Effect of Elevated Progesterone Levels on hCG Trigger Day on Clinical Pregnancy Outcome in Short-Acting GnRHa Downregulated Cycles

Figures & data

Table 1 Characteristics of Patients with Different Serum P Levels (1.5 ng/mL) on the hCG Day

Variable	Group A	Group B	p value
P Level on Trigger Day (ng/mL)	≤1.5	>1.5
Cases (n)	1599	65
Age (y)	31.2 ± 4.2	30.5 ± 3.6	0.23
BMI (kg/m^2)	22.76 ± 3.16	22.32 ± 2.87	0.09
Basal FSH (mIU/mL)	8.04 ± 2.12	7.75 ± 1.83	0.29
AFC (n)	12.71 ± 4.0	13.3 ± 4.0	0.28
Total Gn dose (IU)	2026.6 ± 580.3	1862.5 ± 572.7	0.16
Gn duration (d)	9.4 ± 1.5	9.4 ± 1.4	0.76
P level on trigger day (ng/mL)	0.60 ± 0.33	1.78 ± 0.22	<0.01
Endometrial thickness (mm)	11.89 ± 2.38	11.43 ± 2.32	0.16
P level after trigger day (ng/mL)	5.15 ± 3.29	7.05 ± 4.32	<0.01
Number of oocytes retrieved (n)	10.1 ± 4.1	11.5 ± 3.6	<0.01
Number of total embryos (n)	4.7 ± 2.4	5.2 ± 2.8	0.29
Number of transferred embryos (n)	1.58 ± 0.49	1.65 ± 0.48	0.28
Types of embryos transferred			0.23
Cleavage-stage embryo (n)	1429 (89.37%)	55 (84.62%)
Blastocyst (n)	170 (10.63%)	10 (15.38%)
Embryo implantation rate (%)	53.9 (1361/2525)	56.1 (60/107)	0.74
Clinical pregnancy rate (%)	65.1 (1041/1599)	69.9 (45/65)	0.49
Early miscarriage rate (%)	8.5 (89/1041)	4.4 (2/45)	0.39
Live birth rate (%)	56.2 (898/1599)	61.5 (40/65)	0.45

Abbreviations: P, progesterone; BMI, body mass index; FSH, follicle-stimulating hormone; AFC, antral follicle count; Gn, gonadotropin.

Figure 1 A smooth fitting curve analysis of the relationship between serum P levels on the hCG day and the CPR. The CPR kept stable as the P level increased. The area between two dotted lines is expressed as the 95% CI.

Table 2 Effect Modification of P Levels on the hCG Day on CPR According to Different Types of Embryos Transferred

	Cleavage-Stage Transfer (n=1484)			Blastocyst Transfer (n=180)			P for Interaction
	OR	95% CI	P value	OR	95% CI	P value
Crude	1.103	0.84–1.45	0.48	0.78	0.34–0.99	0.05	0.09
Adjusted	1.012	0.76–1.35	0.94	0.69	0.34–0.98	0.04	0.04

Notes: Adjust for: Age; BMI; Basal FSH; AFC; Endometrial thickness; Number of transferred embryos.

Abbreviations: P, progesterone; CPR, clinical pregnancy rate; BMI, body mass index; FSH, follicle-stimulating hormone; AFC, antral follicle count.

Figure 2 A smooth fitting curve analysis of the relationship between serum P levels on the hCG day and the CPR of different types of embryos transferred. The CPR of blastocyst transfer decreased as the P level on the hCG day gradually increased. The area between two dotted lines is expressed as the 95% CI.

Data Sharing Statement

The datasets generated and analysed during the current study are not publicly available due to the special requirements of our hospital and our reproductive medicine center for the disclosure of patients’ clinical data but are available from the corresponding author on reasonable request.