Document Detail


Progesterone level and progesterone/estradiol ratio on the day of hCG administration: detrimental cutoff levels and new treatment strategy.
MedLine Citation:
PMID:  21324450     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To identify if there are certain cutoff levels for P and or the P/E(2) ratio on the day of hCG that would be defined as detrimental for occurrence of pregnancy in women with normal ovarian reserve undergoing cleavage-stage embryo transfer (ET). Secondarily, to determine if these same cutoffs might have the same potential negative effect in women undergoing blastocyst ET.
DESIGN: Prospective cohort study including two randomized cohorts.
SETTING: Private and university fertility centers.
PARTICIPANT(S): A total of 240 women undergoing long agonist protocol with at least four grade 1 day 3 embryos.
INTERVENTION(S): Women were randomized in a 1:1 ratio to undergo day 3 or day 5 embryo transfer.
MAIN OUTCOME MEASURE(S): Clinical pregnancy rate (CPR) was the primary outcome.
RESULT(S): Using receiver operator characteristics, cutoffs for P and P/E(2) ratio were 1.5 ng/mL and 0.55, respectively. Patients with P ≤ 1.5 ng/mL and P/E(2) ≤ 0.55 undergoing cleavage-stage ET had higher CPR. Using multiple regression, P/E(2) ratio was the only independent predictor for pregnancy. The P and P/E(2) cutoffs were not correlated with CPR in blastocyst transfers.
CONCLUSION(S): Progesterone >1.5 ng/mL and P/E(2) >0.55 affect the CPR in women undergoing cleavage-stage, but not blastocyst ET. P/E(2) ratio is the only independent prognosticator for cycle outcome in women undergoing cleavage-stage ET.
Authors:
Eman A Elgindy
Publication Detail:
Type:  Journal Article; Randomized Controlled Trial     Date:  2011-02-16
Journal Detail:
Title:  Fertility and sterility     Volume:  95     ISSN:  1556-5653     ISO Abbreviation:  Fertil. Steril.     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-03-22     Completed Date:  2011-05-11     Revised Date:  2011-09-07    
Medline Journal Info:
Nlm Unique ID:  0372772     Medline TA:  Fertil Steril     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1639-44     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Obstetrics and Gynecology, Zagazig University School of Medicine, Zagazig, Egypt. eman_elgindy@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Chorionic Gonadotropin / administration & dosage*
Drug Administration Schedule
Embryo Transfer / methods*,  standards
Estradiol / blood*,  standards
Female
Fertility Agents, Female / administration & dosage
Fertilization in Vitro
Humans
Infertility, Female / blood*,  diagnosis,  therapy
Pregnancy
Pregnancy Rate
Progesterone / blood*,  standards
Prognosis
Reference Values
Sensitivity and Specificity
Time Factors
Chemical
Reg. No./Substance:
0/Chorionic Gonadotropin; 0/Fertility Agents, Female; 50-28-2/Estradiol; 57-83-0/Progesterone
Comments/Corrections
Comment In:
Fertil Steril. 2011 Aug;96(2):e137; author reply e138   [PMID:  21700281 ]
Fertil Steril. 2011 Jun 30;95(8):e61; author reply e62   [PMID:  21536272 ]

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