Effect of progesterone on hCG day-to-basal progesterone ratio on live birth rate in long agonist fresh IVF/ICSI cycles: a 5-year, single-center study of more than 10,000 cycles

Abstract

Objective

To investigate whether the ratio of the serum progesterone level on the day of human chorionic gonadotrophin (hCG) administration to the basal serum progesterone level (P_hCG/P_basal) is a predictor of pregnancy outcome during in vitro fertilization (IVF).

Methods

A total of 12,708 cycles were performed in 9747 patients between 19 and 36 years of age who were undergoing controlled ovarian stimulation from October 2011 to July 2016 for their first or second attempts at IVF followed by fresh embryo transfer (ET). hCG was administered 36 h before oocyte retrieval to trigger final oocyte maturation. The serum progesterone level was measured on menstrual cycle days 2-4 (basal progesterone, P_basal) and on the day of hCG administration (P_hCG). P_hCG/P_basal was calculated. Live birth rates were compared among various ordinal P_hCG/P_basal intervals (< 0.5, 0.5–1.0, 1.0–1.5, 1.5–2.0, 2.0–2.5, > 2.5).

Results

The average age of the patients recruited was 29.9 years. The average basal progesterone level was 0.8 ng/ml, while the average progesterone level on the day of hCG administration was 0.9 ng/ml. The live birth rates (according to the abovementioned ordinal P_hCG/P_basal intervals) were 47.3, 49.9, 47.8, 46.3, 45.5 and 44.0%, respectively. The live birth rates were significantly higher for patients with P_hCG/P_basal between 0.5–1.0 (OR = 1.14, 95% CI, 1.02–1.27, p = .02).

Conclusions

P_hCG/P_basal between 0.5-1.0 predicts a higher live birth rate in IVF. Both P_hCG/P_basal and P on hCG day is less predictive value for predicting live birth rate.

长效激动剂方案新鲜IVF/ICSI周期, hCG日孕酮与基础孕酮比值对活产率的影响:一项5年、超过10,000个周期的单中心研究 摘要

目的:探讨人绒毛膜促性腺激素(hCG)给药当天血清孕酮水平与基础血清孕酮水平(PhCG/Pbasal)的比值是否可作为体外受精(IVF)妊娠结局的预测指标。

方法:从2011年10月到2016年7月, 纳入了年龄在19 - 36岁之间的9747例患者, 进行了第一次或第二次体外受精尝试, 然后进行新鲜胚胎移植(ET), 共进行了12708个周期。在卵母细胞采集前36 h给予hCG, 以触发卵母细胞成熟为终点。在月经周期第2 ∼ 4天(基础孕酮, Pbasal)和hCG (PhCG)给药当天测定血清孕酮水平。PhCG / Pbasal计算。依次比较PhCG/Pbasal间期顺序(<0.5, 0.5 - 1.0, 1.0-1.5, 1.5-2.0, 2.0-2.5, >2.5)。

结果:招募的患者平均年龄为29.9岁。平均基础孕酮水平为0.8 ng/ml, hCG给药当天平均孕酮水平为0.9 ng/ml。活产率(按上述PhCG/Pbasal区间排序)分别为47.3、49.9、47.8、46.3、45.5和44.0%。在0.5-1.0之间, PhCG/Pbasal患者的活产率显著高于对照组(OR=1.14, 95% CI, 1.02-1.27, p=.02)。

结论:PhCG/Pbasal在0.5-1.0之间预示着IVF中较高的活产率。hCG日的PhCG/Pbasal和P对活产率的预测价值较低。

Keywords:

• Ovarian stimulation
• progesterone
• in vitro fertilization
• live birth rate

Disclosure statement

The authors report no conflict of interest.