Impact of estradiol and progesterone levels during the late follicular stage on the outcome of GnRH antagonist protocols

Abstract

The study aimed to assess the impacts and the targets of progesterone (P4) and estradiol (E2) levels on IVF outcomes in GnRH antagonist protocols. The study was retrospective and concerned patients for their first fresh embryo transfers, after stimulation by a recombinant FSH (rFSH)-GnRH antagonist protocol, between September 2012 and July 2017 in the Toulouse University Hospital. Multivariable analysis, taking into account female age and the ovarian stimulation index, showed that E2 levels had no impact on IVF outcomes, while high P4 levels (>1.10 ng/mL) were associated to low pregnancy rate. The P4 concentrations were significantly negatively correlated to the percentage of top embryos and to the implantation rate. Therefore, the deleterious effect of high levels P4 could to act mainly by impairing embryo quality, which questions the place of the freeze-all strategy in these cases.

摘要

本研究旨在评估孕酮（P4）和雌二醇（E2）对GnRH拮抗剂方案中IVF结果的影响。回顾性研究, 选取2012年9月至2017年7月在图卢兹大学医院行重组FSH（rFSH）-GnRH拮抗剂方案刺激后, 首次进行新鲜胚胎移植的患者。综合女性年龄和卵巢刺激指数, 多变量分析显示, E2水平对IVF结果没有影响, 而高P4水平（> 1.10 ng / mL）与低妊娠率相关。P4浓度与优质胚胎的百分比和植入率呈显著负相关。因此, 高水平P4可能主要通过损害胚胎质量来发挥有害作用, 这也质疑了这些病例中全胚冷冻策略的位置。

The Chinese abstracts are translated by Prof. Dr. Xiangyan Ruan and her team: Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China.

Keywords:

• IVF
• progesterone
• estradiol
• GnRH antagonist
• embryo

Disclosure statement

No potential conflict of interests was reported by the authors.