Document Detail


Day 14 maternal serum progesterone levels predict pregnancy outcome in IVF/ICSI treatment cycles: a prospective study.
MedLine Citation:
PMID:  15591085     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Serum progesterone has been advocated as a tool in the diagnosis of early pregnancy failure. We conducted this prospective study in order to investigate the potential value of early (14 days after oocyte recovery) serum progesterone measurement, in women undergoing IVF/ICSI and receiving rectal progesterone supplements, in relation to pregnancy outcome. METHODS: 442 women consecutively treated by IVF or ICSI had serum progesterone and bhCG levels prospectively measured 14 days after oocyte retrieval (day 0). All women received natural progesterone 400 mg rectally until the pregnancy test on day 14. Pregnant women were followed up by serial transvaginal ultrasound scans to 8 weeks gestation. RESULTS: 115 women (26%) had a viable intra-uterine pregnancy at 8 weeks gestation, 80 (18.1%) had an abnormal pregnancy (biochemical, ectopic, miscarriage) and 247 (55.9%) failed to conceive. Women with on-going pregnancies had significantly higher serum progesterone levels (median: 430, 95%CI: 390-500 nmol/l) compared to those who had either an abnormal pregnancy (72, 48-96 nmol/l; P < 0.001) or failed to conceive (33, 28-37 nmol/l; P < 0.001). Receiver-operator curve analysis demonstrated that a single serum progesterone on day 14 post-oocyte retrieval, could highly differentiate between normal and abnormal pregnancies (area under the curve = 0.927, 95%CI = 0.89-0.96; P < 0.0001). CONCLUSIONS: In spite of exogenous progesterone supplementation, serum progesterone levels, from as early as 4 weeks gestation (day 14 post-oocyte retrieval) were significantly elevated and predicted women destined to have viable intra-uterine pregnancies. These high levels are suggestive that endogenous progesterone is already sufficient in viable pregnancies and that exogenous progesterone administration will not rescue a pregnancy destined to result in a miscarriage. Single serum progesterone measurement could be a useful indicator of pregnancy outcome in women undergoing IVF or ICSI treatment.
Authors:
G Ioannidis; G Sacks; N Reddy; L Seyani; R Margara; S Lavery; G Trew
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Publication Detail:
Type:  Journal Article     Date:  2004-12-09
Journal Detail:
Title:  Human reproduction (Oxford, England)     Volume:  20     ISSN:  0268-1161     ISO Abbreviation:  Hum. Reprod.     Publication Date:  2005 Mar 
Date Detail:
Created Date:  2005-02-18     Completed Date:  2005-07-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8701199     Medline TA:  Hum Reprod     Country:  England    
Other Details:
Languages:  eng     Pagination:  741-6     Citation Subset:  IM    
Affiliation:
Department of Reproductive Medicine, Hammersmith Hospital, Du Cane Road, London W12 0HS, UK. gioannidis@doctors.org.uk
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MeSH Terms
Descriptor/Qualifier:
Abortion, Spontaneous / blood
Administration, Rectal
Adult
Chorionic Gonadotropin, beta Subunit, Human / blood
Female
Fertilization in Vitro*
Humans
Oocytes*
Osmolar Concentration
Postoperative Period
Predictive Value of Tests
Pregnancy / blood*
Pregnancy Outcome*
Pregnancy, Ectopic / blood
Progesterone / administration & dosage,  blood*,  therapeutic use
Prospective Studies
ROC Curve
Sensitivity and Specificity
Sperm Injections, Intracytoplasmic*
Time Factors
Tissue and Organ Harvesting*
Chemical
Reg. No./Substance:
0/Chorionic Gonadotropin, beta Subunit, Human; 57-83-0/Progesterone

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