Elevated serum progesterone levels on the hCG trigger day have a negative impact on the live birth rate in the first fresh IVF-ET cycle

• Published in: Journal of obstetrics and gynaecology Vol. 42; no. 8; p. 3503
• Main Authors: Jiang, Weihua, Li, Dong, Zhu, Lihua, Wang, Jie, Chen, Linjun, Zhang, Ningyuan, Wang, Shanshan
• Format: Journal Article
• Language: English
• Published: England 17.11.2022
• Subjects: Birth Rate; Chorionic Gonadotropin - administration & dosage; Female; Fertilization in Vitro - methods; Humans; Live Birth; Pregnancy; Pregnancy Rate; Progesterone - blood; Retrospective Studies; Sperm Injections, Intracytoplasmic - methods; Progesterone; hCG trigger day; clinical pregnancy rate; implantation rate; live birth rate; IVF/ICSI cycles
• DOI: 10.1080/01443615.2022.2151345

To investigate whether there is a relationship between elevated serum progesterone (PROG) on the hCG trigger day and the live birth rate (LBR) in IVF/ICSI cycles, the retrospective analysis was carried out from the patients undergoing the first ART cycles throughout 2016. The PROG levels were measured on the hCG trigger day. The LBR, clinical pregnancy rate (CPR), implantation rate (IR) and other parameter rate values were compared among the three different PROG elevations. A total of 2550 IVF/ICSI cycles fulfilling all the inclusion and exclusion criteria were selected. Finally, three groups [PROG <0.40 ng/mL, 0.40 ≤ PROG < 1.5 ng/mL, PROG ≥ 1.5 ng/mL] were categorised based on the serum PROG levels. LBR, CPR and IR declined as the PROG value increased, while there was no difference in the embryo utilisation rates. Serum PROG levels on the day of hCG administration were negatively associated with the LBR, even in ETs with a good prognosis.Impact Statement The clinical effects of PROG are still controversial. Some studies have confirmed that there was not too much association between premature elevation of PROG and live birth, some are still convincing that there is a negative correlation and will result in ART cycles of pregnancy and LBR reduction. Our data substantiated that the high serum PROG level had the lowest LBR, IR and CPR, but the embryo utilisation rate may not have too much to do with the elevated PROG. This study further strengthens the negative impact of elevated PROG levels on pregnancy outcomes, and suggests that frozen thawed embryo transfer appears to be a reasonable and advantageous approach for this subset of patients.