnancy rate

Background: Purpose of this study was to evaluate the in vitro fertilisation outcome in patients having normal or elevated day-2 serum progesterone level undergone IVF by using GnRH antagonist.Methods: A retrospective study conducted in Institute of Reproductive Medicine, Chennai during January 2013 to March 2014. According to patient’s Day-2 serum progesterone level the total no of cases (N=151) were divided into two groups group-1 (N=116) with progesterone value ≤1.5ng/ml and group-2 (N=35) with progesterone value>1.5ng/ml. Ovarian stimulation was started with recombinant FSH on day 2 and GnRH antagonist injections started from day 6 of stimulation. Total dose of gonadotropins, days of gonadotrophin injections, no of eggs collected, Clinical pregnancy rate and live birth rate were compared between two groups.Results: Two groups were similar with regards to age, BMI, days of gonadotrophins and total doses of gonadotrophins. Incidence of elevated P level was 23.17%. Total pregnancy rate was 36.42%. A non-statistically-significant difference was observed in clinical pregnancy (37.06% vs 34.28%) and live birth (32.75% vs 28.57%) between the normal and elevated progesterone groups.Conclusions: Elevated day-2 serum progesterone level was associated with lower clinical pregnancy rate but it was not statistically-significant.

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The Impact of Switching Donors on Clinical Pregnancy Rate During Treatment by Therapeutic Donor Insemination (TDI)

Fertility and Sterility ◽

10.1016/j.fertnstert.2005.07.1211 ◽

2005 ◽

Vol 84 ◽

pp. S462-S463

Author(s):

S. Gascoyne ◽

C. Faraci ◽

G. Hamilton ◽

J. Kredentser

Keyword(s):

Pregnancy Rate ◽

Clinical Pregnancy ◽

Clinical Pregnancy Rate ◽

Donor Insemination ◽

The Impact

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Effects of Vitrified Cryopreservation Duration on the IVF and Neonatal Outcomes

10.21203/rs.3.rs-1212906/v1 ◽

2022 ◽

Author(s):

Yuling Mao ◽

Ping Yin ◽

Yanfen Luo ◽

Jingda Qiao ◽

Lei Li

Keyword(s):

Survival Rate ◽

Pregnancy Rate ◽

Storage Time ◽

Clinical Pregnancy ◽

Clinical Pregnancy Rate ◽

Neonatal Outcomes ◽

Embryo Viability ◽

Storage Duration ◽

Embryo Survival ◽

The Impact

Abstract Objective: To evaluate the impact of cryopreservation storage duration on embryo viability, implantation competence, pregnancy outcome and neonatal outcomes.Design: Retrospective study.Setting: Center for Reproductive Medicine，The Third Affiliated Hospital of Guangzhou Medical University.Patient(s): In vitro fertilization patients who had vitrified cryopreserved embryos and following the first frozen embryo transfer cycles from January 2004 to August 2019. A total of 31143 patients met the inclusion criteria and were grouped according to the storage time (20926 patients in Group 1 with storage time <3 months, 6472 patients in Group 2 with storage time between 3 and 6 months, 2237 patients in Group 3 with storage time between 6 and 12 months and 746 in Group 4 with storage time between 12 and 24 months, 762 patients in Group 5 with storage time >24 months).Intervention(s): None.Main Outcome Measure(s): In the total FET cycles, the embryo survival rate was decreased significantly with the increase of cryopreservation time, and the highest rate was 98. 63 % in the 1-3 months group, and the lowest was 71.13% in the >=731 days group (P <0. 01). The HCG positive rate (57.85%) and clinical pregnancy rate (55. 26%) in the 1-3 months group were the highest (P<0. 01). The >=731 group had the lowest sex ratio of 0.96. There were no significant differences in neonatal birth weight, neonatal height and congenital anomalies among the groups (P>0. 05).Result(s): Length of storage time had a significant effect on post-thaw survival and outcomes for IVF cycles. Conclusion(s): With the prolongation of cryopreservation time, the embryonic survival rate and pregnancy rate were decreased significantly. Short-term cryopreservation (<=3 months) can obtain higher clinical pregnancy rate. Therefore, although long-term hryopreservation of the embryo has no effect on the health of the new baby, but hryopreserved embryos should be recovery as soon as possible if condition allows.

