Document Detail


Circulating progesterone levels and ongoing pregnancy rates in controlled ovarian stimulation cycles for in vitro fertilization: analysis of over 4000 cycles.
MedLine Citation:
PMID:  20539042     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The influence of elevated serum progesterone levels during in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) cycles on pregnancy rates is a matter of continued debate among fertility clinicians. Efforts to resolve this question have been impeded by the various assays used to measure progesterone and the different, arbitrary threshold values for defining 'high' progesterone levels.
METHODS: A non-interventional, retrospective, observational, single-centre cohort study evaluated the relationship between serum progesterone levels on the day of human chorionic gonadotrophin (hCG) administration and the ongoing pregnancy rate in 4032 patients undergoing IVF/ICSI cycles using gonadotrophin-releasing hormone (GnRH) analogues for pituitary down-regulation.
RESULTS: Ongoing pregnancy rates were inversely associated with serum progesterone levels on the day of hCG (P < 0.001 for overall trend), irrespective of the GnRH analogue used for pituitary down-regulation. Patients with serum progesterone levels < or = 1.5 ng/ml had significantly higher ongoing pregnancy rates than those with progesterone levels >1.5 ng/ml (31.0 versus 19.1%; P = 0.00006); odds ratio, 0.53 (95% confidence interval, 0.38-0.72). Multivariate regression analysis showed that daily follicle-stimulating hormone dose, number of oocytes and estradiol values on the day of hCG administration were positively associated with progesterone levels (P < 0.0001 for all). Serum progesterone levels were significantly greater in women treated with GnRH agonists (n = 1177) versus antagonists (n = 2855; 0.84 +/- 0.67 versus 0.75 +/- 0.66 ng/ml; P = 0.0003).
CONCLUSIONS: Elevated serum progesterone levels on the day of hCG administration is associated with reduced ongoing pregnancy rates. In particular, serum progesterone levels of >1.5 ng/ml were associated with lower ongoing pregnancy rates following IVF/ICSI cycles irrespective of the GnRH analogue used for pituitary down-regulation.
Authors:
E Bosch; E Labarta; J Crespo; C Simón; J Remohí; J Jenkins; A Pellicer
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-06-10
Journal Detail:
Title:  Human reproduction (Oxford, England)     Volume:  25     ISSN:  1460-2350     ISO Abbreviation:  Hum. Reprod.     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-21     Completed Date:  2010-11-23     Revised Date:  2011-02-14    
Medline Journal Info:
Nlm Unique ID:  8701199     Medline TA:  Hum Reprod     Country:  England    
Other Details:
Languages:  eng     Pagination:  2092-100     Citation Subset:  IM    
Affiliation:
Department of Reproduction, Instituto Valenciano de Infertilidad, University of Valencia, Plaza de la Policia Local, 3, 46015 Valencia, Spain. ebosch@ivi.es
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MeSH Terms
Descriptor/Qualifier:
Adult
Chorionic Gonadotropin / therapeutic use
Cohort Studies
Female
Fertilization in Vitro*
Follicle Stimulating Hormone / therapeutic use
Gonadotropin-Releasing Hormone / agonists,  therapeutic use
Humans
Middle Aged
Ovulation Induction*
Pregnancy
Pregnancy Rate
Progesterone / blood*
Regression Analysis
Reproductive Control Agents / therapeutic use
Retrospective Studies
Chemical
Reg. No./Substance:
0/Chorionic Gonadotropin; 0/Reproductive Control Agents; 33515-09-2/Gonadotropin-Releasing Hormone; 57-83-0/Progesterone; 9002-68-0/Follicle Stimulating Hormone
Comments/Corrections
Comment In:
Hum Reprod. 2011 Feb;26(2):498-9; author reply 499-500   [PMID:  21159682 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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