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Endometrial thickness measurements among Asherman syndrome patients prior to embryo transfer

Human Reproduction ◽

10.1093/humrep/deaa273 ◽

2020 ◽

Vol 35 (12) ◽

pp. 2746-2754

Author(s):

Peter Movilla ◽

Jennifer Wang ◽

Tammy Chen ◽

Blanca Morales ◽

Joyce Wang ◽

...

Keyword(s):

Pregnancy Rate ◽

Embryo Transfer ◽

Conflicts Of Interest ◽

Endometrial Thickness ◽

Multivariable Analysis ◽

Small Sample ◽

Clinical Pregnancy ◽

Clinical Pregnancy Rate ◽

The Mean ◽

The Impact

Abstract STUDY QUESTION Is there an association between endometrial thickness (EMT) measurement and clinical pregnancy rate among Asherman syndrome (AS) patients utilizing IVF and embryo transfer (ET)? SUMMARY ANSWER EMT measurements may not be associated with successful clinical pregnancy among AS patients undergoing IVF. WHAT IS KNOWN ALREADY Clinical pregnancy rate after IVF is significantly lower in patients with a thin endometrium, defined as a maximum EMT of <7 mm. However, AS patients often have a thin EMT measurement due to intrauterine scarring, with a paucity of data and no guidance on what EMT cutoff is appropriate when planning an ET among these patients. STUDY DESIGN, SIZE, DURATION This is a retrospective cohort study of 45 AS patients treated at a specialized advanced hysteroscopic clinic from 1 January 2015, to 1 March 2019. PARTICIPANTS/MATERIALS, SETTING, METHODS Review of EMT measurements prior to a total of 90 ETs, among 45 AS patients. The impact of the maximum EMT measurement prior to ET on clinical pregnancy rate was analyzed. MAIN RESULTS AND THE ROLE OF CHANCE A total of 25/45 (55.6%) AS patients ultimately went on to have ≥1 clinical pregnancy following a mean ± SD of 2.00 ± 1.26 ET attempts. There was a total of 90 ETs among the 45 AS patients, with 29/90 (32.2%) ETs resulting in a clinical pregnancy. Younger patient age (P = 0.05) and oocyte donation (P = 0.01) were the only variables identified to be significant predictors for a positive clinical pregnancy outcome on bivariate analysis. The mean EMT measurement prior to all ETs among AS patients was 7.5 ± 1.6 mm. EMT measurement prior to ET did not predict a positive clinical pregnancy on either bivariate (P = 0.84) or multivariable analysis (odds ratio 0.91, P = 0.60). 31.8% of EMT measurements measured <7.0 mm. In this small cohort, no difference in the clinical pregnancy rate was detected when comparing ETs with EMT measurements of <7.0 mm versus ≥7.0 mm (P = 0.83). The mean EMT measurement decreased with increasing AS disease severity; 8.0 ± 1.6 mm for mild disease, 7.0 ± 1.4 mm for moderate disease and 5.4 ± 0.1 mm for severe disease. LIMITATIONS, REASONS FOR CAUTION Our small sample size limits our ability to draw any definitive conclusions. In addition, patients utilized various infertility clinics. This limits our ability to evaluate the consistency of EMT measurements and the IVF care that was received. WIDER IMPLICATIONS OF THE FINDINGS EMT measurement cutoff values should be used with caution if canceling a scheduled ET in AS patients. STUDY FUNDING/COMPETING INTEREST(S) This study was not funded. K.I. reports personal fees from Karl Stroz and personal fees from Medtronics outside the submitted work. The other authors have no conflicts of interest. TRIAL REGISTRATION NUMBER N/A.

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Exploration of the value of progesterone and progesterone/estradiol ratio on the hCG trigger day in predicting pregnancy outcomes of PCOS patients undergoing IVF/ICSI: a retrospective cohort study

Reproductive Biology and Endocrinology ◽

10.1186/s12958-021-00862-6 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Yiqing Yang ◽

Bowen Liu ◽

Gengxiang Wu ◽

Jing Yang

Keyword(s):

Pregnancy Rate ◽

Gnrh Agonist ◽

Gnrh Antagonist ◽

Polycystic Ovary ◽

Clinical Pregnancy ◽

Clinical Pregnancy Rate ◽

Progesterone Level ◽

Vitro Fertilization ◽

Hcg Trigger

Abstract Background Polycystic ovary syndrome (PCOS) is a common endocrine disorder with the disorders of estrogen(E2) and progesterone(P) secretion. The purpose of this study was to evaluate the association between the progesterone level or progesterone/estradiol(P/E2) ratio on human chorionic gonadotropin (hCG) trigger day and the outcome of in vitro fertilization in PCOS patients and explore the value of progesterone and P/E2 ratio for predicting the clinical pregnancy. Methods The clinical data of 1254 PCOS patients who satisfied the inclusion criteria were retrospectively analyzed, including baseline characteristics such as age, body mass index, basal sex hormone levels, et al., as well as ovarian stimulation data and clinic outcome. Results The number of follicles larger than 14 mm in diameter (P < 0.001) and retrieved oocytes (P < 0.001) was greater in the high progesterone group (progesterone ≥ 0.92 ng/mL). In the high P/E2 group(P/E2 ratio ≥ 0.3), the number of follicles larger than 14 mm in diameter (P < 0.001) and retrieved oocytes (P < 0.001), as well as the rate of high-quality embryos (P = 0.040) were significantly decreased. In ultralong GnRH agonist protocol, the implantation rate(P < 0.001), hCG positive rate (P < 0.001), clinical pregnancy rate (P < 0.001) and live birth rate (P < 0.001) were all significantly higher than long GnRH agonist protocol and GnRH antagonist protocol. The clinical pregnancy rate of high progesterone group was significantly lower than that of low progesterone group in ultralong GnRH agonist (P = 0.008). The progesterone level could be used as an indicator to predict the positive clinical pregnancy (long GnRH agonist: P = 0.001; ultralong GnRH agonist: P < 0.001) except in cycles using GnRH antagonist (P = 0.169). In the ultralong GnRH agonist, the value of progesterone level in the prediction of clinical pregnancy was significantly higher than that of the P/E2 ratio (P = 0.021). Conclusions In PCOS patients, the progesterone level is associated with clinical pregnancy rate while P/E2 ratio is not. In subgroup analysis using three different COS protocols, a significant association between progesterone level and clinical pregnancy rate can be observed in the long GnRH agonist protocol and ultralong GnRH agonist protocol. The progesterone level is significantly better than the P/E2 ratio in predicting the pregnancy outcome of PCOS patients, especially in ultralong GnRH agonist cycles.

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Progesterone levels on the human chorionic gonadotropin trigger day affect the pregnancy rates for embryos transferred at different stages of development in both general and selected IVF/ICSI populations

10.21203/rs.3.rs-34461/v1 ◽

2020 ◽

Author(s):

Philippe Merviel ◽

Sarah Bouée ◽

Anne-Solenn Jacamon ◽

Jean-Jacques Chabaud ◽

Marie-Thérèse Le Martelot ◽

...

Keyword(s):

General Population ◽

Pregnancy Rate ◽

Embryo Transfer ◽

Predictive Factors ◽

Pregnancy Rates ◽

Clinical Pregnancy ◽

Clinical Pregnancy Rate ◽

Blastocyst Transfer ◽

Progesterone Level ◽

Serum Progesterone

Abstract Background Two meta-analyses have shown that pregnancy and birth rates are significantly higher after blastocyst transfer than after cleaved embryo transfer. Other studies have revealed that a serum progesterone level > 1.5 ng/ml on the trigger day is responsible for premature luteinization and is associated with a low pregnancy rate. The objectives of the present study were to determine whether blastocyst transfer gave higher pregnancy rates than cleaved embryo transfer at day 3 in both the general and selected IVF/ICSI populations, and whether the serum progesterone level influenced the pregnancy rate. Method : We studied IVF/ICSI cycles with GnRH antagonist - FSH/hMG protocols in a general population (n = 1210) and a selected “top cycle” population (n = 677), after blastocyst transfer on D5 or cleaved embryo transfer on D3. The selected cycles had to meet the following criteria: female age < 35, first or second cycle, and one or two embryos transferred. We recorded predictive factors for pregnancy and calculated the serum progesterone to oocyte ratio (P/Ooc), the serum progesterone to serum estradiol ratio (P/E2), and the serum progesterone to follicle (> 14 mm) index (PFI). Results In the general population, the clinical pregnancy rate was significantly higher after blastocyst transfer (33.3%) than after cleaved embryo transfer (25.3%; p < 0.01). The differences between blastocyst and embryo transfer groups were not significant in the selected population (respectively 35.7% vs. 35.8% for the clinical pregnancy rate). The only predictive factors common to the general and selected populations were the serum progesterone levels on the eve of the trigger day and on the day itself, which were significantly lower in the subgroups of women who became pregnant (p < 0.01). We found a serum progesterone threshold of 0.9 ng/ml, as also reported by other studies. The P/Ooc ratio and the PFI appear to have predictive value for cleaved embryos transfers. Conclusions Blastocyst transfers were associated with higher clinical pregnancy rate than cleaved embryo transfers in a general population but not in a selected population. The serum progesterone levels on the eve of the trigger day and on the day itself predicted the likelihood of pregnancy.

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The impact of endometrial thickness change after progesterone administration on pregnancy outcome in patients transferred with single frozen-thawed blastocyst

Reproductive Biology and Endocrinology ◽

10.1186/s12958-019-0545-0 ◽

2019 ◽

Vol 17 (1) ◽

Cited By ~ 7

Author(s):

Zhiqin Bu ◽

Xinhong Yang ◽

Lin Song ◽

Beijia Kang ◽

Yingpu Sun

Keyword(s):

Pregnancy Rate ◽

Pregnancy Outcome ◽

Embryo Transfer ◽

Endometrial Thickness ◽

Clinical Pregnancy ◽

Clinical Pregnancy Rate ◽

Natural Cycle ◽

Thickness Change ◽

The Impact ◽

Day Of Embryo Transfer

Abstract Background The aim of this study was to explore the impact of endometrial thickness change after progesterone administration on pregnancy outcome in patients transferred with single frozen-thawed blastocyst. Methods This observational cohort study included a total of 3091 patients undergoing their first frozen-thawed embryo transfer (FET) cycles between April 2015 to March 2019. Endometrial thickness was measured by trans-vaginal ultrasound twice for each patient: on day of progesterone administration, and on day of embryo transfer. The change of endometrial thickness was recorded. Results Regardless of endometrial preparation protocol (estrogen-progesterone/natural cycle), female age, body mass index (BMI), and infertility diagnosis were comparable between patients with an increasing endometrium on day of embryo transfer and those without. However, clinical pregnancy rate increases with increasing ratio of endometrial thickness. Compared with patients with Non-increase endometrium, those with an increasing endometrium on day of embryo transfer resulted in significantly higher clinical pregnancy rate (56.21% vs 47.13%, P = 0.00 in estrogen-progesterone cycle; 55.15% vs 49.55%, P = 0.00 in natural cycle). Conclusions In most patients, endometrial thickness on day of embryo transfer (after progesterone administration) increased or kept being stable compared with that on day of progesterone administration. An increased endometrium after progesterone administration was associated with better pregnancy outcome.

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